Obstructive Sleep Apnea and Your Toddler

By Sam Kimura

March 28, 2019

Sam is a mother of 2 beautiful children, RN, sleep coach, lactation counselor and prenatal coach. She has a keen interest in maternal mental health and through her work, hopes to decrease isolation and increase community among mothers.

Glance over at your toddler laying on the couch, watching Paw Patrol and notice how he is breathing. If your child is a mouth breather and snores at night, is often very tired in the morning in spite of sleeping long periods and has difficulty concentrating, obstructive sleep apnea (OSA) may be the source of the issue.

What is OSA?

About 3-10% of children will show symptoms of obstruction while they are sleeping. Children have very small airways and their throat is about the diameter of a dime until they are school age. This leaves for a small space that kids can exchange oxygen and carbon dioxide when breathing at night. As children fall in to a deep sleep, all of their muscles relax and the tone that keeps their airway open can reduce and become smaller. If your toddler has any kind of blockage in their airway, such as enlarged tonsils or adenoids, this can make it difficult to breathe at night.

The most obvious sign of OSA is snoring at night. You might notice that this typically occurs 20 mins in to a sleep cycle because this is when your child is falling in to a deep stage of sleep. When they have a blockage and temporarily stop breathing, they may wake slightly to roll or re-position (a natural human response to decreased oxygen levels) which in turn makes falling in to a restorative stage of sleep difficult.

What to do if you suspect OSA?

Your family doctor will be your first point of contact when you suspect your child has obstructive sleep apnea. He or she will likely look in your child’s throat and assess his tonsils to look for enlargement. Your doctor will assess all of the other factors that could contribute to fatigue, such as diet and sleep routines, and will likely refer your child to an ear-nose-throat (ENT) specialist for a further assessment. Many children outgrow this condition but follow up with a specialist is recommended.

What about a tonsillectomy?

For severe sleep apnea, your specialist may want your child to undergo an overnight sleep study at an established sleep clinic. This provides a full picture to determine if surgery is necessary. Because having a tonsillectomy has risks associated with the surgery, your ENT will make every effort to assess this need before taking out tonsils. Your physician may also want to try using a CPAP device (a machine that keeps your child’s airway open while sleeping) before recommending having tonsils removed as this is less invasive and has minimal risks involved compared to surgery.

If you have any concerns about how your child is breathing at night, reach out to your family physician. The Mama Coach will complete a nursing assessment and asks for signs and symptoms of obstructive sleep apnea before starting a sleep program. If you believe your child is in distress while sleeping and is not breathing, call 911 to have immediate attention.

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