Children and Sleep Apnea

Don’t ignore your child’s snoring. It can be a sign of a serious medical problem.

Snoring is often considered a problem of older men, but children snore more often than most people realize. Many parents and other caregivers of children fail to recognize that snoring may indicate a serious sleep disorder such as obstructive sleep apnea. These children can have difficulty breathing during sleep due to obstruction of their throat by enlarged tonsils and adenoids or by redundant throat tissue from obesity or both. When the oxygen level falls in their blood due to throat obstruction, their sleep pattern is interrupted.

About 40% of children with clinically diagnosed sleep disordered breathing have behavioral problems such as:

  • hyperactivity
  • anxiety
  • depression
  • enuresis (bedwetting)
  • poor school performance
  • lower quality of life

Removing enlarged tonsils and adenoids has been shown in medical studies to improve or resolve sleep disordered breathing in most children. Although behavioral problems, poor school performance and lower quality of life can have multiple causes, children with these problems and sleep disordered breathing often show dramatic improvement after surgery.

Enuresis “bedwetting”

Because enuresis or bedwetting is embarrassing, many parents fail to report the problem thinking that their child will “grow out” of the problem. Up to 50 % of children with sleep disordered breathing have enuresis. One recent study showed that 61% of children with sleep disordered breathing were free of enuresis after removal of their tonsils and another 23% showed improvement.


The incidence of obesity in children is markedly increasing. Obese children often have sleep disordered breathing which can further complicate behavioral problems and lower quality of life. Tonsillectomy is most successful in treating sleep disordered breathing in normal weight children. However, many obese pediatric patients also benefit from this surgery. Because treating sleep apnea is more difficult in markedly overweight children, a multifaceted approach including weight loss and perhaps even continuous positive airway pressure may need to be coordinated by their primary care physician.

What Should You Do?

If you child snores or stops breathing for periods of time during sleep, it is important to have them evaluated. Children who have behavioral problems, poor school performance, or enuresis should also be screened with a careful history and physical examination for sleep disordered breathing. Children who routinely don’t get a good night’s sleep don’t necessarily show the same symptoms as adults. Instead of daytime sleepiness and fatigue, they often display hyperactivity and a poor attention span. Although most children do not need their tonsils removed, a tonsillectomy can offer some children the ability to sleep normally and improve the quality of their lives.

If you think your child might be at risk for sleep disordered breathing, talk to your primary care physician to see if a visit with an ear, nose, and throat (ENT) specialist might be indicated. Drs. Chihal and Bryan at Chihal ENT are very experienced in evaluating children with airway problems due to enlarged tonsils and adenoids. Our office is child-friendly. We like kids, and we look forward to providing ENT services for your entire family.

Did You Know?

Women can also suffer with sleep apnea and sleep breathing problems. Fatigue and daytime sleepiness could be symptoms of sleep problems, read Women and Sleep Apnea A Common Cause of Fatigue for more information.


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