In contrast to just feeling tired, how likely are you to doze off or fall asleep in the following situations? (Even if you have not done some of these things recently, try to work out how they would have affected you.) Use the following sleep test scale to choose the most appropriate number for each situation:
0 = Would never doze
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing
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Contrary to popular belief, sleep apnea and snoring are not disorders limited to middle-aged men. In fact, nearly 10% of children may be affected by these problems. It is important to recognize that the signs and symptoms of obstructive sleep apnea, or OSA, in children are much more subtle than in adults. Most children with sleep apnea do not snore or stop breathing. However, snoring in a child is a concerning sign, and every child that snores should be evaluated for sleep apnea. While most adults with sleep apnea complain of fatigue, children may only exhibit inattentiveness and hyperactive behaviors. Studies have suggested that as many as 25% of children diagnosed with attention-deficit hyperactivity disorder may actually have sleep apnea and that much of their learning difficulty and behavior problems can be the consequence of poor sleep. Other signs associated with sleep apnea in children include: irritability, daytime fatigue, bed wetting, sweating during sleep, restless sleep, sleep walking, impaired physical growth, poor school performance and lack of concentration.
Snoring and sleep apnea are caused by a narrowing or complete obstruction of the airway during sleep. The most common cause of sleep apnea in children is enlarged tonsils and/or adenoids. Nasal obstruction due to enlarged nasal turbinates, allergies or sinus problems can also be a factor in developing sleep apnea.
Risk factors for sleep apnea in children include obesity, enlarged tonsils and adenoids, nasal obstruction, African American race, and family history. Snoring and sleep apnea can be inherited. Any child whose parent snores or has sleep apnea, his or her children may inherit this disorder. It is critical to evaluate the children of adults who suffer from these sleep disorders because serious mental, social and physical consequences can arise from untreated sleep apnea.
Sadly, the majority of children with this disorder remain undiagnosed. Studies indicate that children with sleep apnea have a lower quality of life, require more health care interventions and perform worse in school. Growth hormone can be suppressed due to sleep apnea and impair a child’s growth. Also, normal development of the face, jaws and teeth may be irreversibly impaired if sleep apnea is not treated in a timely manner.
The diagnosis of snoring and sleep apnea in children is primarily based upon symptoms and physical examination. Sleep studies are not mandatory for the diagnosis of sleep apnea in most children. However, there may be situations where a sleep study is warranted. You should discuss this issue with your physician.
The main treatment for snoring and sleep apnea in children is tonsillectomy and adenoidectomy. Medical and/or surgical treatment of the nose may be necessary, as well. All diagnostic and treatment options should be reviewed during your consultation.