Sleep apnea in toddlers

Sleep apnea in toddlers is a condition in which a child's breathing is interrupted during sleep. These periods of apnea affect the quality of a child's sleep, and can cause daytime sleepiness and other behavioral problems in children.

Pediatric sleep apnea is a potentially serious disorder in which a child's breathing is repeatedly interrupted during sleep.
It is thought that about 1-4% of children in the United States have sleep apnea. According to the American Sleep Apnea Association, the age at which the condition occurs varies, but many children between the ages of 2 and 8 experience the condition.
Sleep apnea is divided into the following 3 types:
Obstructive sleep apnea (OSA): is caused by a blockage in the back of the throat or nose. This is the most common type of apnea. Central sleep apnea: in which the child does not have an obstruction but the brain does not signal the breathing muscles, causing these muscles not to work properly leading to apnea. Mixed apnea: is a combination of both. The difference between obstructive sleep apnea and central sleep apnea is the amount of snoring. Snoring can occur with central sleep apnea, but this symptom is much more prominent with obstructive sleep apnea because it is associated with airway obstruction.

Obstructive sleep apnea (OSA) can be caused by anything that can block the airways and make it harder for your child to get enough air into the lungs.
In children, enlarged tonsils or adenomas (glands in the throat just behind the nose) are often the cause of obstructive sleep apnea. As your child's muscles relax at night, these oversized glands can temporarily block air from reaching his or her lungs.
A baby's tonsils can naturally be a little enlarged. In fact, sleep apnea is most common between the ages of 3 and 6, when the tonsils and adenoids (VAs) are the largest relative to the airways of children. The tonsils and adenoids can also become enlarged due to infection or allergies.
Other causes of airway obstruction include:
Being overweight Certain facial features, such as a receding chin and cleft palate. Children with Down syndrome and other congenital conditions affecting the upper airways have a higher incidence of sleep apnea. More than half of children with Down syndrome will develop obstructive sleep apnea. Some of the possible causes of central sleep apnea are:
Certain illnesses such as: heart failure, stroke Babies born prematurely Babies with certain birth defects Certain medications

There are many symptoms of obstructive sleep apnea. The most noticeable signs are snoring and difficulty breathing during sleep, often characterized by apnea. Sleep apnea is defined as a pause of ten seconds or more without breathing.
However, don't jump to the conclusion that your child has sleep apnea if you see him snoring. According to Gary E. Freed, DO, professor of pediatrics and director of the Child Sleep Laboratory at Emory University Medical School in Atlanta, about 1 to 3% of children have sleep apnea, while as many as 7 - 12% of children snore. Likewise, babies can have sleep apnea without snoring.
You may suspect your child has sleep apnea if your child has the following symptoms:
Mouth breathing most of the time both night and day. Often coughs or chokes at night. Does not sleep well, or sweats a lot when he sleeps. Combined with any of the symptoms above, repeated nighttime awakenings could be a sign of sleep apnea. Because babies with sleep apnea have trouble breathing, they may fuss more often, waking up to get the air they need.
If you think your child may have sleep apnea, review your child's daytime behavior for more information. Children with apnea often lack sleep, so they are easily irritable and frustrated. Your child may fall asleep at inappropriate times because he is too tired to wake up in the morning.
A child with sleep apnea is also more likely to have health problems related to the tonsils or adenoids. Your baby may grow more slowly than usual if he doesn't sleep long enough to benefit from the growth hormones released at night. Your baby may also not develop normally if he or she has trouble breathing at night to the point of burning calories. It's like running a marathon every night.
Infants and young children with sleep apnea may not snore, especially those with central sleep apnea. Sometimes, the only sign of sleep apnea in this age group is trouble sleeping or disturbed sleep.

Most children with sleep apnea have mild symptoms. But sleep apnea can lead to growth, learning, and behavioral problems. In severe cases, it can cause heart and lung problems and high blood pressure.
If sleep apnea is not treated, it can lead to long-term disturbance in a child's sleep, making them feel tired during the day for long periods of time. A child with this syndrome, if left untreated, may have difficulty concentrating at school. This can cause learning problems and poor academic performance.
Some children also develop hyperactivity which causes them to be misdiagnosed with attention deficit hyperactivity disorder (ADHD). An estimated 25% of children with obstructive sleep apnea are misdiagnosed with ADHD.
These children may also have difficulty developing socially and academically. In more severe cases, sleep apnea is the cause of developmental delays, cognitive delays, and heart problems.
Children with untreated sleep apnea can cause:
High blood pressure Increased risk of stroke Heart attack Childhood obesity

If you suspect your child has sleep apnea, you should talk to your pediatrician. The doctor may ask you about your child's routines and check his or her airways.
If the doctor thinks your child's weight or allergies may be causing the problem, he or she may suggest addressing those conditions first. Your doctor may refer you to an otolaryngologist, pulmonologist), sleep specialist, or apnea specialist.
The test commonly used to diagnose sleep apnea is called a polysomnogram. It monitors brain waves, eye movements, breathing and blood oxygen levels, as well as snoring and panting while the baby sleeps.
If the doctor is not sure if your child needs an adequate sleep study, another option is an oximetry test. This test, which can be done at home, measures your baby's heart rate and blood oxygen levels while they sleep. This is an initial screening tool for signs of sleep apnea.
Based on the results of the oximetry test, your doctor may recommend a complete sleep study to confirm the diagnosis of sleep apnea. In addition, the doctor may recommend that the child have an electrocardiogram to rule out any heart conditions.
Full screening is important because sleep apnea is sometimes overlooked in children. Because children can have this syndrome but have no typical symptoms.

For mild sleep apnea without symptoms, your doctor may choose not to treat the condition. Sleep apnea in some children develops more slowly. So the doctor can monitor the child's condition for a long time to see if it improves. This must be weighed against the risk of long-term complications from untreated sleep apnea.
Topical steroids may be prescribed to relieve nasal congestion in some children. These medications include Fluticasone (Dymista, Xhance, Flonase) and Budesonide (Rhinocort). These medications should only be used temporarily while waiting for the blockage to clear.
In 90% of cases, removal of the tonsils and/or adenoids will help treat sleep apnea in children. Some children with obstructive sleep apnea need to use a CPAP (continuous positive airway pressure) machine to keep their airways open by blowing air into their nose through a mask while they sleep.
However, CPAP does not usually relieve symptoms of central apnea. A device called noninvasive positive pressure ventilator (NIPPV) may work better for children with central apnea. The machine allows for a backup breath setting, which ensures that several breaths are taken every minute even when there is no signal from the brain.
An apnea alarm may be used for infants with central sleep apnea. This device will sound an alarm when an episode of apnea occurs. This will wake the infant and end the apnea.

As a key area of ​​Vinmec Health System, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of leading pediatricians: including leading experts with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All are well-trained, professional, with a mind - range, understanding young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. Advanced techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery - skull surgery, stem cell transplantation blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to play comfortably and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment. In particular, now to detect sleep apnea early in children, Vinmec International General Hospital has deployed polysomnography sleep measurement service. Unlike conventional sleep polygraphs that can only diagnose obstructive sleep apnea, Vinmec uses the Sapphire PSG sleep polysomnography system. This is a comprehensive sleep monitoring system developed by CleveMed that can diagnose obstructive, central or mixed sleep apnea causes.
This machine system has 22 channels to receive signals such as: electroencephalogram, electromyogram, electrocardiogram, electrocardiogram, measuring oxygen saturation, measuring airway pressure, determining snoring, thoracic induction, induction abdominal cavity, blood pressure, temperature... Therefore, parents can rest assured with the method of examination, diagnosis and treatment at Vinmec.

Article references sources: babycenter.com, healthline.com, sleepfoundation.org, webmd.com