Posts Tagged ‘sleep apnea in children’
Sleep apnea
From Wikipedia, the free encyclopedia This article needs additional citations for verification.
Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (November 2008) Sleep apnea Classification and external resources ICD-10 G47.3 ICD-9 327.2[dead link], 780.57 eMedicine ped/2114 MeSH D012891
Sleep apnea (or sleep apnoea in British English) is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea (Greek: á „Ï€Î Î Î Î (à pnoia), from Î – (a-), privative, πΠΠΠΠΠ(pnà ein), to breathe), lasts long enough that one or more breaths are missed, and such episodes occur repeatedly throughout sleep.[1] The standard definition of any apneic event includes a minimum 10-second interval between breaths, with either a neurological arousal (a 3-second or greater shift in EEG frequency, measured at C3, C4, O1, or O2) or a blood oxygen desaturation of 3–4% or greater, or both arousal and desaturation.[citation needed] Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a “sleep study”.
Clinically significant levels of sleep apnea are defined as five or more episodes per hour of any type of apnea (from the polysomnogram).[citation needed] There are three distinct forms of sleep apnea: central, obstructive, and complex (i.e., a combination of central and obstructive) constituting 0.4%, 84% and 15% of cases respectively.[2] Breathing is interrupted by the lack of respiratory effort in central sleep apnea; in obstructive sleep apnea, breathing is interrupted by a physical block to airflow despite respiratory effort. In complex (or “mixed”) sleep apnea, there is a transition from central to obstructive features during the events themselves.[citation needed]
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
Symptoms of Sleep Apnea in Children
Obstructive sleep apnea syndrome (OSAS) is a common problem in children, and is increasing being recognized as a cause of daytime attentional and behavioral problems.
Unlike adults with sleep apnea, who are often overweight and frequently wake up at night, children with OSA are more difficult to recognize and diagnose.
Symptoms Although snoring is a common symptom in children with obstructive sleep apnea, it is important to remember that between 10-20 percent of normal children snore (primary snoring) on a regular or intermittent basis.
In addition to continuous loud snoring, other symptoms of obstructive sleep apnea in children include:
- failure to thrive (weight loss or poor weight gain)
- mouth breathing
- enlarged tonsils and adenoids
- problems sleeping and restless sleep
- excessive daytime sleepiness
- daytime cognitive and behavior problems, including problems paying attention, aggressive behavior and hyperactivity, which can lead to problems at school
Diagnosis The diagnosis of OSA in children is usually based on the characteristic symptoms and evidence of adenotonsillar hypertrophy (big tonsils and adenoids) and mouth breathing. Children suspected of having OSA should usually be evaluated by a Pediatric ENT specialist for further evaluation.
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Obstructive Sleep Apnea
Obstructive Sleep Apnea What is obstructive sleep apnea? Obstructive sleep apnea occurs when a child stops breathing during periods of sleep. The cessation of breathing usually occurs because of a blockage (obstruction) in the airway. Tonsils and adenoids may grow to be large relative to the size of a child’s airway (passages through the nose and mouth to the windpipe and lungs). Inflamed and infected glands may grow to be larger than normal, thus causing more blockage. The enlarged tonsils and adenoids block the airway during sleep, for a period of time. The tonsils and adenoids are made of lymph tissue and are located at the back and to the sides of the throat.
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During episodes of blockage, the child may look as if he/she is trying to breath (the chest is moving up and down), but no air is being exchanged within the lungs. Often these episodes conclude with a period of awakening and compensation for lack of breathing. Periods of blockage occur regularly throughout the night and result in a poor, interrupted sleep pattern.
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Sometimes, the inability to circulate air and oxygen in and out of the lungs results in lowered blood oxygen levels. If this pattern continues, the lungs and heart may suffer permanent damage.
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Obstructive sleep apnea is most commonly found in children between 3 to 6 years of age. It occurs more commonly in children with Down syndrome and other congenital conditions affecting the upper airway (i.e., conditions causing large tongue, small jaw, etc.).
What causes obstructive sleep apnea? In children, the most common cause of obstructive sleep apnea is enlarged tonsils and adenoids in the upper airway. Infections may cause these glands to enlarge. Large adenoids may completely block the nasal passages and make breathing through the nose difficult or impossible.
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There are many muscles in the head and neck that help to keep the airway open. When a person (child or adult) falls asleep, muscle tone tends to decrease, thus, allowing tissues to fold closer together. If the airway is partially closed (by enlarged glands) while awake, falling asleep may result in a completely closed passage.
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Obesity may cause obstructive sleep apnea. While a common cause in adults, obesity is a far less common reason for obstructive sleep apnea in children.
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A rare cause of obstructive sleep apnea in children is a tumor or growth in the airway. Certain syndromes or birth defects, such as Down syndrome and Pierre-Robin syndrome, can also cause obstructive sleep apnea.
What are the symptoms of obstructive sleep apnea? The following are the most common symptoms of obstructive sleep apnea. However, each child may experience symptoms differently. Symptoms may include:
- loud snoring or noisy breathing during sleep
- periods of not breathing – although the chest wall is moving, no air or oxygen is moving through the nose and mouth into the lungs. The duration of these periods is variable and measured in seconds.
- mouth breathing – the passage to the nose may be completely blocked by enlarged tonsils and adenoids.
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Academic grades
Study links sleep apnea in children and teens to lower academic grades
The average academic grades of children and teens with moderate to severe obstructive sleep apnea are worse than the grades of students who have no sleep-disordered breathing, according to a research abstract that will be presented Tuesday, June 8, 2010, in San Antonio, Texas, at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies LLC. Results indicate that moderate to severe obstructive sleep apnea was linked to both lower academic grades and behavioral concerns expressed by parents and teachers. The results remained significant after adjustment for sex, race, socioeconomic status and sleep duration on school nights. Students with moderate to severe sleep apnea averaged a half-letter grade lower than those without any evidence of sleep-disordered breathing. None of the students with moderate to severe OSA had an “A” average, and 30 percent of them had a “C” average or lower. In contrast, roughly 15 percent of participants without sleep-disordered breathing had an “A” average, and only about 15 percent had a “C” average or lower.
“There was an impressive impact of sleep-disordered breathing on academic grades,” said principal investigator and lead author Dean W. Beebe, PhD, associate professor of pediatrics in the division of behavioral medicine and clinical psychology at Cincinnati Children’s Hospital Medical Center in Ohio. “That leaves the subjects with moderate to severe sleep apnea at a serious disadvantage.”
Sleep Apnea in Infants
Sleep apnea in infants occurs in full-term babies under the age of one year and is also a risk for infants born before 34 weeks of pregnancy.
SIDS and Sleep Apnea in Infants
When babies sleep, unexplained lapses in breathing known as apnea lead to a diminished oxygen supply to the brain and heart and can cause Sudden Infant Death Syndrome (SIDS). This tragic syndrome is the leading cause of death among infants ages 1 month to 1-year-old. Although research has made progress, SIDS remains capricious. Current recommendations to reduce the risk of SIDS for your infant include putting babies under the age of one to sleep on his or her back. If SIDS can be avoided, infants experiencing sleep apnea usually grow and develop normally. Most children are believed to be out of danger of SIDS between 6 months and 1-year-old, but the peak for sleep apnea in children is age 2-5 years.
Snoring is one symptom of sleep apnea in infants and worth mentioning to your pediatrician. If a baby snores, it could by a symptom of obstructive sleep apnea. This means that your baby experiences a prolonged partial blocking, or sporadic breathing while they sleep. The cause of this irregular breathing is often caused by enlarged tonsils or adenoids.
Sleep Problems, Sleep Apnea in Children
Sleep problems are common in childhood. They may happen once or many times in a single week. They usually do not need to be treated, unless they keep happening over and over again.
Obstructive Sleep Apnea in Children
Background
Obstructive sleep apnea syndrome (OSAS) is a disorder of breathing in which prolonged partial upper airway obstruction and/or intermittent complete obstruction occurs during sleep disrupting normal ventilation and normal sleep patterns. The signs and symptoms of OSAS in children include habitual snoring (often with intermittent pauses, snorts, or gasps) with labored breathing, observed apneas, restless sleep, and daytime neurobehavioral problems. Nocturnal enuresis, diaphoresis, cyanosis, mouth breathing, nasal obstruction during wakefulness, adenoidal facies, and hyponasal speech may also be present. Daytime sleepiness is sometimes reported but hyperactivity can frequently occur. Case studies report that OSAS in children can lead to behaviors easily mistaken for attention-deficit/hyperactivity disorder as well as behavioral problems and poor learning; however, most case studies have relied on histories obtained from parents of snoring children without objective measurements, control groups, or sleep studies. Severe complications of untreated OSAS in children include systemic hypertension, pulmonary hypertension, failure to thrive, cor pulmonale, and heart failure.
History and physical examination have been shown to be sensitive but not specific for diagnosing OSAS in children. Primary snoring is often the presenting symptom reported by parents, and should warrant careful screening for OSAS. Primary snoring is defined as snoring without obstructive apnea, frequent arousals from sleep or abnormalities in gaseous exchange. It is estimated that 3 % to 12 % of children are habitual snorers but only 2 % will be diagnosed with OSAS. Although surgical treatment has been shown to improve quality of life, it is not without risks (e.g., bleeding, velopharyngeal insufficiency, post-obstructive pulmonary edema). Thus, clinicians must be able to distinguish between primary snoring and OSAS. Primary snoring among children without obstructive sleep apnea is usually considered a benign condition although this has not been well evaluated.