Testing & diagnosis for Obstructive Sleep Apnea (OSA) in children

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Forming a complete and accurate diagnosis is the first step in treating your child’s obstructive sleep apnea (OSA). At Children’s Hospital Boston, we have expertise in evaluating children’s symptoms and providing treatment that is specifically tailored to each child’s individual condition.

How do I know if my child has OSA?

The symptoms of OSA can often be more difficult to detect in children than in adults, since an adult probably knows she’s feeling especially tired due to not having a good night’s rest. A child, on the other hand, may not look sleepy, even if she’s not sleeping well. She may be moody or inattentive or have problems in school—or she may not have any obvious problems.

If you think your child might have a sleep disorder such as OSA, talk to her primary care doctor about her your concerns. If your doctor suspects a diagnosis of OSA, your child’s pediatrician may refer your child to Children’s for a consultation with our sleep specialists or to one of our otolaryngologists (ear, nose and throat doctors).

How is a diagnosis of OSA made?

Physicians in ourSleep Center use a number of different tests to help us accurately diagnose your child’s disorder and evaluate her condition.

To learn about your child’s situation, one of our specialists may:

  • take a detailed medical history and perform a physical examination
  • talk with your family to find out about how your child breathes while asleep
  • talk with your family about whether your child’s sleep problems are having any negative effects on her—such as behavior or school problems
  • evaluate your child’s upper airway (by direct examination or x-ray)


Tests used to confirm a suspected diagnosis may include:

  • Multiple Sleep Latency Test (MSLT), a daytime nap study that helps make specific sleep-disorder diagnoses by measuring how quickly your child can fall asleep and identifying the type of sleep attained
  • Maintenance of Wakefulness Test (MWT), a test that measures sleepiness by recording a child's brain and body activity at certain times throughout the day
  • actigraphy, a noninvasive test that uses a sensor that measures a child's body movements
  • overnight oximetry, a test in which a plastic clip is placed on a child's finger to track heart rate and blood oxygen content during sleep
  • polysomnogram, a sleep study used to assess quality of sleep and detect any sleep disorders


What happens during a sleep study?

During a sleep study, you and your child spend a night in our sleep laboratory so we can carefully observe how your child sleeps. We use a test called a polysomnogram to record things such as brain waves, eye movements and heart rate. This is the best way to know whether your child has obstructive sleep apnea, and if so, how severe it is.

Sometimes, it’s helpful for you to take a short video of your child sleeping, when her breathing is at its worst. If you’ve done that, be sure to bring the video to your appointment. Keeping a sleep diary is also a good idea. Keep track of how many hours of sleep your child had, how many times she woke up during the night and how alert she feels in the morning.

These strategies may help your doctor diagnose your child’s condition and speed up the process of starting treatment.

After we complete all necessary tests, our experts meet to review and discuss what they have learned about your child’s condition. Then we will talk with you and your family to outline the best treatment options.

Specialized equipment and techniques

Children’s sleep clinics and laboratories use advanced methods and sleep-monitoring technologies to study your child’s sleep and breathing patterns. These allow us to noninvasively diagnose even subtle forms of sleep disorders and help lead us to the best treatments for your child. Our sleep studies page explains sleep studies in more detail. And in our sleep study walkthrough, you and your child can actually see what a sleep study is all about.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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