Sleep apnea is a condition in which breathing repeatedly stops and starts during sleep. These pauses can disrupt rest and may be alarming for anyone who notices them. There are two main types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA). OSA happens when the airway becomes blocked, often because the muscles in the back of the throat relax too much during sleep. People who are overweight, have a wider neck, or are male may be at higher risk for OSA.
CSA is different because the problem is not caused by a blocked airway. Instead, it occurs when the brain does not consistently send the proper signals to the muscles that control breathing. In this article, we’ll focus on central sleep apnea in children and the treatment options that may help.
What is central sleep apnea?
Sleep apnea occurs when there is a disruption to normal breathing patterns while one is sleeping. The most common type is obstructive, caused by a blockage at the back of the throat due to muscles relaxing or the jaw pushing back and blocking proper airflow. This is demonstrated by snoring, choking, and cessations in breathing.
Central sleep apnea is less common, but potentially more concerning, because it is an issue with the brain signaling your respiratory system to function. Therefore, you stop breathing briefly or breathe so lightly that you don't get enough oxygen.
It is reported that 1-5% of all children have some type of sleep apnea. As a parent, it may be hard to identify sleep apnea, as you are not monitoring their sleep habits. If you notice snoring or strange breathing noises when they do sleep, that could be a sign that your child does have sleep apnea.
Causes and Symptoms
It can be unclear why children get CSA, but there are several factors associated with the development of CSA. These include:
- premature birth
- smoking by the mother during pregnancy
- brain tumors
- cerebral palsy
- head injury
- problems at the base of the skull, or brainstem
- high-altitude sleeping
- use of narcotics or opioids
Common symptoms include sudden and frequent awakenings with breathlessness, daytime sleepiness, headaches in the morning, and trouble focusing on a task.
You or your children's care providers may be able to notice these changes and associate them with issues like ADHD or some other mental health disorder. CSA can be hard to spot, but it is important to keep in mind, especially if it seems like your child isn't sleeping very well.
Other signs of not sleeping well are nighttime bedwetting and being very hard to wake in the morning. They also may be falling asleep at school or very irritable and moody because they are not getting enough sleep.
Diagnosing CSA
Keep a diary or log of your child's sleeping habits. When you visit the doctor, they will want to know how long these things have been happening and how often. The more detail you can provide them, the more efficient and productive your appointment will be.
If your doctor thinks they have CSA, then they will refer them to an overnight sleep study. On the night of the test, medical professionals will attach monitoring devices to your child's head and body to monitor their breathing, brain waves, and heart rate during different stages of sleep. A sleep specialist will interpret the results to see if your child has CSA.
It's a good idea to use a sleep lab that has experience with children. Sleep studies may be strange and uncomfortable for children, so if the space is child-friendly without large beeping and scary devices, they may feel more comfortable going to sleep so the doctors can get an accurate reading.
If your child is determined to have CSA, additional tests may be warranted to find the cause.
Treatment for CSA
There are a few options for treating central sleep apnea. One is to treat the underlying cause. If additional tests point to a root cause, then doctors will be able to attend to that and see if the CSA improves.
Another option is to watch and wait. Children are growing and developing so fast that they may eventually grow out of it as their brain forms. They will require follow-up studies to see if things get better.
More oxygen is also a treatment option, especially for those living at high altitudes. Breathing can be more difficult as the oxygen in the air becomes less available at elevated altitudes.
Breathing assistance may be necessary to ensure children are getting adequate oxygen. A BiPAP or CPAP machine delivers light air pressure through your child's nose and mouth to help them breathe.
Medication is another option if your child can't tolerate the two machines; your doctor may recommend drugs that can help normalize breathing patterns, including:
Finally, surgery may be necessary if the cause is severe enough. A Chiari malformation is a condition where the skull is small or misshapen and pushes on an area of the brain. Your doctor may suggest an operation to solve this issue.
If you are concerned about your child's sleep, then please click the orange button below to take a free online sleep test and get in touch with one of our sleep health professionals.
Resource:
https://www.webmd.com/sleep-disorders/sleep-apnea/central-sleep-apnea-in-children