Sleep apnea may increase sleep fragmentation, meaning that rather than experiencing the normal periods associated with each sleep stage, a child with apnea moves more frequently between deep and lighter stages of sleep. Research suggests that the longterm effects of sleep apnea in children include cognitive, behavioral, and psychosocial problems as well as growth delays and impacts on cardiovascular health.
Problems With Intellectual Development
Children with untreated sleep apnea may perform poorly on standardized tests of mental development. In a school-based study in India, children with sleep apnea were found to perform significantly less well in academic subjects than their peers. Other potential problems with intellectual development include lower scores on learning and memory metrics and on some types of intelligence quotient (IQ) tests. Children with the most severe apnea appear to also experience the most significant challenges to cognitive development.
Hyperactivity and Other Behavioral Problems
Unlike in adults—who become sleepy and sedate with sleep deprivation—children tend to become hyperactive. This may cause difficulties with attention and social behavior and may also contribute to anxiety and depression. Hyperactivity resulting from sleep apnea in children sometimes is misdiagnosed as Attention Deficit and Hyperactivity Disorder (ADHD).
An English study in the Journal of Thoracic Disease also showed that children with untreated apnea were more likely to exhibit poor social and communication skills and have difficulty regulating their behaviors. These traits are often experienced by caregivers as uncooperativeness or emotional volatility.
Inflammation
When sleep apnea continues over a long period in childhood, increasing markers of inflammation can also be found.3 Inflammation, in turn, can lead to a cascade of negative health outcomes such as compromised organ function.
Sleepiness During the Day
A child who is not getting enough restorative sleep at night could show signs of excessive sleepiness during the day.6 Babies and children need different amounts of sleep based on their age and stage, but if you notice your child napping longer or more frequently than usual or seeming tired when he or she is normally energetic, apnea could be the cause.
Issues with Growth
Sleep-disordered breathing in children is associated with negative effects on growth. Children with apnea may lose ground among their peers, or slow along their previous growth path, resulting in an inability to meet their full growth potential. This may be caused by frequent awakening from deep, slow-wave sleep which in turn could disrupt normal hormonal secretion, including growth hormones. In extreme circumstances, a child with apnea whose growth falls far below healthy levels may be diagnosed with failure to thrive.
Risk of Cardiovascular Problems
If left untreated, sleep apnea in children can result in certain cardiovascular problems. These include issues with blood pressure regulation, hypertension, and other precursors to cardiovascular events. During vigorous exercise, it’s also possible a child with untreated apnea will experience diminished cardiac performance.
