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Boston, MA 02115
(617) 355-6000
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My Child Has:
Obstructive Sleep Apnea
Programs that treat this condition
Center for Pediatric Sleep Disorders   Center for Healthy Infant Lung Development (CHILD)  
General Otolaryngology Program   Chronic Pulmonary and Ventilator Program  
What is obstructive sleep apnea?
Obstructive sleep apnea is a condition in which a child's breathing is repeatedly blocked during sleep. During episodes of blockage, the child continues trying to breath, working hard and snoring because of the obstruction. However, the amount of air inhaled with each breath is reduced or even absent. These periods of blockage may lead to temporarily low levels of oxygen in the blood as well as disrupted sleep.
What causes obstructive sleep apnea?
In sleep, muscle tone decreases allowing structures of the mouth and throat to fall closer together. Any disorder that causes a further narrowing of the upper airway in the back of the throat can lead to obstructive sleep apnea.

The most common causes of obstructive sleep apnea is children are:

  • Adenoid and tonsillar enlargement (enlargement of these spongy, glandular tissues at the back of the throat is most common cause in children)
  • Obesity
  • Down Syndrome (and other genetic disorders)
  • Oher disorders affecting the structure of the jaw and face(such as Pierre-Robin, Apert, and Crouzon syndromes)
  • Oher disorders affecting muscle tone and function (such as muscular dystrophy and spasticity.
What are the symptoms of obstructive sleep apnea?
The most common symptoms of obstructive sleep apnea are:
  • loud snoring or noisy breathing during sleep
  • periods inadequate and difficult breathing lasting typically 6 - 20 seconds, often ending in a gasp, snore, snort, or sigh
  • mouth breathing
  • restlessness during sleep
  • excessive daytime sleepiness or irritability (because the quality of sleep is poor)
  • hyperactivity during the day (as a symptom of sleepiness in a child).
The symptoms of obstructive sleep apnea may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
How is obstructive sleep apnea diagnosed?
If your pediatrician suspects your child may have obstructive sleep apnea, he/she may refer your child for a sleep study and/or for consultation with a sleep specialist, or to an ear, nose, and throat (ENT) physician (otolaryngologist) for further evaluation.

Full assessment includes:

  • medical history and physical examination
  • sleep history - report from parents or caretaker
  • evaluation of the upper airway (by direct examination or x-ray)
  • sleep study ( polysomnography) - the best test available for diagnosing obstructive sleep apnea.
Treatment for obstructive sleep apnea:
Specific treatment recommendations for obstructive sleep apnea will be determined by your child's physician based on:
  • cause of the condition
  • the severity of the condition
  • your child's age, overall health, and medical history
  • your child's tolerance for specific intervention
  • your opinion or preference
The most common treatments in children are:

  • Adenotonsillectomy (with removal of the enlarged tissue)
  • CPAP (wearing a special mask over the nose at night through which air is blown to keep the airway open)
  • weight loss (generally a long-term treatment)
  • other surgery of the facial structures (in special circumstances).
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