Sleep time and sleep quality are very important elements to have a healthy and productive life. While there has been much media attention on the

importance of sleep in adults, problems with sleep time and sleep quality often go undiagnosed or are not considered in children. Poor sleep quality in children may lead to daytime problems such as below average school performance, tiredness, decreased attention span, poor appetite and growth and, in severe cases, to heart and lung problems.

The causes for poor sleep quality in children are varied, including family or school problems, poor sleep habits, and certain physical abnormalities. Poor sleep habits can result in difficulty falling asleep or prolonged wakeful periods. Physical abnormalities, such as enlarged tonsils and/or adenoids, can result in obstructive sleep apnea, which then disturbs sleep.

Obstructive sleep apnea occurs when a sleeping child struggles against a blockage in the nose or throat. Sometimes the blockage is so severe that the child has to wake up dozens of times per night.

Parents often recognize this as restless sleep. The most common cause for obstructive sleep apnea in children is enlargement of the tonsils and adenoids. When the child falls asleep his/her muscle tone relaxes and this relaxation allows the tonsils and/or adenoids to partially or completely obstruct the airway.

Most children with obstructive sleep apnea benefit greatly when the tonsils and adenoids are removed; quality of life improves. Sleep apnea in children is a serious disorder that should not be left untreated.

One of the most common nighttime signs of obstructive sleep apnea is snoring. Snoring in children is not unusual; in fact, 10% of all children snore. Obstructive sleep apnea affects 1-3 % of children and is often marked by loud and frequent snoring.

The parent may also notice difficulty breathing during sleep, short periods of completely obstructed breathing, choking, gasping, or restless sleep. Daytime symptoms include tiredness, mouth breathing, poor growth and developmental problems. When the child is awake, the child may breathe normally and without added effort.

The evaluation of children who are suspected of having obstructive sleep apnea includes a complete medical history with specific

questions about the quality of breathing during sleep, as well as a thorough physical examination. Your doctor may also decide that your child needs to have an overnight test performed to assess the degree of difficulty breathing during sleep.