Sleep Disorders in Children
Many children have sleep disorders. These range from night terrors and sleep walking to serious breathing problems. Some of the breathing disorders known to affect children and their sleep are:
Obstructive Sleep Apnea (OSA)
One of the most common abnormalities of breathing during sleep with children is obstructive sleep apnea. OSA occurs in about 2% of all kids, most commonly in preschool-age children.
Symptoms of OSA in children include:
- Restless sleep
- Interruption of breathing (apnea)
- Chronic mouth breathing
- Difficulty awakening
- Problems with school performance
Factors that increase the risk of OSA include:
- Large tonsils and/or adenoids
- Abnormalities of the head and neck
The diagnosis of OSA cannot be made by discussing your child's sleep pattern with a qualified specialist. Your child must be evaluated at a sleep laboratory. Additionally, the sleep study is useful for identifying children who are susceptible to complications from anesthesia and surgery. If OSA goes untreated, it can lead to heart failure, poor school performance and high blood count.
Treatment of OSA depends on its severity and includes:
- Surgery if tonsils and/or adenoids are enlarged
- Weight reduction if the child is obese
- Non-invasive nasal pressure support (BiPap)
- Tracheostomy when severe
Central Hypoventilation Syndrome (CHS)
CHS is a problem with the signals sent by the central nervous system that allow a person to breathe. This disorder is often worse when the person afflicted is asleep. It's characterized by slow and/or shallow breathing inadequate for removing carbon dioxide from the lungs. CHS may be present at birth (congenital) or as a result of pressure on the brainstem (trauma, tumor, brain damage). A diagnosis can be made through an- overnight sleep study. Treatment may call for the relief of brainstem pressure depending on the cause, or chronic ventilator support.
Central Apnea of Prematurity
Central apnea of prematurity is common in newborns and is more common in premature newborns. It is caused by an immaturity of the central respiratory drive and may be evident through color changes (blue around the lips or face) and low heart rate (bradycardia). Apnea of prematurity can be diagnosed through cardiorespiratory monitoring or a daytime sleep study. Treatment consists of oxygen and/or caffeine and usually cures the problem within the first few months of life.
Chronic Lung Disease
Chronic lung disease is often a result of premature birth, but may be due to lung injury after the neonatal period caused by aspiration syndromes, sickle cell disease, and neuromuscular diseases such as certain types of muscular dystrophy.
Low blood oxygen and high blood carbon dioxide levels characterize chronic lung disease. Evaluation is possible by a day (if the patient is less than six months old) or an overnight (if the patient is more than six months old) sleep study and can determine if the lung disease is subsiding or progressing. Therapy consists of oxygen, non-invasive ventilatory support (nasal BiPap) in milder cases, or tracheostomy with ventilator support in more severe cases.
For more information or to arrange for a sleep study, please call 410-787-4768.