About infantile sleep apnea

What is infantile sleep apnea?

Apnea is a term used to describe the temporary absence of spontaneous breathing. Infantile apnea occurs in children under the age of one year. Apnea may occur because of neurological impairment of the respiratory rhythm or obstruction of air flow through the air passages. The symptoms of infantile apnea include the stoppage of breathing during sleep, an abnormal bluish discoloration to the skin (cyanosis) and sometimes an unusually slow heartbeat (bradycardia). Infantile apnea may be related to some cases of sudden infant death syndrome. Episodes of apnea may decrease with age. However, several forms of adult sleep apnea also exist.

What are the symptoms for infantile sleep apnea?

Infants and young children with obstructive sleep apnea don't always snore. They might just have disturbed sleep.

During the day, children with sleep apnea might:

  • Perform poorly in school
  • Have difficulty paying attention
  • Have learning problems
  • Have behavioral problems
  • Have poor weight gain
  • Be hyperactive

What are the causes for infantile sleep apnea?

Obesity is a common factor underlying obstructive sleep apnea in adults. But in children the most common condition leading to obstructive sleep apnea is enlarged tonsils and adenoids. However, obesity also plays a role in children. Other underlying factors can be craniofacial anomalies and neuromuscular disorders.

What are the treatments for infantile sleep apnea?

Your doctor will work with you to find the most appropriate treatment for your child's sleep apnea. Treatment might include:

  • Medications. Topical nasal steroids, such as fluticasone (Dymista) and budesonide (Rhinocort, Pulmicort Flexhaler, others), might ease sleep apnea symptoms for some children with mild obstructive sleep apnea. For kids with allergies, montelukast (Singulair) might help relieve symptoms when used alone, or with nasal steroids.
  • Removal of the tonsils and adenoids. For moderate to severe sleep apnea, your doctor might refer your child to a pediatric ear, nose and throat specialist to discuss removing the tonsils and adenoids. An adenotonsillectomy (ad-uh-no-ton-sil-EK-tuh-me) might improve obstructive sleep apnea by opening the airway. Other forms of upper airway surgery might be recommended, based on the child's condition.
  • Positive airway pressure therapy. In continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BPAP), small machines gently blow air through a tube and mask attached to your child's nose, or nose and mouth. The machine sends air pressure into the back of your child's throat to keep your child's airway open. Doctors often treat pediatric obstructive sleep apnea with positive airway pressure therapy when medications or removal of adenoids and tonsils is not effective.

    Proper fitting of the mask and refitting as the child grows can help the child tolerate the mask over the face.

  • Oral appliances. Oral appliances, such as dental devices or mouthpieces, may be recommended. Some devices help to expand the palate and nasal passages, or move your child's bottom jaw and tongue forward to keep your child's upper airway open. Only some children benefit from such devices.

What are the risk factors for infantile sleep apnea?

Besides obesity, other risk factors for pediatric sleep apnea include having:

  • Down syndrome
  • Abnormalities in the skull or face
  • Cerebral palsy
  • Sickle cell disease
  • Neuromuscular disease
  • History of low birth weight
  • Family history of obstructive sleep apnea

Is there a cure/medications for infantile sleep apnea?

Medications or treatment for infantile sleep apnea will be decided by the doctor depending on the symptoms and their severity.

  • Infants with sleep apnea can require breathing help from a machine or additional oxygen therapy. They might also require pharmaceutical therapy. These are all typically temporary solutions.
  • Infant sleep apnea typically disappears as the child becomes older and more developed. By 40 weeks following conception, 98 percent of preterm infants will be symptom-free. Infants born less than 28 weeks after conception have a higher chance of the issue lasting longer.
  • Treatment is also necessary for any medical condition that either causes or exacerbates baby sleep apnea. In some cases, surgery to treat airway anomalies may be necessary. The type of medical issue will determine the course of treatment.
  • For the majority of infants with newborn sleep apnea, long-term consequences are uncommon. Infants that require resuscitation frequently are more susceptible to issues. If a serious medical condition is linked to newborn sleep apnea, health issues are also more likely to occur.
  • Wearing CPAP or, in rare and severe circumstances, getting a tracheostomy are other therapy possibilities. The type of medical issue will ultimately determine the course of treatment, but the sooner the issue is identified, the sooner it may be treated.


Symptoms
Snoring,Pauses in their breathing while sleeping,Restless sleep,Snorting, coughing or choking,Mouth breathing,Nighttime sweating,Bed-wetting,Sleep terrors
Conditions
Disturbed sleep, resulting in chronic daytime fatigue,Low oxygen,Slow heartbeat
Drugs
Aminophylline or another xanthine medication in severe symptoms,Medical device - Continuous Positive Airway Pressure (CPAP) to montior obstructions

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