CanOnly Sleep Sitting up because of Apnea

[Anonymous]

This is taken from the link posted below:

Sleep Apnea

Sleep apnea is a condition where the normal sleep patterns of a child are disrupted. The word “apnea” refers to a condition where breathing stops. This can be due to central causes, where the brain no longer transmits the signals to the body to actually breathe, or can be due to an obstruction in the airway where breathing is curtailed because of a blockage. Most causes of central apnea are due to neurologic abnormalities and will not be addressed here as they are usually cared for by neurologists or pulmonologists. Obstructive apnea, however, is most frequently treated by the otolaryngologist (ear, nose, and throat specialist).

Within sleep apnea, there is a broad range of sleep disordered breathing abnormalities, including obstructive hypopneas, where the child doesn’t totally stop breathing, but there is enough obstruction in the airway such that the breaths taken are too small and not really effective.

The most common cause of sleep apnea in children is due to enlarged tonsils and adenoids. However, any obstruction, from the level of the nose down to the voice box, or larynx, can cause sleep obstruction and apnea.

Whereas in adults, obesity has been shown to be a major risk factor for sleep apnea, this is not always the case in children. Very thin children can has sleep apnea.

Untreated sleep abnormalities can be associated with behavioral problems and learning difficulties. In addition, more serious, irreversible health problems can occur including heart failure and pulmonary hypertension.

Sleep disordered breathing includes snoring, snorting, restless sleeping, and pauses in the respiration. Some children can only sleep in a sitting position because of the obstruction. Parents are usually the first to notice that their child is having difficulties breathing during sleep. Sometimes, however, if the problem has been present for a long time, the parents may assume that this is simply “normal” for their child and it is only identified when another family member or a friend sleeps over. Sometimes it’s identified when the family is on vacation at a hotel and everyone sleeps in the same room together.

Once the problem is identified, an examination of the child is needed to determine the cause of the obstructed breathing. If the history is clear by the parents description of their child’s breathing and the examination is consistent (i.e., very large tonsils and adenoids), treatment can proceed. If however, it is unclear whether the obstruction is truly dangerous or of concern, parents can supply a videotape of the child sleeping to their physician. Audiotapes can also be helpful. Sleep fluoroscopy or even the use of cine-MRI can be used in more complicated cases of sleep apnea to determine the exact level in the airway where the obstruction is occurring.

If there is still a question about the diagnosis, further documentation is available with a polysomnogram or sleep study. This is a study where the child comes to the hospital and sleeps overnight attached to different monitors that record many parameters including obstructive apnea and hypopnea, central apnea and hypopnea, oxygen levels, carbon dioxide levels, heart tracing, and brain wave tracings. This study is also very helpful for children with underlying medical problems that can be associated with different causes of airway obstruction or in children where the obstruction may occur at different levels in the airway.

Most commonly however, sleep apnea is due to enlarged tonsils and adenoids and treatment consists of removal of the tonsils and adenoids. Other times it may be due to the adenoids alone or from nasal obstruction from a deviated nasal septum. Surgery is then tailored to fit the child’s specific problem.

Children with craniofacial anomalies, such as Down syndrome or Pierre Robin sequence, will have a higher incidence of sleep apnea and more extensive evaluations will be needed for these children both before and after treatment.

http://www.cincinnatichildrens.org/svc/alpha/o/ent/glossary. htm

I have also read on other sites that GERD can be a cause of APNEA also because of the acid irritating the tonsils and making them bigger (inflamed).

[Author]

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