Pediatric OSA

This presentation focuses primarily on adults, but it is worth talking about pediatric patients for a moment.

Kids are most at risk from the ages of 3 to 9. During this time, the development of the airway is such that the tonsils are largest, in relation to the rest of the airway. These relatively large tonsils and adenoids are the leading cause of OSA in kids.

The link between ADD of ADHD and Obstructive Sleep Apnea has received a lot of attention in the popular press, but they may have overstated the case. The exact overlap between Obstructive Sleep Apnea and ADHD patients is unclear.

OSA does result in poor sleep, tired adults get sleepy, tired kids get cranky fussy, and have a short attention span, just like kids with ADHD. In adults, a suspicion of depression should trigger a suspicion of OSA. In kids, a suspicion of ADHD should trigger a suspicion of OSA as well. Remember, ADHD and Obstructive Sleep Apnea are two very different diseases, but they share many of the same symptoms. The overall prevalence in kids is about the same as in adults.

In summary, we begin with the clinical definition of Obstructive Sleep Apnea: A total closure of the upper airway resulting in reduction or cessation of airflow, despite persistent respiratory effort.

Unfortunately nobody knows what causes sleep apnea, but major symptoms of the disease include snoring, gasping and/or choking while sleeping, daytime sleepiness, and chronic fatigue. It should be noted that several of these symptoms are similar to those found in adult depression.

In addition, OSA is more common in obese patients, than in the rest of the population. The prevalence of OSA in the US is approximately 4% for men, and 2% for woman; and, even more so than diabetes, a significant portion of people with obstructive Sleep Apnea has not been diagnosed.

Finally, we discussed the prevalence of OSA in children, approximately the same as in the adult population, and noted, symptoms commonly associated with ADHD, should trigger a suspicion of OSA as well.