Sleep Apnea in Child
- prevalence and risk factors -
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>> Sleep Apnea in Child - risk factors
How will you know if your child could have sleep apnea? What are the risk factors? The very first thing that can make you think about sleep breathing disorders in children is
swollen tonsils,
waist size and body mass index. These are also the most common risk factors for sleep apnea. According to a study about sleep disorders in children: - BMI and waist circumference were significant and strong predictors of sleep apnea in child, at all severity levels: snoring, mild sleep apnea and moderate sleep apnea.
- nasal anatomic factors such as chronic sinusitis, nasal drain and rhinitis were significant risk factors of mild sleep apnea.
Note: Mild sleep apnea in child has an apnea hypopnea index - AHI - of at least one but less than five breathing pauses per hour of sleep!
- Tonsils or adenoids size, are significant factors for moderate sleep apnea in toddlers and children.
Note: Moderate sleep apnea in child has an apnea hypopnea index - AHI - of five or more breathing pauses per hour of sleep!
However, this study suggest that the causes of sleep apnea in kids are more complex, and there may be a systematic influence of obesity. That's why adenotonsillectomy may not always be the most effective treatment for sleep apnea.
The first warning sign of obstructive sleep apnea in children is snoring.
Snoring is a common form of sleep breathing disorder that occurs when soft tissues in the back of the throat collapses and blocks the airway during sleep. A sleep apnea snoring tends to be loud and irregular, and include obvious pauses in breathing and gasps for breath. Parents often notice that the child seems to be working hard to breathe during sleep.
There are some other risk factors for sleep disorders and sleep apnea in child, that are not necessarily related to weigh gain:
- newborns that are considered premature due to weight and timing, especially small premies (under 3 lbs).
- child identified with Asperger's, ADHD, Autistic Spectrum Disorders, Nonverbal Learning Disorders, Bipolar Disorder.
- children with migraines and headaches.
- child with a history of acid reflux.
- child with asthma.
- children with a history of food allergies and intolerances.
- girls who have difficulties with menstruation in puberty.
- children who tend to fall asleep during seat work or lectures.
- child with a history of early, repeated trauma (which can lead to eating disorders, etc.)
A big concern for sleep therapists is that in many schools, programs and day care facilities there is a lack of awareness of sleep disorders and their relationship with neurological problems.
At day care centers, due to timing, children and infants are put to sleep after they eat, often on flat nap matts, which is the worst for digestion. If the staff observe that some kids are snoring, chocking, coughing and waking up crying or screaming, they should talk to the parents (to see if this is an ongoing issue) and to provide modifications, such as: - allowing for rest time before napping,
- elevating the first half of the matt.
Another problem is that children's times are much more structured. Unless the parents or kids build in physical activity as part of after school recreation, it doesn't happen.
Schools are very pressured for maintaining scores on standardized tests and are penalized if they do not. Upper grades, just recess after lunch, but many kids are rushing through lunch, and slower kids end up staying inside. Other schools...they don't even have recess! It varies from state to state, but in inner city area, there is also the issue that parents are concerned by safety, so unless a child is signed up for after school activities, they are often stuck in their apartments the rest of the time. And when it comes to nutrition, where grocery shopping is limited to going to the local shop, there are not so much options for healthy food for the children. And the inexpensive restaurants are not much better. As you can see, it's a complex social issue to prevent sleep disorders and sleep apnea in child, which unfortunately is much more complicated than telling parents to put locks on their refrigerators at night.
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