jbodach@thestamfordtimes.com

You'd never know by looking at Price Snedaker's three boys that there was ever a time when they lacked energy.

Jack, 10, Charlie, 10, and James, 8, enjoy sports and playing outside with their friends and black Labrador puppy. By all accounts they are active, healthy, well-adjusted boys.

"I had no idea that any of my children were having trouble sleeping until their speech therapist referred them to an ear, nose and throat

specialist because she thought their tonsils and adenoids were enlarged," Snedaker said. "The ENT suggested that the boys undergo a sleep study."

According to the National Institutes of Health, more than 12 million Americans are affected by sleep apnea. Sleep apnea is a condition in which the airway is obstructed during slumber, causing the brain to wake the sleeper up several times. Even if the person doesn't remember waking up, these interruptions affect a person's ability to stay in a deep sleep.

There are two forms of sleep apnea: central and obstructive. Central sleep apnea occurs when the brain has a problem signaling the diaphragm to move. Most people have obstructive sleep apnea, in which the muscle tone in the throat relaxes, causing the soft tissue in the thoat walls to collapse, thereby obstructing airflow.

Obstructive sleep apnea historically peaks in children between the ages of 2 and 6, coinciding with when a child's tonsils and adenoids grow larger. However, children under the age of 2 can also experience a narrowing of their nasal passages, and children as young as 18 months have been known to experience obstructive sleep apnea.

Like many parents, Snedaker was unaware of the symptoms of sleep apnea.

"I knew the boys snored, but I just thought it was cute," Snedaker said. "I also knew that they threw the covers off and that when they woke up, their heads were really sweaty, but they were easy to put to bed and woke up early so I didn't think it was a problem."

Dr. Lewis Kass, pediatric pulmonologist and pediatric sleep director at Norwalk Hospital, said that snoring, sweating and restless sleep are all common signs of sleep apnea.

"Just five years ago snoring was thought to be benign, just a funny little noise a kid makes, but it is now known that this is a clear sign of sleep apnea," Kass said.

Since it wasn't until recently that parents and pediatricians started considering sleep issues in children, many kids with sleep apnea have been diagnosed with Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder.

"Symptoms of sleep apnea mimic those of ADHD, particularly hyperactivity, impulse control issues, poor attention span and poor school performance," Kass said. "Studies have found that a significant number of kids were being medicated for a disorder they did not have."

That was the case with Snedaker.

"My kids were all tested for learning disabilities and for ADD," Snedaker said. "I wasn't asked specific questions about their sleep patterns so I never considered that something else might be wrong."

Further perpetuating the problem of misdiagnosis is that the treatment for ADHD often "cures" sleep problems.

"As adults, if we are sleepy when we wake up we have a cup of coffee and we feel better," Kass said. "For children, we give them a stimulant called ritalin, which is like their cup of coffee. For a few hours, the ritalin acts like a cup of joe and this is why there is so much overlap and why sleep conditions are overlooked in children. We are treating the symptoms, but not underlying cause."

Once Snedaker's sons were correctly diagnosed with ADHD, they were each outfitted with a Continuous Positive Airway Pressure machine. C-PAP is a mask that blows pressurized air into the wearer to inflate their airways.

"They love their C-PAPs," Snedaker said. "They don't sleep without it. When one of my sons was at a sleepover and didn't have it, he came home and told me that he didn't want to sleep without it again."

Most children with sleep apnea do not require a C-PAP machine, Kass said.

"A tonsillectomy and adenoidectomy will cure sleep apnea close to 90 percent of the time," Kass said. "This makes this one of the coolest diagnosis because the condition can be fixed so completely. The others need C-PAP."

If sleep apnea is not diagnosed in children it can lead to health problems later in life.

"In uncorrected, sleep apnea can have the same long-term effects on children that it does on adults who are undiagnosed, including high blood pressure and cardiac dysfunction," Kass said.

Sleep apnea can cause cardiovascular stress because the heart rate slows down and then speeds up and the blood pressure jumps on every single apnea. Blood oxygen also begins to drop and the repeated dropping puts an added stress on heart and brain.

After her sons were diagnosed with sleep apnea, Snedaker decided to do her part to educate other parents.

"I'm really kind of obsessed with this subject," Snedaker said. "I tell everyone I can about this and a lot of parents say that their children have the same symptoms that mine did. Of the people I've talked to, four parents also had children with sleep apnea."

At 6:30 p.m. on Wednesday, Oct. 10, there will be an informational session about sleep disorders and children at Norwalk Hospital in the Perkins Auditorium. Sleep specialists from Norwalk Hospital and Yale-New Haven Children's Hospital are scheduled speakers.

The event is free. Interested parents should RSVP to WHRC@norwalkhealth.org or call 1-866-NHB-WELL.