Types
of Apnea
There
are three types of apnea: central apnea, obstructive apnea
and mixed apnea. Central apnea is the least common type of
apnea. It caused by the section of the brain that controls
breathing. It is often seen in premature infants. Problems
with breathing regulation are more frequent with their immature
respiratory system. Obstructive apnea occurs when there is
an airway obstruction such as enlarged tonsils or adenoids.
It is the most common type of apnea. Children with obstructive
apnea may snore, wake up frequently at night, or you may see
labored breathing when they sleep. Mixed apnea is a combination
of central apnea and obstructive apnea.
Symptoms
of Apnea
- Pauses
in breathing
- Changes
in color (turning blue or pale)
- Snoring
- Waking
frequently at night
- Labored
breathing
- Bedwetting
or waking up frequently to use the bathroom
- Irritability
or tiredness during the day
- Gasping
for air
Causes
of Apnea
- Enlarged
tonsils or adenoids: During sleep, the soft tissues
in the back of the throat relax. This can cause a partial
blockage of air through the throat and result in a pause
in breathing.
- Being
overweight: Overweight children are at higher
risk of having apnea. Snoring is often associated with
apnea in children that are overweight. Weight loss can
improve symptoms.
- Congenital
abnormalities in the face, neck or throat: Problems
such as tracheomalacia, a weak or floppy trachea, can
cause obstructions in the airway. Your doctor will do
a physical exam or other testing to look for possible
abnormalities.
- Certain
Medications: Certain medications can result in
apnea. Carbon monoxide poisoning or exposure to certain
toxins could create an episode of apnea. If mother is
breastfeeding, medications that she is taking could affect
baby as well.
- Prematurity:
Premature infants are at higher risk of having central
apnea. Because their respiratory system is immature, they
may not regulate breathing as well.
- GERD
(gastroesophageal reflux): GERD can cause obstructions
in the airway and result in apnea. Apnea may be more frequent
after feedings.
- ALTE
(Apparent Life Threatening Events): ALTE is an
event where a child stops breathing for longer than twenty
seconds. Symptoms will be changes in color (blue lips
or face), floppy or weak muscle tone, gagging or choking.
If your child has an ALTE call 911 immediately.
Treatment
for Apnea
Treatment
for apnea generally includes apnea monitoring. Premature infants
who experience apnea while in the hospital will normally be
sent home on an apnea monitor. The monitor will alarm when
there is an episode of apnea or bradycardia (slow heart rate).
Parents are given instructions on how to change the leads
on the monitor, what to do if there is an episode, and infant
CPR instructions. Other treatments for premature infants include
medications such as caffeine. Children with obstructive apnea
may require surgery if they have enlarged tonsils or adenoids.
Children may also be treated with CPAP (Continuous Positive
Airway Pressure) if they have obstructive apnea. CPAP involves
having the child wear a mask at night while they are sleeping.
The mask blows air into your child’s throat at a pressure
that is appropriate for you child. The increased pressure
keeps the throat open and prevents obstructions from occurring
while she is sleeping. This treatment is not always tolerated
well by children.
Issues
for Children With Apnea
Children
with apnea may also have hypotonia (low muscle tone). This
may be seen with other neurological conditions. Failure
to thrive is more common in infants with apnea. This may
be because they are using more energy to breath and therefore,
burning extra calories. Other problems associated with sleep
apnea are poor attention span and irritability. Not sleeping
well may affect your child’s behaviors.
If
you are concerned that your child may have problems with apnea,
please consult your pediatrician for more information and
treatment.
