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Overweight children at risk for problematic sleep apnea

Overweight children at risk for problematic sleep apnea

There are a number of complications to obesity in children. One that is often overlooked is that ext

Jennifer Hall of Cohoes is concerned about her 7-year-old son, Chris.

“My son is a little overweight and snores heavily,” said Hall. “He doesn’t sleep through the night, and he’s incredibly cranky in the morning. He’ll get up and get in the shower, and fall back to sleep sitting in the shower. Also, four of his teachers have said he has trouble focusing at school. It’s hard to tell what’s going on.”

More than 15 percent of Americans between the ages of 6 and 19 are considered overweight or obese.

Studies show that obesity puts them at a higher risk for heart disease, type 2 diabetes and high blood pressure. But there is another complication to obesity that is often overlooked. Those extra pounds put children at risk for sleep apnea, a serious debilitating and potentially life-threatening sleep disorder, according to the National Sleep Foundation.

What to look for

Some symptoms of sleep apnea include:

At nighttime:

-- Snoring.

-- Breathing pauses during sleep.

-- Restless sleep.

-- Mouth breathing.

-- Difficulty getting up in the morning, even after getting the proper amount of sleep.

During daytime:

-- Hyperactivity.

-- Inattention.

-- Behavior problems.

-- Sleepiness.

“Sleep apnea is basically difficulty breathing while sleeping,” said Dr. Bilal Chaudhry, clinical director and board certified pulmonary sleep specialist at Capital Region Sleep Wake in Slingerlands.

Chaudhry is one of 20 sleep medicine physicians from around the country recently chosen to participate in the creation of guidelines for pediatric sleep medicine.

“This difficulty with breathing leads to strain on the body and non-restorative sleep,” said Chaudhry. “You sleep but you are still tired. Basically it’s like the cellphone is on the charger, but it’s not getting the charge.”

Creating guidelines

Obstructive sleep apnea causes your body to stop breathing during sleep. It occurs when the tissue in the back of the throat collapses and blocks the airway. This keeps air from getting into the lungs. It happens because the muscles inside the throat relax as you sleep. Gravity then causes the tongue to fall back and block the airway. Blockage of the airway can happen a few times a night or several hundred times per night.

Obstructive sleep apnea is becoming is a common problem, especially in obese children, and is being increasingly recognized as a cause of daytime attention and behavioral problems, said Chaudhry.

Unlike adults with sleep apnea, who are often overweight and frequently wake up at night, children with sleep apnea are

usually more difficult to recognize and diagnose, he said.

“The first thing we look at is the size of the tonsils and adenoids,” Chaudhry explained. “The second thing we look at is weight.”

If the tonsils are too big, when you relax while you are sleeping they block your airways, Chaudhry explained. If you have too much weight on your body, it causes collapse of the windpipe or the tissues.

Chaudhry said it’s difficult to know how many children and teens have sleep apnea. Some studies estimate approximately 3 percent, but with the continued rise in childhood obesity, he believes the number is probably much higher.

The repercussions of sleep apnea and poor sleep for children are vast. When children do not get the sleep they need, they are at risk for health, performance and safety problems and difficulty in school.

If parents suspect that their child has sleep apnea, his or her symptoms should be discussed with a pediatrician or other health care provider, who may refer him to a sleep specialist for a pediatric sleep study.

“The standard way to make a diagnosis is to have the children sleep in a monitored setting,” Chaudhry explained.

Parents should know there are many resources available to help them, he said.

“If there is an underlying medical condition that is treatable, we have the potential to improve or resolve the disorder,” he said.

He referred to one study that looked at the worst performing students in New York who had sleep apnea.

“When treated for their sleep apnea, their grades improved and the children’s IQs improved,” he said.

If the patient has enlarged tonsils or adenoids, Chaudhry said he would recommend they be taken out. If the child is obese, weight loss should be the first step.

Some children may need to have their nasal passages opened with sprays or medications. Rarely, they may need to sleep with continuous positive airway pressure or (CPAP) administered through a mask that supplies a gentle air pressure. The air pressure opens the upper airway and allows the person to breathe uninterrupted during sleep.

“As practitioners, we are making an active push to educate parents, teachers and health care providers about this,” said Chaudhry.

Hall, who also suspects that she also has sleep apnea, said her son is going to have a sleep study.

“If, indeed, he does have sleep apnea, it would be nice to take care of it now, before he gets older, and before it becomes a serious medical problem,” she said.

Preventive steps

To help your child avoid sleep apnea, parents can do the following:

-- Limit fatty foods and foods high in calories.

-- Encourage outdoor and physical activity.

-- Avoid school lunches that may be high in calories and fat.

-- Be aware of the sleep and weight connection. If your child is overweight, look for signs of sleep apnea and let your pediatrician know.

-- Make healthful eating, like healthful sleep, a priority for your whole family.

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