Usually kids are fully awake within minutes of waking up.
Does your child drag himself around the first half hour or
more of the morning instead of having the bounce the others
have? Do you have a child whom you know spends plenty of time
asleep but still is tired in the day, falling asleep at
unusual times, especially as soon as he gets into a car? If
so, it may be worth considering getting a fuller assessment.
The child might have Sleep Apnea.
What is Sleep Apnea?
Sleep Apnea is a sleep disorder which involves brief
interruptions of breathing during sleep. This means that
while the person is sleeping, he actually stops breathing for
a short while. When this happens, the oxygen levels in the
blood drop dramatically. When the breathing stops for about
ten seconds, the brain sends a signal which (so to speak)
pushes a panic button, and the person partially wakes up
while struggling for breath. After the person gasps a deep
breath, he will then continue to breathe normally until the
next episode. People with sleep apnea can stop breathing many
times in the night, constantly waking to take breaths, while
in the morning they will have no recollection of any of this
happening.
Symptoms
The main symptom for this disorder is tiredness. The person
rarely falls into a deep restorative sleep that leaves him
refreshed. Instead, they wake up feeling tired and lethargic,
the same way you might feel after a night being woken many
times by a baby. This will cause them to feel sleepy during
the day. As you might know, tiredness, especially in
children, will then lead to many other problems, both
behavioral and in concentration and performance. They may
have headaches in the mornings, be forgetful, irritable or
experience mood changes.
Causes of Sleep Apnea
There are two main causes of breathing disturbances during
sleep. One is due to some obstruction in the airway and is
called Obstructive Sleep Apnea. The most common obstruction
in this case is the soft tissue at the back of the throat,
which relaxes and falls across the breathing tube, the
trachea. However, sometimes there is some sort of flap, or
extra bit of skin, that can obstruct the passage, a condition
called a 'floppy larynx.'
The obstruction often also causes unusually loud snoring or
night breathing, and this is often a symptom of Obstructive
Sleep Apnea (especially in adults). The other cause of Apnea
is that the part of the brain that controls breathing is in
some way acting irregularly during sleep. This is called
Central Sleep Apnea. Most people with Sleep Apnea will have a
combination of both types.
Diagnosis
If you suspect your child may suffer from this disorder, you
could try to simply watch him while he sleeps. Remember to
watch the stomach and chest, as it is often the stomach that
rises and falls when breathing, not the chest, (and this is
very normal and okay). If you watch the child carefully as he
sleeps, you might see if he stops breathing, because the
movement stops. If this happens, you will then see that after
a few seconds, the child will suddenly take a deep breath. If
you do see this, then it is worthwhile, if you can, to take a
record of how often he stops breathing and for how long. This
information can be useful to the doctor to help him make an
accurate diagnosis.
Sometimes children breathe in such a light and shallow way
that it is difficult to visually tell what is happening. It
may be that the child does not actually stop breathing, but
that each breath is partially obstructed, preventing a full
amount of air from getting into the lungs. In this case, the
child takes deeper breaths among other shallow ones, but
without actually stopping. You may also notice the nostrils
'flare,' that is, widen at the bottom. This is to allow more
air in, and is a sign that the child is not getting enough
oxygen. Another significant observation is to look at the
muscles between each rib. If the child breathes pushing his
chest right out, while these muscles pull in, making the ribs
stick out, it means that he is struggling to get air into his
lungs.
It is important to note that it is normal for very young
babies to occasionally stop breathing — just because
they are so immature; this does not necessarily signify a
problem or a danger. It would depend on the age and maturity
of the baby and the frequency and duration of the episodes.
If you have any concerns, you should mention them to your
doctor.
Treatment
It is important to treat Apnea, because besides the greatly
reduced quality of life for the sufferer, it is also
associated with a higher risk of heart problems. The
treatments available will depend on the severity of the
episodes, and the type of Apnea causing them.
There are some very effective surgical procedures which
remove tissue that is causing the obstruction. Others will be
helped by pillows which stop the person from sleeping on his
back. There is also a special facemask which can be worn,
which is attached to a machine, and gently forces air into
the lungs throughout the night. People who have been helped
with this and other methods report a dramatic increase in the
quality of their lives and their productivity. Remember a
child is used to the way he is, and he does not realize that
others are not feeling what he feels, and they may not even
be aware that what he is feeling is exhaustion.
Apnea is more common in men than women, and is more common in
the overweight (so it is important to try to lose weight).
Not all sufferers have all the symptoms, and anyone who has
some of these symptoms should think about being more fully
evaluated by a doctor, as it is very often missed. In fact
many adults only discover after a lifetime of suffering that
they have this condition.
People don't think to go to the doctor to complain of 'just
tiredness' or 'snoring' (usually the spouse's or roommate's
complaint). The doctor will have no reason to think of it
unless the patient or parent specifically mentions the
relevant symptoms. It is one of those conditions that can
severely alter the quality of life, but which are relatively
easy to diagnose and treat, and where you might say to
yourself . . . "If only we would have known earlier."
