SNORING in children is usually harmless and a sign they are having a deep restful sleep.
But scientists have warned it could be the sign of a condition commonly seen in adults that has harmful implications on health.
Called obstructive sleep apnoea, the syndrome causes breathing to stop for short periods of time during sleep.
Some of the main signs of the condition are snoring and grogginess and headaches in the daytime.
Researchers at the American Heart Association have now discovered the long-term impact it may be having on kids and teenagers.
In a scientific statement, which is a review of current evidence, they said sleep apnoea in youngsters could lead to high blood pressure and possibly heart disease or potentially fatal heart attacks in later life.
It’s also known that sleep apnoea can disrupt restorative sleep – having a domino effect on emotional mental health and immunity.
Metabolic syndrome is another concern – a cluster of problems such as low “good” cholesterol, high insulin and high blood pressure.
Obesity a risk
An estimated one to six in 100 children and adolescents have sleep apnoea, according to the statement in the Journal of the American Heart Association.
Looking at the youngsters most likely to be affected, the researchers said obesity came up time and time again.
Between 30 and 60 per cent of those studied with the condition were obese.
“The likelihood of children having disordered breathing during sleep and, in particular, obstructive sleep apnoea, may be due to enlargement of the tonsils, adenoids or a child’s facial structure,” said statement writing group chair and cardiologist Dr Carissa M. Baker-Smith.
A lack of muscle, sickle cell disease and premature birth are also linked to the disorder.
Dr Baker-Smith, director of pediatric preventive cardiology at the Nemours Children’s Hospital in Wilmington, Delaware, added: “However, it is important for parents to recognize that obesity also puts kids at risk for obstructive sleep apnoea.”
What are the signs?
Everyone snores occasionally.
But what are the signs it could be sleep apnoea, and that your child may need to be seen by a doctor?
The statement said children with sleep apnoea may have the following:
- snoring more than three nights per week
- gasps or snorting noises while sleeping
- labored breathing during sleep
- sleeping in a seated position or with neck hyperextended
- signs of upper airway obstruction – like choking, gasping for air and wheezing
In the daytime, your child may have:
- daytime sleepiness
- headache upon waking up
- difficulty concentrating
- mood swings
The good news is that sleep apnoea can be treated, in both kids and adults.
Continuous positive airway pressure (CPAP) is a free treatment on the NHS, and involves gently pumping air into a mask worn at night.
It improves breathing during sleep, helping to offset the harms of sleep apnoea.
Other treatments involve a gum-shield device that holds the airways open during sleep, or the use of a nasopharyngeal airway (NPA) which acts as a “splint” to maintain an open airway and keep the tongue from falling back.
Some people get surgery to remove large tonsils – which is the most common treatment for kids.
Sometimes a simple trick to help a patient sleep on their side can work, such as taping a tennis ball to the back, or getting a specially designed pillow.
If confirmed your child has sleep apnoea, the right treatment will be decided by a GP.
However, the key problem to be fixed is obesity, the AHA said.
Dr Baker-Smith said: “Obesity is a significant risk factor for sleep disturbances and obstructive sleep apnoea, and the severity of sleep apnoea may be improved by weight loss interventions, which then improves metabolic syndrome factors such as insulin sensitivity.”
Adults are also told by the NHS to lose weight if they have trouble with sleep apnoea, as well as to stop smoking, drinking too much and using sleeping pills.
What is sleep apnoea?
During breathing, air passes through the nose and down the upper airway to the lungs. The oxygen in the air is passed into the bloodstream via the lungs.
While asleep, muscles in the body naturally relax, including those in the throat.
The relaxed muscles cause narrowing, which can reduce the airflow and make breathing difficult for some people, Great Ormond Street Hospital explains.
This can cause snoring and irregular breathing.
When breathing is interrupted or reduced, there may be a fall in the level of oxygen in the body and this may lead to bigger efforts to breathe.
Sensors in the brain will tell the body to restart or increase breathing and the person wakes up briefly.
Breathing often restarts with a gasp or snort and this returns breathing to normal and the person goes back to sleep.
When the problem is severe, this can happen many times each night and disturbs the quality of sleep.
Generally the person recalls very few, if any, of these events in the morning.
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