Large Tonsils Aren’t the Only Cause of Sleep Apnea in Children

Excess body weight is a major risk factor for obstructive sleep apnea in adults. In children, sleep apnea often occurs when a child has large tonsils and adenoids.

But a new study in the journal Sleep shows that the causes of sleep apnea in children are complex. You can’t put all of the blame on the tonsils; weight and nasal problems also play a role in child sleep apnea.

The study involved 700 children between the ages of 5 and 12 years. They were randomly selected from 18 public elementary schools.

Results show that 1.2 percent of children had moderate sleep apnea; it was more common in older children between 9 and 12 years of age. Twenty-five percent of children had mild sleep apnea; 15.5 percent had primary snoring.

Body mass index (BMI) and waist size were significant and strong predictors of both snoring and all severity levels of sleep apnea. Nasal factors such as chronic sinusitis, rhinitis and nasal drain were significant predictors of mild sleep apnea. Black and Hispanic children were more likely to have primary snoring and mild sleep apnea.

And tonsil size? Surprisingly, it wasn’t a significant risk factor for snoring or for any severity level of sleep apnea.

This means that adenotonsillectomy may not always be the best treatment for sleep apnea in children. This surgery involves the removal of the adenoids and tonsils.

Study author Edward O. Bixler, PhD, said that other treatments may be better options for some children with sleep disordered breathing (SDB).

“Risk factors for SDB in children are complex,” Bixler told the AASM. “Treatment strategies should consider alternative options, such as weight loss and correction of nasal problems.”

Get help for child sleep apnea at an AASM-accredited sleep center near you; a board-certified sleep specialist will determine which treatment option is best for your child.

Learn more about sleep apnea in children at SleepEducation.com.