Sleep apnea in children: symptoms, causes and treatment.

Summary of sleep apnea in children, to know how to detect and treat it in time.

Night is the part of the day when we try to rest. Sleep is that period of our routine in which we replenish energy, in addition to making the body rest and repair itself.

If in adulthood having a poor quality of sleep has a very negative effect on our physical and mental health, sleep problems during childhood are even more critical. Not being able to sleep well translates into cognitive development problems and impaired growth.

One of the sleep problems that young children can suffer from is sleep apnea in children, a disorder that, although it is a common sleep disorder in children, can cause sleep apnea.Although it is a relatively uncommon disorder, it can seriously affect our children's health to such an extent that it is important for us to know it very well. Below we will go deeper into what it is, its causes, symptoms and treatment.

What is sleep apnea in children?

The syndrome of obstructive sleep apnea (OSAS) in children is a sleep breathing disorder that affects approximately 2% of infants, especially between the ages of 2 and 5 years.. This problem is characterized by repeated episodes of airway obstruction during sleep, which may be partial (hypopnea) or total (apnea).

This disorder is usually due to a narrowing or blockage in the upper airway during sleep.

Because the child cannot breathe well during sleep, the lungs do not receive enough oxygen which causes a reduction of oxygen in the Blood (hypoxemia), and there may also be an increase in CO2 retention (hypercapnia). This interruption of pulmonary ventilation can be repeated up to 400 times a night, preventing the affected person from enjoying a deep and restful sleep..

Not sleeping well at night because of inability to breathe properly affects the physical and mental health of adults and children, but this problem has different consequences depending on age. While adults with apnea usually have daytime sleepiness, in the case of children, behavioral problems, attention and hyperactivity are manifested, which can make sleep apnea is not properly diagnosed thinking that behind the behavioral problem of the child there is some psychological disorder.

The underlying cause in adults is usually obesity, while in children it is usually a problem in the adenoids and tonsils, especially by enlargement of the same.

Whatever the cause, it should be noted that can impair the physical and intellectual development of children, which is why it is so important to diagnose and treat early to avoid any complications affecting the cognitive and behavioral development of children.This is why early diagnosis and treatment is so important to avoid any complications that may affect the cognitive and behavioral development of children.

Symptomatology

The signs and symptoms that can be observed in the child with sleep apnea while sleeping are:

• Snoring
• Breathing pauses
• Restless or restless sleep
• Snorting, coughing, or choking
• Mouth breathing
• Night sweats
• Bedwetting: urinating in sleep
• Night terrors and nightmares
• Early awakening
• Excessive thirst on waking
• Morning headaches

In infants and very young children, obstructive sleep apnea does not always manifest itself in the form of snoring.. In their case, they may simply manifest a sleep disturbance and difficulties in having a restful sleep.

When awake, children with sleep apnea may manifest the following problems related to their sleep disorder.

• Poor school performance
• Attention problems
• Learning problems
• Behavioral problems
• Poor weight gain (critical in very young children)
• Hyperactivity
• Delayed growth

Obstructive sleep apnea in children can involve multiple complications in the physical and psychological health of the affected person, among which we can highlight delay in the growth, cardiac problems and death..

Causes and risk factors

Obesity is often a common cause behind obstructive sleep apnea in adults. However, in the case of boys and girls, although that is also a cause, the most common cause is usually an enlargement of the tonsils and adenoids or vegetations, masses of tissue located in the back of the nasal cavity.These are masses of tissue located at the back of the nasal cavity.

This sleep problem may also occur as a result of craniofacial anomalies and neuromuscular disorders..

In addition to obesity, risk factors for sleep apnea in children include:

• Down syndrome
• Abnormalities of the skull or face
• Cerebral palsy
• Neuromuscular disease
• Sickle cell disease
• Low birth weight
• Family history of this sleep disorder

Diagnosis

Diagnosis of pediatric sleep apnea is somewhat complicated, since it is it is necessary to make the diagnosis while the affected person is sleeping.. The doctor will review the child's symptoms and medical history and perform a physical examination while the child is awake, including examination of the neck, mouth, and tongue to check the condition of the tonsil and adenoids.

But, since it is necessary to see how the child sleeps in order to detect this problem, the doctor may order several tests to diagnose the condition. Among the tests used are:

1. Polysomnography

The doctor evaluates the child's condition during an overnight sleep study. This test uses sensors placed on the entire body to record brain wave activity. brain wave activity, breathing pattern, oxygen levels, heart rate, muscle activity, and snoring while the child is sleeping. while the child sleeps.

2. Oximetry

In the event that pediatricians suspect that a child has obstructive apnea, and a complete polysomnogram is not required or not available, a recording of oxygen levels during sleep may be helpful in confirming the diagnosis.. Oximetry can be done at home.

3. Electrocardiogram

An electrocardiogram requires electrode pads connected to a machine that measures the electrical impulses coming from the child's heart. measures the electrical impulses coming from the child's heart.. The pediatric team can use this test to determine if the child has a heart condition that could be behind the sleep apnea.

Treatment

There are several therapeutic options for treating sleep apnea in children. Each case will require a particular treatment, being mainly the following.

1. Medications

The pharmacologic route for treating this type of apnea includes topical nasal steroids, such as fluticasone and budesonide, which can relieve the symptoms of this sleep disorder in some children with mild obstructive sleep apnea. For children with allergies, montelukast appears to be helpful in relieving symptoms, both when used alone and with nasal steroids.

2. Removing the tonsils and adenoids

When the child suffers from moderate or severe sleep apnea, one of the therapeutic options, although drastic, is the removal of the tonsils and adenoids..

This type of intervention is called adenotonsillectomy and is only performed when an otolaryngologist considers it to be the best option available to improve the child's quality of life by opening the airway.

3. Positive airway pressure therapy

Positive airway pressure therapy uses several machines that blow air through a tube and a mask placed over the nose and/or mouth. uses several machines that blow air through a tube and a mask placed over the nose and/or mouth..

This machine sends air pressure into the back of the child's throat to keep the airway open. This option is used when medications or removal of the adenoids and tonsils have not been effective.

4. Oral appliances

Another option is oral devices, such as dental appliances or mouthpieces, which can help to expand the palate and can help expand the palate and nasal passages.. They also serve to move the child's lower jaw and tongue forward so that the upper airway remains open. It should also be noted that few children benefit from oral appliances.