Treating sleep apnoea in children improves behaviour

12^th February 2012 - Children with obstructive sleep apnoea are often tired during the day, have trouble paying attention, and experience other behavioural problems as a result of not getting enough quality sleep at night. A new study may help turn that around - without surgery. 

Sleep apnoea is marked by pauses in breathing while asleep. This is often a result of an obstruction in the airway such as oversized tonsils or adenoids. These pauses can occur throughout the night and disrupt sleep. Continuous positive airway pressure (CPAP) machines help keep the airways open during sleep.  

These devices deliver pressurised air through a mask to hold the airways in the throat open. 

New research shows that this treatment can improve the quality of life and behaviour issues for children with sleep apnoea. The findings appear in the American Journal of Respiratory and Critical Care Medicine. 

“The main message is that treatment, although it may be difficult to tolerate, can result in a significant improvement in childhood behaviour symptoms and quality of life,” says researcher Carol Marcus, professor of paediatrics at the Children's Hospital of Philadelphia. 

3 hours a night can make a big difference

One of the issues with this treatment is that children may not want to wear the bulky mask while they sleep, but the study shows that even three hours a night is enough to make a big difference. “This was a surprise to me and made me feel better. Any use is better than no use,” Carol Marcus says. 

The new study included 52 children with obstructive sleep apnoea, with an average age of 12. Ten children in the study had significant developmental delays. Children used the device on average for about three hours per night during the three-month study period. 

All children showed improvements in attention, behaviour, sleepiness, and quality of life when they wore the mask while sleeping. The longer they wore the mask, the less sleepy they tended to be during the day, the study shows.  

The improvements were seen in all children, including those with developmental delays. 

Behavioural problems

Sleep apnoea is quite common in children aged two to seven, particularly during upper respiratory tract infection when the tonsils enlarge. Sleep disturbance can lead to a number of symptoms, including sleepiness, hyperactivity, poor attention span and bad behaviour. 

Sleep apnoea is a common reason for recommending that a young child has their tonsils out.

Commenting on the study, Adrian Williams, professor of sleep medicine at King's College, London,

Says the results are not surprising as they are the same as are generally found among adults. He tells us that the "issue would be the lack of diagnoses in children and lack of paediatric sleep services".