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Pediatric Sleep Disorders
Every parent is familiar with the dangers of SIDS and most breathe a sigh of relief once their babies pass their first birthday, generally accepted as the end of the SIDS danger period. However new studies are showing that children are susceptible to
sleep disorders such as obstructive sleep apnea (OSA) throughout their lives.
Sleep Apnea in Children
OSA is a condition where a sleeper stops breathing when the airway becomes obstructed by soft tissues. Although this condition is most common among overweight, middle-aged patients it is present in all age groups and body types. It is not common among children – studies estimate 2% to 3% of children have it – the long-term consequences are severe enough that it is not something that should be ignored.
Sleep disorders in children can have short-term effects such as sleepiness or hyperactivity, but it’s the long term effects that are of concern. Children do most of their neurodevelopment during sleep and those that suffer sleep disruptions may show cognitive delays later in life.
The Challenges of Pediatric Diagnosis and Treatment
Sleep disorders often manifest themselves in children differently than adults. For example, adults with OSA are usually sleepy during the day – not a surprising result. Children often are not sleepy and in fact may be hyperactive which can lead parents to feel that lack of sleep is not a serious issue.
A sleep laboratory with a history of treating adult patients may not have the expertise to properly diagnose or treat children. The diagnosis of the pediatric patient requires more time and effort than the adult patient so many sleep labs won’t serve children.
Although there are a growing number of pediatric sleep specialists, they are still rare and will remain so for many years. A recent survey showed only 116 board-certified pediatric sleep specialists in the entire United States.
Are CPAP Machines the Answer?
The traditional treatment for adult OSA is the Continual Positive Airway Pressure or
CPAP machine. The patent wears a mask while sleeping which allows a stream of air to be introduced into the airway. This is normal room air not pure oxygen. The air is at a slightly higher pressure, titrated to the exact pressure the patient needs, and the pressure holds the airway open to allow even breathing and restful sleep.
Until recently, this technology was not available to children. As public and professional awareness of pediatric OSA has increased, so have the treatment options.
ResMed was the first company to offer a pediatric CPAP machine, the VPAP III ST-A. This machine is limited to patients at least 7 years old or weighing at least 40 pounds.
Still, it’s a start. More pediatric specialists are appearing and more child-sized equipment is in development as well. Physician awareness is still low in many areas and parent often have to be advocates to ensure their children get the help they need.
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