(Courtney sleeping with her Barbies & cell phone)
I have been researching sleep apnea in children with Down syndrome to better understand the effects that it has and wanted to share some facts and Courtney's sleep apnea story.
Courtney has NEVER slept through the night in 12 1/2 years. While she may not always get out of bed, she is still restless, snores, sits up, changes positions several times a night and gasps for breaths. Courtney had her tonsils and adenoids removed at the age of 5 then this year she had her adenoids removed again because of regrowth.
Courtney also is very tired during the day and has trouble focusing on tasks. She has also been exhibiting times of confusion and having difficulty making decisions. Irritability has also been an issue.
After 2 sleep studies at Children's Hospital Courtney has been diagnosed with OSA. Courtney will be using a BiPAP machine to treat OSA. A BiPAP machine allows the air that is delivered through the mask to be set at one pressure for inhaling and another for exhaling. This makes BiPAP much easier for users to adapt to and these dual settings also allow more air in and out of the lungs.
Here are some facts:
Sleep Apnea Problems in Children with DS
It has been said by some experts that 100% of children with DS have sleep apnea. But studies have shown that this is not the case. While the numbers are fairly high at 45%, not all children with DS suffer from OSA.
Obstructive sleep apnea can be caused by several different factors present in DS: the flattened midface, narrowed nasopharyngeal area, low tone of the muscles of the upper airway and enlarged adenoids and/or tonsils.
Why is this important? The first problem is that of the child not getting enough quality sleep and the behavioral effects that brings. Second, during sleep apnea, the oxygenation of the blood decreases. It has been shown that in children with DS and heart disease the low blood oxygenation causes an increase in the blood pressure in the lungs as the body tries to get more oxygen. This "pulmonary hypertension" can cause the right side of the heart to become enlarged and other cardiac complications can follow.
As stated above, DS children tend to have poor tone in the muscles of the upper airways which lead to the tongue relaxing back into the airway thus causing an obstruction. Enlarged tonsils and adenoids alone can create an obstruction but when the issue of a flaccid tongue comes into play, then a more-serious obstruction may occur.
Children with DS may also have larger than usual soft palates that usually do not create obstructions but tend to cause snoring which is also a problem. When a child sleeps, their brain goes to sleep in different stages. A deep refreshing sleep is cycled in and out throughout the night but can be disturbed by the noise of snoring. This, or any noise, puts the brain in an “on notice” mode therefore inhibiting the ability to achieve refreshing and nourishing sleep. The child appears to sleep well but the brain never actually gets the rest it needs to function at peak performance.
Does your child have sleep apnea and does the CPAP or BiPAP machine seem to help?
(I will be updating Courtney's progress using the BiPAP machine.)
Here are some links to sleep apnea resources and information:
No comments:
Post a Comment