An Underlying Cause for ADHD Symptoms: Sleep Apnea in Children

Does your child experience behavioral or learning troubles combined with sleep difficulties at night? If so, they may have pediatric obstructive sleep apnea.

By Nicole Gleichmann

Does your child struggle with attention problems, hyperactivity, or learning troubles? What if I were to tell you that these seemingly telltale symptoms of ADHD (attention-deficit/hyperactivity disorder) are commonly due to another condition altogether: sleep apnea.

With up to 5 percent of children suffering from sleep apnea, it’s helpful for parents to understand its dangers and be able to spot its symptoms. Read on to learn more about this underdiagnosed chronic health condition and what you can do if you suspect that your child might have it.

Sleep Apnea: A Health Hazard in Children

Pediatric obstructive sleep apnea (OSA) is one of the most common causes of sleep problems in children. OSA is a condition where breathing during sleep is disrupted due to partial or complete obstruction of the upper airway.

If I were to ask you to envision someone with sleep apnea, you’d likely conjure up the image of an older adult who is carrying around some extra weight. Unfortunately, this association leads to doctors often missing sleep apnea symptoms in children.

Children with OSA and other sleep disorders are at a higher risk of developmental abnormalities. Kids who don’t get proper sleep can experience:

  • Stunted growth
  • Learning disorders
  • Behavior problems
  • Cardiovascular distress
  • Death (in extreme cases)

Why Do Some Kids Have Obstructive Sleep Apnea?

While the most common cause of sleep apnea in adults is obesity, the risk factors for children’s sleep apnea are a bit different. Sleep apnea in kids is often due to swollen or enlarged tonsils and adenoids. Common causes of the enlargement of these parts of the respiratory tract include:

  • Allergies
  • Asthma
  • Tonsillitis
  • Abnormalities from birth

Other risk factors of developing sleep apnea for children include obesity, low birth weight, family history of OSA, and a variety of disorders, including cerebral palsy and neuromuscular disease.

Symptoms of Sleep Apnea in Children

It’s much easier to diagnose sleep apnea in adults than it is in children. Not only are the signs a bit more obvious, but adults often feel like they aren’t getting proper rest each night. Kids, on the other hand, don’t know what their nights should be like. They don’t chat with their friends about how well they sleep or how they feel throughout the day.

This makes it even more important to be able to accurately identify the symptoms of sleep apnea in your child. Symptoms fall into one of two categories: sleep symptoms and waking symptoms.

Sleeping Clues That Your Child Might Have Sleep Apnea

When a child with OSA experiences interruptions in their breathing throughout the night, it can lead to a whole slew of outcomes. These include:

  1. Snoring
  2. Night terrors
  3. Sleepwalking
  4. Tossing and turning during the night
  5. Night sweats
  6. Wetting the bed
  7. Mouth breathing
  8. Irregular breathing or breathing lapses
  9. Restless sleep
  10. Excessive need to nap during the day
  11. Teeth grinding

Because each of these symptoms can also be caused by another sleep disorder, it’s important to go to a sleep specialist for evaluation if your child is struggling with sleep difficulties.

Waking Clues That Your Child Might Have Sleep Apnea

When adults have sleep apnea and the resultant poor sleep at night, fatigue and daytime drowsiness are common symptoms. Yet, for children, they don’t often experience these same symptoms. If your child has OSA, you might notice:

  1. Hyperactivity
  2. Behavioral problems
  3. Poor school performance
  4. Difficulty focusing or paying attention
  5. Learning and memory troubles
  6. Stunted growth or difficulties gaining weight

With these same symptoms often associated with ADHD, many children are thought to be diagnosed with ADHD and prescribed medications that don’t target the root cause of their behavioral issues: interrupted sleep caused by sleep apnea.

Diagnosing Sleep Apnea in Children

Because sleep apnea shares many of its symptoms with other sleep disorders and ADHD, it’s tough to diagnose OSA without proper testing.

If your child is exhibiting the above symptoms, the first step is to discuss them with your primary care physician. You will likely be referred to a sleep specialist who may conduct a sleep study and other testing to determine if your child has OSA, and if so, what the underlying cause is.

Treating OSA in Children

Once your child has been diagnosed with OSA, it’s time to begin on a path of healing. The exact measures that will be taken can depend on the underlying cause of sleep apnea.

If allergies or asthma are involved, medications and environmental changes might be made. This can include antihistamines, inhalers, air filters, or keeping your pets outside. Some children may also have chronically inflamed tonsils or adenoids that require surgical removal for them to regain their health and ability to sleep properly.

For others, lifestyle changes like diet and exercise may be needed to expedite weight loss to support optimal health and sleep abilities.

Sometimes these measures alone will fix sleep apnea in children without the need for further action. But for some kids, they will need similar treatment as adults: positive airway pressure (PAP) devices. PAP devices are machines used to encourage proper breathing throughout the night to ensure increased oxygen levels. The most common PAP device is the continuous positive airway pressure (CPAP) machine.

Sleep Apnea in Children: Closing Thoughts

If your child is struggling to sleep properly or exhibits behavioral or learning difficulties during the day, they may be one of the nearly 5% of children experiencing sleep apnea. Proper diagnosis and treatment are critical to helping your child sleep well and regain their health and quality of life.


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