Sleep Apnea and Inattention or Daydreaming in Kids

Sleep Apnea and Inattention or Daydreaming in Kids

From the library of

Frank Barnhill M.D.

“I just don’t know what to do doctor!” The anxious mom said on her first office visit with her son. “His teacher tells me he daydreams or seems spacey most of the time he’s in class or she finds him asleep with his head on his desk.” “His grades can’t go much lower or he will fail this year.” “His father and I have tried everything we can do to make him get a better night’s sleep or focus on his school work.” “We had his pediatrician start him on ADHD medications to help his concentration, but it’s still not working.” Most parents don’t realize sleep apnea can occur in children, and for the same reasons as in adults.

This ten year old was a perfect example of a sleep apnea affected kid. He was only four foot six inches in height, but weighed 137 pounds. His neck was very thick, he had a large abdomen, was short of breath just from walking down the hall, and his entire nasal-throat-upper airway passages were narrow and clogged with clear mucous. His mother was surprised when I asked if he snored at night. Her answer was quick, “So does his father!” “He got that naturally”. Further questions revealed what I suspected; he ate a lot of junk food, watched television and played video games during his awake hours, and avoided exercise like the plague. He was irritable when asked to do chore or homework and kept a bad attitude. Mom had blamed his weight problem on heredity and avoided enforcing the need for good nutrition and exercise in order to keep family peace.

The obesity epidemic we’re currently seeing in children is probably responsible for most of the obstructive sleep apnea (OSA) diagnosed in kids. When a short child gains weight, it tends to cause neck, throat, and nose tissues to grow very thick, thus decreasing effective airflow through these areas. A large abdomen pushes up on the diaphragm and breathing muscles, further decreasing the child’s ability to move air in and out of his lungs.

Kids can suffer from central sleep apnea (CSA) just like adults and some studies show that the brain breathing control centers in overweight kids may not function properly in the face of obesity. CSA can likewise occur in kids of normal weight and height and losing weight will not help these children’s sleep apnea.

When should you suspect sleep apnea in your child?

When your child:

Shows excessive daytime sleepiness
Sleeps poorly at night with frequent awakening
Experiences a lot of nightmares
Seems to daydream or act spacey a lot
Can’t concentrate or focus at school or work/grades are worsening
Is irritable most of the day or complains of frequent headaches
Avoids exercise and complains of being tired a lot
Has rapid weight gain and complains of shortness of breath
Has developed “asthma” without a cause
Develops bedwetting not previously noted
Has unexplained seizures

So, once you suspect the disorder what should you do? In all cases, a parent should discuss these symptoms and the concern about possible sleep apnea with the child’s doctor. At that point, blood studies may be necessary to rule out other diseases and a sleep study to confirm presence of sleep apnea.

What about treatment in kids? For obese kids, weight loss is critical, along with control of symptoms of asthma, allergies and correction of air flow problems. Some children get a little relief from the use of allergy medications and antihistamines. It is very important for overweight children to receive a diet that promotes weight loss and start an exercise program.

CPAP or continuous positive airway pressure can be used to treat sleep apnea in children from birth into adulthood. Rarely do children require laser surgery on the soft tissues of the throat, but having adenoids and tonsils removed can help in select cases. For further information, please see our articles “Using CPAP to treat sleep apnea” and “Snoring, chainsaws and sleep apnea”.

Helping your kids overcome their sleep related problems at a young age would improve their quality and length of life.

Dr. Frank

These health tips are offered for your common sense use and are not intended to take the place of a visit to your doctor. Your use of the materials implies your understanding that nothing herein contained represents individual medical advice.

drhuggiebear, drhuggiebear.com and contained materials are the copyrighted and/or registered properties of Frank Barnhill, M.D. and may not be reproduced for profit without the express written permission of the author. All materials may be photocopied in whole for educational use. For information please contact us at drfrank@drhuggiebear.com.