Pediatric Sleep Apnea

Children suffer from sleeping disorders that prevent them from getting a sufficient amount of sleep, just as adults do. Pediatric sleep apnea is a common sleeping disorder that involves a narrowing of the upper airway during sleep, causing patients to experience short periods of stopped or disrupted breathing that can interfere with sleep.

Symptoms of this condition may experience mouth breathing, snoring, bed wetting, and restless, as well as irritability or difficulty concentrating when awake. Sleep apnea usually develops because of enlarged adenoids or tonsils, obesity or muscle weakness. This condition can be treated surgical removal of the tonsils and adenoids, which is done through a safe, minimally invasive procedure.

Pediatric Sleep Apnea Treatment

TA Surgery

Obstructive sleep apnea in children may result from blockages to the airways. A combination tonsillectomy and adenoidectomy, or TA, procedure removes the tonsils and adenoids of a patient, resulting in less breathing obstruction. Though this procedure addresses pediatric sleep apnea, only rarely is TA used as a treatment for adult patients with snoring issues.

Children experiencing chronic inflammation of the tonsils and adenoids see improvements in sleep quality, fewer coughs and colds, and possible reductions in hyperactive behavior. TA surgery is often the primary treatment for children with obstructive apnea. Patients with other respiratory conditions, such as asthma or respiratory infections, may need to have these conditions under control before and after surgery to reduce the risks of complication.

Pediatric Obstructive Sleep Apnea

Your seemingly-healthy kid is starting to show signs that something is up. They’re cranky more often. Teachers are sending home reports of behavior problems. You catch them yawning or falling asleep when they should be doing their homework. They complain about feeling tired, even after a full night of sleep.

Believe it or not, these are all symptoms of a condition called pediatric obstructive sleep apnea (POSA).

What is POSA?

POSA is a condition that causes your child’s airway to become blocked during sleep, usually due to enlargement of the tonsils or the adenoids (aka the fleshy area behind the dangly thing in the back of the throat). POSA is a serious and potentially life-threatening condition, as it means that whatever is blocking the airway during sleep is stopping airflow to the point that the child wakes up.

At the Roswell Center for Ears, Nose, Throat, and Allergy, we want to make sure parents have all the info they need to understand POSA and figure out the right treatment options to keep their kids safe. This guide will help you determine if your child’s symptoms might be POSA and familiarize you with treatment options if that turns out to be the case. If you think your child’s behavior issues might be due to POSA, please schedule an appointment with us today.

Signs of Pediatric Obstructive Sleep Apnea

One of the most common ways a parent identifies their child’s POSA is by noticing concerning habits in their sleep patterns. POSA symptoms during sleep include:

  • Disturbed sleep
  • Restless sleep
  • Pauses in breathing
  • Night terrors
  • Snoring
  • Mouth breathing
  • Night sweats
  • Bed-wetting
  • Persistent coughing
  • Snorting or choking

Because these problems are often intermittent, many of the parents who notice their children’s nighttime symptoms do so by sleeping in the same room, often during camping trips. Long car rides or vacations. A casual checkup during the night may not be enough to observe these symptoms, and children often have no memory of them when they wake up (other than bed-wetting, which is fairly obvious).

If you do notice your child exhibiting any of these symptoms, please schedule an appointment with a pediatric sleep apnea specialist at ROSWELL today. We can determine whether these symptoms are the result of POSA, or if another issue could be affecting sleep.

Daytime Symptoms

The daytime symptoms of POSA are much easier to spot than their nighttime counterparts. These include:

  • Inability to focus
  • Hyperactivity
  • Learning problems
  • Poor weight gain
  • Behavioral issues

Common risk Factors For Pediatric Obstructive Sleep Apnea

Sleep apnea in adults is usually associated with obesity. While that is still a risk factor for kids, the more common risk factors for POSA are enlarged adenoids and tonsils. Other potential risk factors include:

  • Neuromuscular disorders
  • Craniofacial disorders or abnormalities
  • Down syndrome
  • Sickle cell
  • Cerebral palsy
  • Low birth weight
  • Family history of sleep apnea

Complications From Pediatric Obstructive Sleep Apnea

If left untreated, POSA can lead to serious complications, including stunted growth, heart problems, and even death. That’s why it’s important to get it taken care of as soon as possible with one of the many treatment options available at ROSWELL.

Pediatric Obstructive Sleep Apnea Treatment Options

ROSWELL pediatric sleep specialists are sensitive to apprehension regarding treatment (both from children and their parents!). When your child comes in for a consultation, we will work with you and them to identify their disorder and safely remedy it in a way that makes your family comfortable. Treatment options include:

Lifestyle (“Home”) Remedies

Sometimes, the symptoms of POSA are mild enough to where some simple changes around the home can correct the issue. We encourage families to adopt these healthy lifestyle goals, but caution that depending on the severity of the issue, other treatment options may have to be considered.

Weight loss

Obesity is not the primary cause of sleep apnea in children, but it can be a contributing factor. If your child is overweight, focusing on a healthy diet and exercise may lead to a reduction of symptoms.

Avoiding irritants and allergens

Sometimes symptoms may present as POSA, but could actually be due to nasal irritants like allergens in the home that cause irritation and congestion. And, of course, all children should be kept away from tobacco smoke, especially in enclosed spaces.

Non-Surgical Remedies

There are some treatment options that can reduce the symptoms of POSA without surgery. It should be noted that some of these options merely treat the symptoms, not the underlying causes.


Often, the causes of POSA can be mitigated through medication by using nasal steroids or allergy medicines. Sometimes, a combination of the two is enough to eliminate symptoms entirely. This usually happens in children who present mild symptoms.

Oral appliances

For cases where jaw or tongue position is causing the apnea, oral appliances can often provide the solution. There are numerous kinds of retainers and jaw repositioning devices that can be worn to prevent symptoms, and in some cases, solve the underlying issues that cause the apnea in the first place.

Positive Airway Pressure (PAP) therapies

For cases where the airway becomes blocked that can’t be solved with a retainer, a PAP machine can be used to push air past the blockage during sleep. This method is often used when the above methods prove to be ineffective.


While non-surgical options are often preferable for parents and children alike, the reality is that surgery is the most common treatment for POSA – specifically, surgery to remove the tonsils and adenoids. In uncomplicated cases, this surgery is between 70 and 90% effective at solving the underlying issue behind POSA, with no lasting side effects.

ROSWELL For Pediatric Obstructive Sleep Apnea Solutions

The ROSWELL Center for Ear, Nose, Throat, and Allergies is dedicated to providing the absolute best care for your child in a soothing, comfortable setting. Whether you are coming in for an initial consultation, sleep study, or treatment, you can expect to find caring pediatric specialists who will help you every step of the way. Call or click below to set up an appointment today.