An apnea is a brief pause in breathing which often happens during sleep. When these apneas cause arousals and sleepiness, a diagnosis of sleep apnea is warranted. This sleep disorder affects about 25 percent of adults. According to 2010 survey published in the "European Respiratory Journal," at least 3 percent of third-grade children receive a diagnosis of sleep apnea as well. Many more children remain at risk. Fortunately, sleep-disordered breathing can be safely and effectively treated. Yet it physicians must first identify it. Several warning signs for sleep apnea indicate that professional help should be sought.
Anatomy: Restricted Airway
Anatomical features may play a role in pediatric sleep apnea. In general, features that reduce the size of the airway are problematic. A 2010 review presented in the journal "Seminars in Ultrasound, CT, and MR" describes some of these features. Common issues noted included enlargement of the adenoid tonsils, enlargement of the lingual tonsils, abnormal soft palate, glossoptosis and hypopharyngeal collapse. The presence of these features must be determined by qualified medical personnel. Yet they are often discovered in routine diagnostic tests. Often standard surgical procedures can easily rectify these problems. For example, removing the adenoids and tonsils is typically an outpatient surgery.
Physiology: Breathing Cessation
Apneaic pauses can be detected by observing someone while they sleep. These lapses in breathing often persist for only a few seconds. They are typically followed by an arousal. For example, the sleeper will startle or snort. According to a 2010 summary in "Clinics in Chest Medicine," analysis in a sleep laboratory reveals more detailed information. Brain wave recordings can show the stage of sleep from which most apneas start and whether they cause an awakening. In addition, monitoring blood oxygen levels can indicate the carbon dioxide-oxygen balance. This data will determine the extent to which the brain is denied oxygen. Diagnostic tests may also reveal other sleep disorders such as periodic leg movements.
Behavior: Daytime Sleepiness
Consequences of sleep apnea include a reduction in daytime alertness. This effect can negatively impact school, work, and hobbies. A 2004 paper offered in the periodical "Biological Research for Nursing" investigated the effects of mild sleep-disordered breathing in a pediatric population. Psychometric tests evaluate working memory, attention and mental flexibility. Children with apnea showed impaired attention and vigilance. They also spent more time in lighter sleep stages and experienced more nocturnal arousals.
Psychology: Life Quality
A 2005 review in "Seminars in Respiratory and Critical Care Medicine" describes the psychological and social impact of pediatric sleep apnea. Sleep-disordered breathing can trigger psychiatric issues like anxiety, depression and moodiness. These symptoms affect interpersonal relations and life quality. Although the changes often prove small, they may persist across the entire lifespan. Early identification and treatment of sleep apnea in children can prevent this negative cascade.
References
- "European Respiratory Journal"; Population Prevalence of Obstructive Sleep Apnoea in a Community of German Third Graders; M. S. Urschitz et al.; Mar. 11, 2010
- "Seminars in Ultrasound, CT, and MR"; Magnetic Resonance Sleep Studies in the Evaluation of Children with Obstructive Sleep Apnea; L. F. Donnelly; April 2010
- Clinics in Chest Medicine"; Polysomnography; B. Jafari et al.; June 2010
- "Biological Research for Nursing"; Cognitive Executive Dysfunction in Children with Mild Sleep-Disordered Breathing; K. H. Archbold et al.; January 2004
- "Seminars in Respiratory and Critical Care Medicine"; The Psychosocial Aspects of Obstructive Sleep Apnea; W. D. Brown; February 2005
