Sleep Apnea – Sleep Apnea and Children
Home : What is Obstructive Sleep Apnea : Sleep Apnea and Children Sleep Apnea and Children
Although typically considered an adult condition, obstructive sleep apnea affects 1 to 3 percent of otherwise healthy children nationwide. The majority of sleep apnea sufferers range in age from two to six, and in rare instances, the condition can be found in newborns and adolescents. Obstructive sleep apnea occurs equally in boys and girls and is often caused by large tonsils, adenoids, cleft palate or cleft palate repairs, a receding chin, allergies, anatomical abnormalities or obesity. Additionally, research suggests that children with Downs Syndrome may be at greater risk for obstructive sleep apnea.
Symptoms of Childhood Sleep Apnea
Pediatricians encourage parents to check for signs of sleep apnea in their children as the vast majority of sleep disorders go undiagnosed until later in life. The symptoms of children who have obstructive sleep apnea are similar to those in adults, and include:
Difficulty breathing while asleep Pauses in breathing Snoring Restless sleep Heavy sweating while asleep Nightmares and night terrors Consistent bed-wetting
If sleep apnea is left untreated in children, consequences could include failure to thrive, continued bed-wetting, attention deficit disorder, behavioral problems, poor academic performance and cardiopulmonary disease. Recent studies funded by the National Institute of Child Health and Human Development (NICHD) and published in the October 2004 issue of The Journal of Pediatrics found that one-year-old infants who have multiple apneas or slow heart rates during sleep scored lower on mental development tests than did other infants of the same age. Furthermore, a second study funded primarily by the National Heart, Lung, and Blood Institute (NHLBI) found that five-year-old children who had frequent snoring, loud or noisy breathing during sleep or sleep apneas observed by parents, scored lower on intelligence, memory and other standard cognitive tests than other children their age. These children were also more likely to have behavioral problems.
Diagnosis of Childhood Sleep Apnea
Diagnosing sleep apnea in children is critical because many sleep disorders often go undetected. If a parent suspects that his or her child may suffer from a sleep disorder, the American Academy of Pediatrics (AAP) recommends that the child have a thorough physical examination by his or her pediatrician. On the advice of a physician, the child should undergo a polysomnography, commonly referred to as a sleep test, administered by a sleep specialist, who will ask the parents to provide a complete medical history. At that point, a pediatrician, pulmonologist or physician specializing in sleep disorders will be able to diagnose the condition and recommend treatment.
Treatment of Childhood Sleep Apnea
The most common treatment for children with obstructive sleep apnea is adenotonsillectomy. By removing the tonsils and adenoids, a childs airway is no longer blocked. In extreme cases, jaw advancement and other craniofacial surgeries may be required. Although adenotonsillectomy is the most common treatment for children with obstructive sleep apnea, there are potential complications, which can include post-operative pain, poor oral intake, respiratory problems, hemorrhaging and pulmonary edema.
For children with minimal adenotonsillar tissue, persistent OSA following surgery or for those who would like a surgical alternative, physicians may prescribe continuous positive airway pressure (CPAP) treatment. CPAP is a long-term therapy and requires frequent clinician assessment of adherence and efficacy. According to the American Academy of Pediatrics (AAP), older children generally tolerate CPAP, but younger children or those with learning or behavioral problems may require desensitization techniques. Physicians must evaluate and recommend CPAP treatment on a case-by-case basis only as it is not generally recommended or FDA-approved for use on children.
Prognosis
The long-term prognosis for children with obstructive sleep apnea is good with most children experiencing significant relief following the appropriate treatment. However, it is possible that children with sleep apnea may be at risk for recurrence during adulthood, so therapy compliance and regular physician visits will remain important.
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