Sleep apnea in children
Disturbed sleep, in children, may be associated with a multitude of problems. These may include disorders and aggression. Even nocturnal enuresis has been associated with sleep disturbances. However, a serious concern is sleep apnea.
Researchers in England sent questionnaires to 996 parents asking about breathing disorders occurring during their child's sleep. Breathing problems during sleep with temporary cessation of breathing (sleep apnea) are one of the most significant problems encountered in the area of sleep disturbances. Of the parents sent questionnaires, 782 responded.
Of the respondents 95 (12 percent), reported snoring and disturbed sleep. Of these, 66 children were felt to be at high risk based on a severity scale developed by the researchers. An equal number of normal children were randomly chosen as controls for the research project.
To study these children the authors utilized night time monitoring. This included videotaping for movement detection, oxygen testing of the blood during sleep and cardiac and breathing measurements. These children were also subjected, when awake, to in-depth behavioural testing.
It was found that the high risk group of children had more nocturnal movement, lower blood oxygen levels and higher pulse rates during sleep. Parents as well as teachers reported these youngsters to have, as a group, more behavioural problems. These behaviours included hyperactivity and inattentiveness. Parents also felt that these children were more aggressive than their peers.
An apneic episode may be secondary to a reduction in respiratory drive or in the ability of the respiratory muscles to respond to the central respiratory output. Mixed apnea is a combination of central and obstructive sleep apnea: Respiratory function ceases intermittently due to partial obstruction.
A detailed history, though often helpful, may not elicit adequate diagnostic clues. Some children may have been sleepy for so long that they are no longer aware of it. Pierre Robin syndrome in children has also been associated with sleep apnea. A substantial number of children feel drowsy during the day simply because they're not getting enough sleep at night.
The authors of the study felt that about one percent of children have sleep apnea. The main reason for this type of difficulty is usually due to a combination of enlarged tonsils and adenoids as well as a smaller than normal oropharynx. This leads to a narrowed airway which can be intermittently obstructed during sleep. The treatment for the disorder is surgical. Other treatments include oral and dental devices to keep airway open.