Sleep Apnea: Sleep Disorders symptoms, Causes, Tests & Treatments

What is apnea?

Apnea is the loss of airflow through the airways that can disrupt gas exchange and respiration at the tissue level. Any healthy person may experience brief pauses in breathing during sleep. They usually last a maximum of 15 seconds. Prolonged and irregular breathing interruptions require special attention.

What is apnea caused?

There are basically three types of apnea : obstructive apnea, central apnea, and mixed apnea.

Obstructive apnea is most common in children. Obstructive apnea is mainly related to the disturbance of air flow through the upper respiratory tract (this is the case, for example, in the hypertrophy of the palatine and/or adenoid tonsils). The air flow is also disturbed due to the relaxation of the muscles of the back wall of the pharynx and the soft palate. The main symptoms of obstructive apnea are snoring, a tendency to fall asleep in unnatural positions, and daytime sleepiness. With persistent symptoms, a child may even develop behavioral disturbances. The observed symptoms result from the periodic hypoxia of the central nervous system. At the same time, it should be emphasized that obstructive apnea can be observed during sleep in 1–3% of healthy children.

Central apnea is observed mainly in premature babies, whose disorders result from the immaturity of the nervous system. Mixed apnea (central and obstructive) is seen in children with poorly controlled breathing. They appear primarily during periods of awakening or falling asleep.

Sudden respiratory arrest accompanied by cyanosis and flaccidity (ALTE) is particularly dangerous to life and health. This can be a cause of Sudden Cot Death (see: Cot Death – How to minimize the risk of it ). In infants, it may be associated with an infection, e.g. of the central nervous system, neurological disorders or severe gastroesophageal reflux.

Apnea in premature babies (babies born before the 34th week of pregnancy) is associated with the immaturity of the nervous and respiratory systems.

Short-term apnea in infants may be considered a variant of the breathing pattern if they do not lead to a decrease in blood oxygenation.

What tests does apnea require?

Suspicion of apnea and respiratory disorders requires careful observation, sometimes even in a hospital setting. This is especially important for the youngest children, i.e. newborns and infants. There are so-called breathing monitors, such as Angelcare, signaling the appearance of baby’s apnea, which can be used at home.

What should I do if I get apnea?

Short-term apnea episodes (less than 15 seconds) do not require any intervention. Sudden respiratory arrest accompanied by cyanosis and relaxation requires immediate intervention. You should quickly remove the baby from the bed, turn it so that its face is facing downwards. Then shake the baby lightly and sensitively and pat him on the back. Make sure nose and mouth are clear. If there is no improvement, call an ambulance, and until the child arrives, if the child is not breathing, use mouth-nose-mouth artificial respiration.

The appearance of obstructive apnea requires consultation with a physician, including an ENT specialist. Apnea resulting from lymphatic hypertrophy usually requires removal of the pharyngeal tonsil and / or surgical volume reduction (tonsillectomy). Masks with Supplemental Positive Respiratory Pressure (cPAP) are relatively rarely used in children. Preterm apnea requires separate management, including oxygen therapy. The decision about the management of apnea in a newborn is always made by a neonatologist or pediatrician. Treatment of apnea in term babies depends on the cause of the apnea.

Apnea monitoring should be recommended by the pediatrician who carried out extensive diagnostics on the child. The purchase of monitoring devices is recommended primarily to parents of premature babies, although the devices available on the market allow monitoring not only of apnea, but also act as an electronic nanny, and thus can be purchased by any parent.