Child with sleep apnea

[dojiscalper]

I have two daughters and one of them seems to sleep very normal and even gets out of bed at the appropriate times each day and gets ready for school without any trouble.
The other however is very hard to get moving in the morning and always has been even before she could walk, getting her changed and dressed to take to the babysitter was a huge chore that we didn't experience with the older child. Now she's 8 and we drag her out of bed every day and she doesn't get moving well until later in the day. They both get 8-9 hrs per night with good sleep hygiene.

We have been observing her and talking about finding a place to get a sleep study done.
I myself have had sleep apnea for as long as I can remember and didn't know it until recently as many people do. I don't want her to get to 40 yrs old before she's treated if she does need help.

Any thoughts from the experts are appreciated.

[D.H.]

I'm not from your part of the country, but I googled these:

http://www.ghschildrens.org/specialists ... -medicine/
https://www.palmettohealthchildrens.org ... eep-center
https://www.musckids.org/our-services/s ... rs-program
https://doctor.webmd.com/doctor/dominic ... e-overview

[palerider]

I have two daughters and one of them seems to sleep very normal and even gets out of bed at the appropriate times each day and gets ready for school without any trouble.
The other however is very hard to get moving in the morning and always has been even before she could walk, getting her changed and dressed to take to the babysitter was a huge chore that we didn't experience with the older child. Now she's 8 and we drag her out of bed every day and she doesn't get moving well until later in the day. They both get 8-9 hrs per night with good sleep hygiene.

We have been observing her and talking about finding a place to get a sleep study done.
I myself have had sleep apnea for as long as I can remember and didn't know it until recently as many people do. I don't want her to get to 40 yrs old before she's treated if she does need help.

Any thoughts from the experts are appreciated.

First, just ignore DH. he's our resident DME... sometimes he says things that are reliable and accurate, but it's not worth trying to find those amongst all the noise.

Second, yes, it's a great thing that you're jumping on this. You could try doing a home study, that'd probably be a lot easier to manage, own bed, familiar environment, (probably) lower cost.

[colomom]

My son had his first sleep study as a teenager, I often wonder if he had undiagnosed sleep apnea from an early age. Anecdotal, but your daughter's symptoms sound exactly like my son. Despite following a structured bedtime routine, practicing good sleep hygiene, and getting plenty of sleep for my son's entire life before CPAP he was impossible to wake up and was sleepy all the time despite getting in plenty of hours of sleep. That has all changed now that his sleep apnea is being treated, he now wakes up easily every morning and the daytime fatigue is gone.
You're wise to look into getting your daughter a sleep study. If she has sleep apnea treating it will save her from all kinds of problems down the road and if she doesn't have it that knowledge will put your mind at ease. If you were not aware the sleep apnea severity scale is different in pediatrics. For kids and AHI of 1-5 is mild, 5-10 is moderate, over 10 is severe. If your daughter does an in lab sleep study they will require one parent to spend the night there with her. If she does have sleep apnea they will likely recommend removing her tonsils and adenoids, that is the standard first line treatment for pediatric sleep apnea.

[zebras]

Schedule an appointment with an ENT doctor. Sleep apnea in children can be due to anatomical reasons.
One of the main causes is mouth breathing. It is absolutely crucial to identify these thing early and treat them as soon as you can.

[palerider]

Sleep apnea in children can be due to anatomical reasons.

Um... sleep apnea in anybody is due to anatomical reasons....

[Janknitz]

Try to find a sleep lab that specializes in pediatrics because testing kids is tricky and not all sleep labs are equipped to handle them. You may have to look at teaching hospitals at major universities.

While I agree with PR that a home sleep test might be easier, in the case of a child I think an in lab test might be more accurate because kids may have more than "run of the mill" obstructive sleep apnea, especially since the onset was from a very young age.

[dojiscalper]

She has a check up coming with her primary doctor in a few weeks. We are going to try to express our concerns again. Last time we got dismissed mostly which is no surprise to me.

[zebras]

Sleep apnea in children can be due to anatomical reasons.

Um... sleep apnea in anybody is due to anatomical reasons....

Alright. What I was trying to say:
Common cause of pediatric sleep apnea is mouth breathing. This could be caused by nasal congestion due to adenoids, turbinate hyperplasia, deviated septum, enlarged tonsils ... also jaw problems can cause it.

[ChicagoGranny]

Child with sleep apnea

Don't have a sleep study ... yet.

Zebras has it right. Your daughter needs to be seen first by a pediatric ENT. She will examine your daughter's airway. She will make an evaluation of the size and condition of the tonsils, adenoids and turbinates. She will check for a high, arched palate and underdeveloped jaw.

You should find an ENT who is very familiar with the causes of obstructive sleep apnea. Some cases of sleep apnea are solved by removal of enlarged tonsils or adenoids.

If the ENT does not find anything she can correct, then a sleep study would be the next step. You can find a board-certified doctor associated with an accredited sleep lab using this tool - http://sleepeducation.org/find-a-facility

Should your daughter be found to have obstructive sleep apnea and prescribed CPAP, there is another step that comes when she is a bit older. An orthodontist who is familiar with the causes of sleep apnea should examine her. It may be that some form of orthodontics, especially palate and jaw expanders, could be a cure for the condition.

Thank you for observing this and finding the forum. I hate to see children suffer.

I myself have had sleep apnea for as long as I can remember and didn't know it until recently as many people do.

Don't neglect your own health. CPAP has been wonderful for many of us!

[palerider]

Sleep apnea in children can be due to anatomical reasons.

Um... sleep apnea in anybody is due to anatomical reasons....

Alright. What I was trying to say:
Common cause of pediatric sleep apnea is mouth breathing.

Mouth breathing does not *cause* sleep apnea,

Sleep apnea often *causes* mouth breathing.

Unless you have some credible reference material.

[ChicagoGranny]

Mouth breathing does not *cause* sleep apnea,

Sleep apnea often *causes* mouth breathing.

Right. It's a symptom, not a cause.

[Gryphon]

Most of my life as a kid - I would walk around with my mouth slightly ajar - lots of mouth breathing all the time... My sinuses were always a mess. They still are but hey... I'm scared to have some cut happy surgeon play around inside my nose even if it might radically change my life for the better... Also could wreck it.

Some times you take the devil you know rather then the one you don't.

As for pediatric issues... I think having a full work up and assessment is a good idea. The kinds of things they can do for children usually have much better results and fewer bad reactions then with adults. IE: removing adenoids and tonsils etc... much faster recovery time in kids with fewer complications then with adults, usually.

They're finding all kinds of evidence linking sleep problems with childhood issues like ADHD or other learning issues. As you said - much better to find things out now and work to fix/treat them rather then find out about it 30-40 years down the road and go... "Ahhhh, well that all makes more sense now..."

Best of luck, Rest well.

Gryphon

[ChicagoGranny]

I'm scared to have some cut happy surgeon play around inside my nose even if it might radically change my life for the better... Also could wreck it.

You are very much underestimating the quality of surgical techniques that have been developed in the last 20 years. The risks have also been greatly reduced.

[zebras]

Sleep apnea in children can be due to anatomical reasons.

Um... sleep apnea in anybody is due to anatomical reasons....

Alright. What I was trying to say:
Common cause of pediatric sleep apnea is mouth breathing.

Mouth breathing does not *cause* sleep apnea,

Sleep apnea often *causes* mouth breathing.

Unless you have some credible reference material.

Dude, how does sleep apnea cause mouth breathing?
Mouth breathing is a risk factor for sleep apnea and often aggrevates it.
Things that cause mouth breathing in children also cause sleep apnea in children.
https://www.ncbi.nlm.nih.gov/pubmed/20963335
"It is well known that mouth breathing is associated with adenotonsillar hypertrophy - which is the main cause of obstructive sleep apnea among children. Despite the importance of this matter, there are only a handful of studies showing the relationship between OSAS and mouth breathing."

But whatever. Let's just claim whatever we feel like...