Obstructive sleep apnea being a common disorder in kids can cause significant problems which include neurobehavioral, psychiatric disorders, neurocognitive deficit, and poor performance in school as well as growth failure.
First of all, you should be able to know the facts about sleep apnea and separate them from myths. There are several myths associated with sleep apnea. They include;
• Sleep apnea is just snoring. The myth is wrong since people with sleep apnea tend to stop breathing on average 400 times during their sleep with 10-30 seconds of pauses and a snort when breathing starts again.
• Sleep apnea is nothing to cause worry. On the contrary, all breaks in your sleep take a toll on your body, and when it is untreated, it leads to heart attacks, strokes, injuries that are job-related and even car accidents.
• Only older people can get it. Sleep apnea affects people of all age even toddlers and especially when you are overweight, and it also runs in families.
• Alcohol helps you sleep. Alcohol only relaxes back of your throat muscles making it easier airway to be blocked in people with sleep apnea.
• Sleep apnea is rare in kids. As false as it is, one child out of ten is likely to be affected and can cause serious medical issues or even behavioral troubles.
However, there are methods to treat or manage sleep apnea in kids.
• Upper and Lower Jaw Expansion (Functional Jaw Orthopedics ex. Bioblock, RPE – Rapid Palatal Expansion, Facemask, Bionator, etc) – It is an effective way in pediatric patients to which OSA responds. Narrow and underdeveloped upper and lower jaw affects the airway by making it smaller. Functional Jaw Orthopedics (ex RPE and Facemask) allows for jaw expansion that increases nasal and airway volume. In the case of a screening test that exhibits crowding, underbite, overbite, narrow jaw and/or long face, the airway is likely to narrow and the oropharyngeal space encroached.
• Adenotonsillectomy– It is an effective way in pediatric patients to which OSA responds. Keep in mind that not all kids are candidates for surgery. Adenotonsillectomy together with normalization of weight is considered a first-line therapy in children and adolescents with OSA.
• CPAP Machine – These machines help to blow a stream of air into your airway, and you can also adjust the flow.
It involves surgically removing tonsils and adenoids which lead to increase in the cross-sectional airway caliber in patients.
Children with severe OSA require overnight observation at the hospital following the surgery.
• Dietary restrictions –If obesity complicates OSA, then this is a necessary action to take. Children with OSA should avoid eating large amounts before bedtime. You should also introduce appropriate diet in obese patients to facilitate a reduction in weight.
• Activity Restriction – Patients with OSA are sleepy during the day with attention span reduced as well as finding it difficult to focus their concentration. Teenagers suffering OSA should avoid driving long distances without breaks or when tired.
• Avoid certain drugs and alcohol –Depressant recreational drugs and alcohol often worsen sleep apnea. Patients should avoid them unless necessary whereby medical supervision is required or otherwise an appropriate monitoring.
• Drug Therapy –Oxygen therapy to a typical pediatric patient, shouldn’t be the primary treatment of OSA even though antihistamine and antimuscarinic therapy might lead to relief in nasal congestion.
• Positive pressure ventilation –There are different methods which are; CPAP (Continuous Positive Airway Pressure) and BiPAP (Bilevel/ biphasic positive airway pressure).
In CPAP, the pressure is maintained above atmospheric pressure throughout the cycle of respiration and is mainly for adults with OSA. These machines help to blow a stream of air into your airway, and you can also adjust the flow.
In BiPAP pressure is delivered during the inspiration cycle and the pressure difference between inspiration and expiration is usually greater than 10cm H2O in BiPAP. The BiPAP device can be set to control ventilation entirely known as control mode and to deliver breaths when a negative pressure threshold triggers it (assist mode) or even configured to do both(assist/control mode)
• Oral Appliances which help improve OSA by tools that bring the tongue and lower jaw forward during sleep.
• Nasal strips which are said to reduce resistance in nasal airflow.
• Sleeping Positions especially on your side.
• Nasal Fluticasone which is administered daily for six weeks to children with OSA to reduce the frequency.
• Nasal steroids which help to reduce events of OSA while awaiting surgery or even an alternative remedy for children with mild OSA.
You should keep in mind that before you take any cause of action, you should consult first with a pediatric specialist in sleep apnea where you will get appropriate advice for your child’s situation.
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