Obstructive sleep apnea (OSA) is a medical condition that causes breathing trouble during sleep. Children with weak muscles or low muscle tone, as in Down syndrome, are more likely to have OSA.

Signs and symptoms of OSA

  • Loud snoring or noisy breathing during sleep
  • Being very sleepy or irritable during the day
  • Difficulty paying attention at school
  • Sleeping in unusual positions
  • Mouth breathing
  • Trouble falling and staying asleep
  • Periods of not breathing (even though the chest might be moving, air might not be moving through the nose and mouth into the lungs)
  • Difficulty waking up in the morning

Some children with Down syndrome who have OSA may not have any symptoms at all. In some children, the only problems are difficulty paying attention or learning problems.

How do I know if my child has OSA?

A sleep study (also known as a “polysomnogram”) is the only way a doctor can diagnose OSA.

When should my children have a sleep study?

All children with Down syndrome should have a sleep study by the age of four. Anyone with Down syndrome who is older than four and has not had a sleep study should have one as soon as possible.

What causes OSA?

The most common cause of OSA in children is large tonsils and adenoids. Tonsils and adenoids grow most quickly in children between the ages of two and seven years old. Children with Down syndrome are more likely to have OSA because of the following:

  • Their upper airways are usually smaller
  • They have larger tongues
  • They have low muscle tone
  • Enlarged tonsils and/or adenoids
  • Obesity

How is my child treated for OSA?

An ear-nose-and-throat (ENT) doctor will help you plan the treatment for your child.

If enlarged tonsils and adenoids are the cause of your child’s OSA, surgery might be needed to remove the tonsils/adenoids.

Many children are cured by surgery. But some might still have OSA and might need a machine to help them breathe at night. This machine is called a “CPAP” (Continuous Positive Airway Pressure).

CPAP is a machine that blows air into the child’s nose and/or mouth and helps them to breathe. If the cause of OSA is obesity, weight loss and exercise are strongly encouraged.

Rev: 6/2013. This webpage is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.