What is apnea in children and what are the features of the night form?
Many mothers listen to the breath of a sleeping child, and they do it, guided by the ancient instinct. Night breathing can tell a lot. Restless breathing is a sign of sleep disturbances, and the occurrence of pauses in breathing can be a sign of apnea in children.
Short pauses in breathing are called sleep apnea syndrome. This is a dysfunction of the respiratory system, which is manifested by systematic short-lived stops in the sleeping toddler. In addition to episodes of respiratory failure, for children, apnea is characterized by such phenomena as night snoring and lethargy and drowsiness during the daytime.
Sleep apnea syndrome is considered a potentially life-threatening baby. If the pauses in night breathing exceed 10 seconds, then the child is quite pronounced hypoxia (lack of oxygen). Simultaneously with the lack of oxygen, the need for which is high at any time of day, the level of carbon dioxide in the child’s blood increases. Both of these factors have a hyper-stimulating effect on the state of the brain, which leads to the fact that the little one often wakes up at night, does not get enough sleep, feels overwhelmed and tired.
During the night, boys and girls with a mild form of sleep apnea can experience up to 5 stops per hour, with severe forms of the disorder, up to a hundred episodes can be observed in 60 minutes. If you add up all the pauses and calculate the total time of respiratory failure, sometimes it turns out up to 3 hours. Apnea is considered the most common cause of sudden infant death in a dream.
Physiological apnea does not threaten the health of the child, they do not exceed the frequency of 5 episodes per hour, and each respiratory pause lasts no more than 10 seconds.
In the causes of the development of apnea in infants and older children, there is still a lot of incomprehensible, not obvious. But this issue is addressed by specialists in the field of somnology and otolaryngology.
In newborns, apnea may be due to congenital insufficiency of the respiratory center, while the baby’s skin is bluish and the respiratory pauses in sleep in babies occur in the absence of pathologies from the lungs or heart. Such apnea, as well as arising after a head injury, are called central.
There is also a large group of obstructive apnea that develop in overweight children, hormonal disorders, impressionable and nervous babies. Allocate also hereditary apnea.
The main causes of occurrence, known today, are as follows.
- Birth prematurely - It is in babies who were born before 37 weeks of pregnancy, the most common primary immaturity of the respiratory center. Premature babies usually develop central apnea.
- Maxillofacial pathology with a congenital small jaw, with other congenital forms of violations of its anatomical structure.
- Pathology of the heart, blood vessels, nervous system. With some malformations of the heart or circulatory diseases, hypoxia can be caused at the cellular level, which also affects the functioning of the respiratory system during sleep.
- Birth injuries. The true cause of apnea can be found in any trauma that the baby suffered during childbirth. As a rule, if these are disorders of the central nervous system, then apnea may be central.
- Mom's bad habits - refers to smoking, alcoholism, taking drugs while carrying a baby.The likelihood of apnea after birth in children of such moms exceeds 30%.
If we talk about children over the age of one year, then the most common causes of apnea are such situations:
- overweight and obesity - night breathing stops are caused by the deposition of adipose tissue on the soft palate, uvula;
- respiratory diseases - most often, sleep apnea syndrome develops in children with adenoids, chronic forms of rhinitis, when unrestricted nasal breathing becomes inaccessible;
- hormonal disorders - most often as a risk factor are increased function or insufficient function of the thyroid gland, as well as diabetes;
- infectious diseases - at the same time anoe can develop not only in case of acute respiratory disease, but also systemic diseases, for example, in sepsis;
- metabolic disease - insufficiency in the body of a baby or a preschooler, a schoolboy of magnesium, calcium quite often leads to sleep apnea;
- drugs - to drugs that are potentially capable of causing an apnea in a child, include sleeping pills, potent sedatives, as well as some antihistamines, for example, Fenistil, if given to a child under one year old.
What happens for any of these reasons is not difficult to imagine: a pharyngeal collapse occurs in the deep phase of sleep. At the level of the pharynx, the airways fall. The lack of oxygen in the brain is felt instantly, he gives the command to “wake up”, and the child wakes up. Breathing is restored, he falls asleep again and so on until the next episode of apnea.
Symptoms and signs
The main symptom of pathology is intermittent, restless sleep. Parents of infants can detect the problem more quickly, since most often the crib is placed up to 2-3 years in the parent’s bedroom. If the child is 5 years old and more and he sleeps separately, then you need to pay attention to the fact that during the daytime the child is sluggish, apathetic, he does not get enough sleep, complains about it. Almost always, apnea is accompanied by snoring.. Children with this pathology sleep restlessly - their bed is always “gathered” in a pile.
In the morning, the child has complaints of headaches, he wants to sleep in the daytime, his activity, curiosity, and ability to learn are reduced. The child is irritable, weeping, it is difficult for him to concentrate attention and to memorize new information.
In children, quite often, apnea is combined with such disorders as enuresis, severe sweating in sleep. They can fall asleep in the most bizarre poses. Often, you can pay attention that the day the child breathes through his mouth.
Apnea negatively affects everyday life and its quality. A sleepless child in the daytime is inattentive, distracted, which increases the likelihood of injuries, falls, accidents.
Apnea increases the likelihood of developing hypertension, heart rhythm disturbances. Also, this problem markedly worsens the course of all respiratory ailments, and children often get sick with them.
What to do?
To wait, that the apnea will pass by itself, is dangerous.
When detecting facts of respiratory failure in a child, parents should show the child to the pediatrician.
The doctor will weigh the child, determine his body weight, determine if the child has obesity, measure the pressure and give a direction to the ENT doctor. An examination by an otolaryngologist plays an important role - it is necessary to identify the mechanical factors by which the upper airways in a dream fall over measure.
Children are given polysomnography — simultaneous recording of electrical potentials for 8 hours or more, or a polygraphic study is prescribed, in which heart rate, nasal breathing is recorded during one night, and snoring episodes are determined.
How is it treated?
For the treatment of apnea in childhood use a large list of drugs. There are also non-drug methods.It is acceptable to use the achievements of surgery, but only to eliminate the main cause of respiratory dysfunction in a dream. If a child has a mild form of pathology, he is strongly recommended to go to bed with his head elevated. Also, parents are encouraged to teach the baby to sleep on the sideby avoiding the position on the back.
Necessarily treat ENT diseases that have been identified as a result of the examination. Overweight children are advised to reduce this setting.. There are many different devices that will help your child sleep more comfortably - tongue holders, jaw holders. These orthopedic appliances can also be recommended.
Prevention of childhood apnea includes monitoring the weight of the child, timely treatment of rhinitis and other respiratory diseases.
Parents who have experienced child apnea are well aware that it looks rather daunting, but not short-term respiratory arrest is dangerous, but prolonged apnea. Any child who suffers from such a problem can become a victim of a protracted form of respiratory arrest, which puts his life at risk. Therefore, doctors (and Dr. Komarovsky are not an exception) recommend knowing how to provide first aid for prolonged apnea.
Call an ambulance". At the same time, place the child on a horizontal surface, see if there is something foreign in the mouth. If the mouth is clean, shake the child, pinch, rub your palms and heels - it is important to wake him up, because with the awakening the breathing stops.
If the actions of the parents did not help to bring the child to consciousness, the breathing has not recovered, it is necessary to perform cardiopulmonary resuscitation at home, to make an indirect heart massage combined with artificial respiration. After the attack, the baby must be examined by doctors.
More information about baby apnea is in the next video.