Signs of Sleep Apnoea in Children

A good night’s sleep is essential for every child’s growth, development, and emotional well-being. But what happens when your child sleeps through the night yet still wakes up tired, cranky, or struggles to focus in school? The issue might not be behavioural, it could be sleep apnoea.

While often associated with adults, sleep apnoea can also affect children. Unfortunately, it often goes undiagnosed because the signs can mimic normal childhood challenges like restlessness, irritability, or even ADHD. Signs of Sleep Apnoea in Children.

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Let’s dive into this silent disruptor of children’s sleep and why catching it early makes all the difference.

What Is Sleep Apnoea?

Sleep apnoea is a condition where breathing repeatedly stops and starts during sleep. In children, the most common type is obstructive sleep apnoea (OSA), which occurs when the airway becomes blocked, often by enlarged tonsils or adenoids.

These breathing interruptions can happen dozens or even hundreds of times a night, disrupting the deep, restorative sleep a child needs.

There are two main types:

• Obstructive Sleep Apnoea (OSA): Caused by physical blockage of the upper airway.
• Central Sleep Apnoea: A less common type where the brain fails to signal the body to breathe.

Why Is It Dangerous?

When a child struggles to breathe during sleep, their body goes into a state of stress. Oxygen levels drop, sleep becomes fragmented, and the brain may constantly “wake” the child to resume breathing, even if they don’t fully awaken.

Over time, this can lead to:

• Behavioral problems
• Learning difficulties
• Delayed growth
• Heart or blood pressure issues

That’s why recognising the signs of sleep apnoea early is critical.

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Common Signs of Sleep Apnoea in Children

Some signs of sleep apnoea are obvious, while others are subtle and easily mistaken for unrelated issues.

Here’s what to watch for:

1. Loud, Chronic Snoring

Snoring isn’t normal in young children. If your child snores loudly or regularly, it could signal a blockage in the airway.

Look for:

• Snoring 3 or more nights per week
• Gasping or choking sounds during sleep
• Snoring that improves only when the child changes position

2. Pauses in Breathing

If you notice your child stopping breathing for a few seconds while asleep, followed by a gasp, snort, or sudden movement, this is a red flag.

This is the most classic sign of sleep apnoea and should prompt a conversation with your pediatrician.

3. Restless Sleep

Children with sleep apnoea rarely sleep soundly. They may:

• Toss and turn frequently
• Sweat excessively during sleep
• Sleep in unusual positions, like with their neck extended to open the airway

You may also notice that they kick off the covers repeatedly or wake up tangled in their sheets.

4. Daytime Sleepiness or Fatigue

Even after a full night’s sleep, a child with sleep apnoea may appear:

• Sleepy during the day
• Prone to falling asleep during quiet moments (e.g., in the car, at school)
• Frequently irritable or emotional

This kind of fatigue often goes unnoticed in young kids but may appear as poor attention span or “zoning out.”

5. Morning Headaches

If your child wakes up with frequent headaches, especially in the morning, it could be due to a lack of oxygen during sleep. Morning headaches are common in children with moderate to severe sleep apnoea.

6. Mouth Breathing

Children with blocked airways may habitually breathe through their mouths, even while awake. This can lead to:

• Dry mouth in the morning
• Bad breath
• Dental problems
• Speech delays

7. Behavioural or Learning Issues

Because sleep apnoea disrupts healthy sleep cycles, children may exhibit symptoms similar to ADHD, such as:

• Difficulty concentrating
• Impulsivity
• Hyperactivity
• Poor school performance

Some children with sleep apnoea are misdiagnosed with behavioural disorders when the root cause is sleep-related.

8. Bedwetting (After Potty Training)

Sleep apnoea can interfere with bladder control in some children, especially if they were previously dry at night. If bedwetting starts suddenly or continues past age 6, consider a sleep evaluation.

9. Delayed Growth

Chronic poor sleep and disrupted hormone cycles can interfere with a child’s growth and weight gain. Some children with sleep apnoea even fail to grow properly until their condition is treated.

What Causes Sleep Apnoea in Children?

Several factors can contribute to or worsen sleep apnoea in kids:

• Enlarged tonsils or adenoids (the most common cause)
• Obesity or excess weight
• Craniofacial abnormalities (e.g., small jaw, cleft palate)
• Allergies or chronic nasal congestion
• Neuromuscular conditions (less common)

A family history of sleep apnoea can also increase risk.

How Is It Diagnosed?

If you or your pediatrician suspect sleep apnoea, the child may be referred for a sleep study, formally known as a polysomnography. This overnight test records:

• Breathing patterns
• Oxygen levels
• Heart rate
• Brain activity
• Body movements during sleep

It’s painless and can provide critical insight into your child’s sleep health.

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Treatment Options for Pediatric Sleep Apnoea

Treatment depends on the severity and underlying cause:

1. Tonsil and Adenoid Removal (Adenotonsillectomy)

This is often the first-line treatment for children with large tonsils or adenoids. Many kids experience immediate improvement after surgery.

2. CPAP (Continuous Positive Airway Pressure)

For children who aren’t good candidates for surgery or still have apnoea after surgery, a CPAP machine may be prescribed. It delivers steady air pressure to keep the airway open during sleep.

3. Weight Management

In cases where obesity contributes to the condition, a healthy diet and regular physical activity can help reduce the severity of symptoms.

4. Allergy Treatment

If allergies or nasal congestion are making things worse, medications like nasal sprays or antihistamines can be part of the solution.

5. Orthodontic Devices

Some children benefit from dental appliances that reposition the jaw or tongue to improve airflow.

When to See a Doctor

You should contact your pediatrician if you notice:

• Loud, frequent snoring
• Long pauses in breathing at night
• Persistent fatigue or irritability
• Sudden behavioural changes or poor school performance
• Difficulty breathing during sleep
• Concerns with growth or weight

Early intervention is key. Left untreated, sleep apnoea can affect your child’s cognitive development, heart health, and emotional regulation.

Tips for Better Sleep While You Seek Treatment

While waiting for diagnosis or treatment, here are a few ways to support your child’s sleep:

• Elevate the head of the bed slightly to improve airflow.
• Use a cool-mist humidifier to keep nasal passages clear.
• Encourage your child to sleep on their side, not their back.
• Avoid allergens (dust, pets, smoke) in the bedroom.
• Create a consistent, calming bedtime routine.

These won’t cure sleep apnoea but can offer temporary relief.

Final Thoughts: 

Sleep apnoea isn’t just an adult problem, and it’s far more common in children than most parents realise. It can sneak in under the radar, disguised as simple snoring, hyperactivity, or fatigue. But left unchecked, it can have lasting consequences.

The good news? With early detection and the right treatment, most children recover fully and experience dramatic improvements in behaviour, focus, and overall well-being.

If something about your child’s sleep doesn’t seem right, trust your instincts. That extra attention could make all the difference in your child’s health and happiness.