Dr. Supriya Jambhekar
Medical Director of the Pediatric Sleep Disorders Center at Arkansas Children’s Hospital and professor of pediatric pulmonology and sleep medicine at the University of Arkansas for Medical Sciences in Little Rock
What are the types of sleep apnea?
SJ: In sleep apnea, children repeatedly stop breathing while sleeping. In central sleep apnea (CSA), common in infants — especially premature — children stop breathing with no effort to start breathing. In obstructive sleep apnea (OSA), the upper airway closes intermittently during sleep causing breathing difficulty and disturbed sleep.
What causes sleep apnea?
SJ: CSA can be caused by immature control of breathing, like in premature babies, brainstem abnormalities, increased intracranial pressure, reflux, infection or medications, like sedatives. Causes for OSA include enlarged tonsils/adenoids, large tongue or uvula, small chin or flat midface (seen in craniofacial syndromes), obesity and abnormal muscle tone (seen in cerebral palsy and Down syndrome).
How is central sleep apnea diagnosed and treated?
SJ: Some CSA is normal for infants. Many outgrow it and establish a fairly regular breathing pattern by two to three months. Infants experiencing prolonged central apnea or with adverse effects will be tested with an apnea monitor in the hospital. If doctors discover an underlying cause, it will be treated.
How is obstructive sleep apnea diagnosed and treated?
SJ: An overnight polysomnogram or sleep study, determines OSA severity. Surgery can be an option. Children or infants can also wear a continuous positive airway pressure (CPAP) machine or bilevel positive airway pressure (BPAP) machine. As children grow, sleep studies can be repeated. Obstruction can resolve or become worse with time.
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