Sleep Apnea: Babies Too

No, sleep apnea does not only affect adults. Today, Dr. Madiha El Lafi, an allergist who specializes in pediatric sleep disorders (ALBI), knows what she is talking about. With four children affected by the disorder (see box below), she faced real hurdles a few years ago due to her peers’ ignorance of the disorder. The situation made him aware of the shortcomings of childcare.

No, a child who snores like someone called his grandfather or his father is not normal.”

Determined to make things happen, I wrote a book in 2017, groundhog sleep (other versions reg’Art), since then available in a free downloadable app, “Sommeil de marmotte”. This has just been enriched with fun new physiotherapy exercises, games and videos, developed with Meryl Manoukian, Physiotherapist specializing in Maxillofacial Rehabilitation (New Bel Air Clinic in Bordeaux) and for her part the author of an adult book. No, a child who snores like someone called his grandfather or his father is not normal.”Dr. El Lafi, a pulmonologist, insists by training. Much less well-known than that of adults, sleep apnea in children is under-recognized and is common. “Prevalence is estimated at 2% to 5% among children but the numbers are underestimated.”says the specialist.

Sleep apnea, what is it?

Several acronyms are used to refer to this disorder: SAHOS (sleep apnea syndrome and hypoventilation), SAOS (sleep apnea syndrome) and in children, specialists talk more about TROS (obstructive respiratory disorders during sleep). In practice, the child snores, sleeps poorly (his sleep is disturbed) and his head returns to a state of hyperextension, often sweats upon waking and is tired. He may have interruptions (apnea) or decreased (hypopnea) in breathing during sleep that are diagnosed on sleep recordings. Due to upper airway obstruction, these pauses in breathing last for a few seconds (less than 10) in children, are prolonged in adults (10 to 30 seconds) and occur at least five times per hour and can repeat themselves a hundred times per night. This decrease or interruption of ventilation during sleep causes a lack of oxygen which causes the brain to respond, that is, to wake up to resume breathing. These awakenings are short-lived: we are talking about a “little awakening” that a person does not know about.

And if there are certain symptoms that are common with those of adults (snoring, heavy breathing, restless sleep …), then the consequences here have a different order. In adults, daytime fatigue and drowsiness come to the fore, but in children it is more related to mood disorders (irritability), behavioral disorders (hyperactivity) and also to more serious difficulties in school learning with sometimes significant repercussions. “Today, the treatment of these disorders is still very fragmented, between the intervention of an orthodontist, psychologist, otolaryngologist, and allergist, each specialist actually staying in his corner‘ says Dr. Lafi. Hence the idea, in addition to the help provided to parents and children through the book and the app, to also include a specialized care network, the Interdisciplinarité Enfant Adolescent Sommeil (IDEAS).

It was created with the support of Dr. Marc Sabine (Pulmonologist in Bordeaux) and three other doctors, Dr. Marie-Pierre Periol (Neurophysiologist in Lille), Catherine Lamplin (allergist in Lille) and Anik Andreu (Pediatric Pulmonologist in Bordeaux), “The purpose of this network is to direct the parents of these children to interested and trained professionals.”Dr. Lafi explains. On the site there are pages dedicated to professionals, eg training and other practical pages, dedicated to parents, explaining mechanisms and support. The specialist should continue:I’m actually trying to piece together what I couldn’t find.”

It should also be checked in schools, Annick Andrew insists, to learn to me Teachers to detect warning signs, dark circles in the eyes, tired and often sick children. Doctors can also with simple questions asked to parents such as “Does your child snore? Is his sleep disturbed? Does he wake up at night” They first sort”.

There are treatments

Because solutions and remedies exist. Most often, it is based on co-management, depending on the case, between the otolaryngologist, orthodontist, physiotherapist and possibly a surgeon, in the case of removal of the tonsils and adenoids. Rarely, in severe cases, installation of a continuous positive pressure (CPAP) machine may be necessary for a few months or years.

A message to remember anyway:He should Moving away from the idea that this disorder is rare in children and it is important to think about it.” Dr. Lafi concludes. But, good news,”This interest in sleep, for example in children with asthma, not necessarily apnea, is better today than it was ten years ago, d . details. We are aware that nasal hygiene (daily washing with sea water), allergy management, and physiotherapy exercises to soothe the tongue, do not make it possible to cure asthma but to greatly ease the treatments”.

In complex cases, it is still essential to be able to access polysomnography, which is the only way to highlight periods of respiratory arrest. There are only two pediatric sleep units in France, in Paris (Robert Depres Hospital) and Lyon (Civil Hospitals in Lyon).

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