Sleep Apnea in 14 yr old

rbud · Post by **rbud** » Mon Feb 19, 2007 3:07 pm

My son was recently diagnosed with sleep apnea. Not sure of the cause, tonsils, past critical illnes, who knows. Anyway, he is currently using a cpap and it runs between 4 and 11 on the settings. It does not seem to be doing the trick. Doc said he didn't know if tonsillectemy would help. This is really affecting him at school. Any suggestions??????

Thanks to all.

Goofproof · Post by **Goofproof** » Mon Feb 19, 2007 3:13 pm

Join the forum, fill in your equiptment, and the pressure he uses and how you use the equiptment. CPAP is a set pressure, you tell us he is using two pressures. that's why we need to know more. Jim

rbud · Post by **rbud** » Mon Feb 19, 2007 3:15 pm

Thanks Jim. I will get more info. But his machine is actually adjustable pressure. His would fluctuate according to his need from a min. 4 to an 11 or 12. The doc said he was going to try a set pressure machine. But I will get more info. Thanks again.

roster · Post by **roster** » Mon Feb 19, 2007 3:17 pm

What type of doctors are advising you? Has he seen a good otolaryngologist (Ear-Nose-Throat doctor)? Especially one who has surgery experience with apnea patients.

rbud · Post by **rbud** » Mon Feb 19, 2007 3:19 pm

He is a Pulmonary/Critical Care Medicing/Sleep Disorder MD

Snoredog · Post by **Snoredog** » Mon Feb 19, 2007 3:20 pm

if it were my son, I'd take him to the best ENT you can find. Take a copy of the Sleep Study with you, have them examine the tonsils, palate, uvula etc. Much easier to get them out when they are young vs. old.

If you are close to Standford, I would take him there, they have some great surgeons there for sleep medicine.

14yrs old is too young to be on cpap for the rest of his life. There is a GA and MMA procedure which for many just about cures OSA. There is also a palatal advancement procedure where they cut right where the hard and soft palate meet, they remove about 1/8" of the bone from the hard palate and stitch the soft palate back to it. Healing and discomfort time is short.

Standford would be the place where they are up on the most advanced procedures.

Sleepy Dog Lover · Post by **Sleepy Dog Lover** » Mon Feb 19, 2007 3:22 pm

We still need more info, but it sounds like your son has an APAP. 4 is a really low starting pressure, and many people find it is too low for them to breathe easily. Has he had a titration done with a sleep study or is the doctor guessing at the pressure? Its possible that the 11 or 12 pressure isn't high enough. The last question is how long has your son been on the apap, and has he been keeping the mask on all night. For many of us, it takes a while to "catch up" on the sleep deprivation.

I will add one more thing, teens tend to nap a lot, it is really important to pap when you nap, not using a cpap when you nap can undo some of the good that has been done with cpap.

pidgeon92 · Post by **pidgeon92** » Mon Feb 19, 2007 3:24 pm

Is he very overweight? If so, losing weight should help.

rbud · Post by **rbud** » Mon Feb 19, 2007 3:26 pm

You all have given me a good starting point. He has been on it two weeks. You are right, sometimes he takes it off at night. He hates it. But right now there is no other choice. He sometimes removes it at night and probably doesn't ever realize he has done this. I appreciate all the info. This will help. I will get more info about the machine.

Thanks to all of you.

Sleepy Dog Lover · Post by **Sleepy Dog Lover** » Mon Feb 19, 2007 3:40 pm

Masks can be the most important part of therapy, and it is a personal decision. Talk with your equipment supplier and make an appointment so you son can try many different masks on (at pressure) and find the one that works best for him.

Wulfman · Post by **Wulfman** » Mon Feb 19, 2007 4:24 pm

If he's wearing a "nasal" mask (as opposed to a full face mask which covers nose and mouth), he's probably leaking air out his mouth. This is like no therapy at all. The two options are to either tape his mouth shut at night or get a full face mask.

In addition.....as someone else suggested......his bottom pressure is too low.

Best wishes,

Den

rbud · Post by **rbud** » Mon Feb 19, 2007 4:36 pm

He is only wearing the nasal mask. Not the full face mask. I didn't know that you had to keep your mouth shut (other than when my mom told me to ) when wearing the mask. That might help. Thanks for the info.

Julie · Post by **Julie** » Mon Feb 19, 2007 5:14 pm

If he naturally (prior to Cpap) sleeps with his mouth open, he can't control that when asleep, but may need a "full face" mask (same as a nasal, only longer, so it also just covers your mouth) which would alleviate the problem - he'll be able to continue mouth breathing, but benefit from Cpap rather than losing the benefits if he does it when sleeping with a nasal mask.

snoregirl · Post by **snoregirl** » Mon Feb 19, 2007 5:45 pm

I would get that machine off 4 for a low level. I can't breath at 4 (at least 6 would be more reasonable).

Wulfman · Post by **Wulfman** » Mon Feb 19, 2007 6:08 pm

AND......depending on which machine he's using, (specifically the REMstar Auto), there's a chance that there are some other things that might not be set up correctly. There's a feature in the REMstar Auto called "Ramp time setting" (also referred to as the "Split-night setting")......that if it is not set up correctly, could leave him at a pressure of 4 cm for up to 4 hours. In normal use, this setting needs to be set to 0's (zeros).

The REMstar Auto I'm referring to is the one pictured in my profile (below).

Den