Sleep Apnea or Sleep Disordered Breathing

Sleep is crucial state of everyday living that every living creature goes through every 24 hours. We are aware of the impact of poor quality or insufficient quantity of sleep, how it can impair important functions of the brain during wakefulness. There is some evidence that during sleep, brain cells disengage from daytime activities and try to recover the energy that they have spent the day prior and prepare for the next day's activities. There is also evidence that during sleep, the brain also gets rid of waste material

In the presence of poor quality or insufficient quantity of sleep, these two important functions are impaired and the research community has produced enough evidence that shows that good quality of sleep is essential for daytime functioning. There is also extensive data about the long term consequence on the health of individuals with poor quality sleep. Sleep apnea or sleep disordered breathing is an example of the condition that impairs both the quality & quantity of sleep in both adults and children.

Sleep Apnea in Children

Children are not immune to sleep apnea. It is estimated that 2-4% of children have sleep apnea and appproximtely 12 % of children snore during sleep, condition called primary snoring.

Sleep apnea or sleep disordered breathing is a spectrum of condition where airway (breathing tube in our throat) collapses during sleep for brief periods of time. This results in low oxygen in our body and causes arousal causing sleep fragmentation. This airway collapse is on a spectrum from mild narrowing causing snoring, to partial collapse to complete collapse.

In children, the major cause of sleep apnea is enlarged tonsils & adenoids. The face of child is small compared to adult and as these tissues in the back of the airway grow, they cause narrowing of the airway. During sleep, this narrowed airway is more likely to collapse causing sleep apnea. Obesity is seen as a major factor for sleep apnea in older children.

Most children with sleep apnea present with snoring, breathing pauses during sleep, gasping or choking during sleep, mouth breathing during daytime or during sleep, poor academic performance, attention deficit & hyperactivity, poor concentration, and other symptoms.

Sleep apnea in children and adults can only be diagnosed with a comprehensive evaluation including overnight sleep study.

Treatment of sleep apnea in children requires removal of tonsils & adenoids and this will need an ear, nose, & throat doctor. The second line of therapy includes CPAP (continuous positive airway pressure), and other therapies.

We at Sleep & Children's Pulmonary Center offer a complete spectrum of care from diagnosis to sleep study to treatment and follow ups.

Sleep Apnea in Adults

Sleep apnea in adults remained underestimated at this time. It is estimated that 3-7% of adult men & 2-5% of women are inflicted with sleep apnea. This prevalence is rising due to obesity.

The cause of sleep apnea is adults is a little different and is mostly related to obesity and the facial structure that predispose them to have small airway. There are special sub-groups of patient who have condition such as neuro-muscular disease that predispose them to have sleep apnea.

The pathology of sleep apnea is similar to children, which is intermittent, partial or complete closure of breathing tube during sleep causing fluctuation in oxygen and fragmented sleep. It is a little different than children as adult do not have enlarged tonsils or adenoids and most sleep apnea in older patient is related to above mentioned risk factors.

The most common symptoms of sleep apnea is snoring, brief pauses in breathing during sleep followed by gasping or choking, excessive daytime sleepiness, tiredness, difficulty to focus during day. Patient may remain unaware of these symptoms for a long period of time. The diagnosis of sleep apnea is best done by a sleep specialist who is board certified in sleep medicine. The treatment of sleep apnea in adults is also different than children and include CPAP therapy, dental devices, weight loss, and good sleep hygiene. The evaluation includes comprehensive history, physical examination, diagnostic and titration sleep studies, and close follow up with sleep specialist.

We at Sleep & Children Pulmonary Center offer comprehensive care from diagnosis, sleep studies, management, and follow up care.