Obstructive sleep apnea (OSA) are episodes of partial or complete closure of the upper airway occurring during sleep and lead to respiratory failure. Symptoms include snoring and sometimes restless sleep, night sweats and morning headaches. Complications learning or behavioral disorders, growth disorders, pulmonary heart disease and pulmonary hypertension may include. Diagnosis is made by polysomnography. The treatment is mostly a Adenotonsillectomie.
The prevalence of OSA in children is about 2%. The disease is underdiagnosed and can lead to serious complications.
Obstructive sleep apnea (OSA) are episodes of partial or complete closure of the upper airway occurring during sleep and lead to respiratory failure. Symptoms include snoring and sometimes restless sleep, night sweats and morning headaches. Complications learning or behavioral disorders, growth disorders, pulmonary heart disease and pulmonary hypertension may include. Diagnosis is made by polysomnography. The treatment is mostly a Adenotonsillectomie. The prevalence of OSA in children is about 2%. The disease is underdiagnosed and can lead to serious complications. Etiology Risk factors for OSA in children include the following: Enlarged tonsils or adenoids obesity (now the most common cause) Craniofacial anomalies (eg micrognathia, retrognathia, hypoplasia in the middle face, excessively angled base of the skull.) Certain medications (eg. sedatives, opiates) mucopolysaccharidosis disorders, hypotension or hypertension cause (z. B. down syndrome, cerebral palsy, muscular dystrophy) possibly genetic factors (eg. as congenital central hypoventilation disorders that can include obstructive and central apnea, and possibly Prader-Willi syndrome and other) symptoms and complaints For most affected Ki countries, falls to parents on the snoring. But it may be that snoring is selbt then not reported when the OSA is severe. Other symptoms sleep a restless sleep, night sweats and an observed apnea may include. The children can have nocturnal enuresis. Symptoms and complaints on the day include nasal obstruction, mouth breathing, morning headaches and difficulty concentrating. Excessive daytime sleepiness is less common than in adults with OSA. Among the complications of OSA learning and behavioral problems, pulmonary heart disease, pulmonary hypertension and growth disorders can include. It may be that an investigation installed or no anomalies that open anatomical face, nose, or mouth abnormalities are found that contribute to the obstruction, an increase of pulmonischen component of the second heart sound or stunting. Diagnostic polysomnography with oximetry and end tidal CO2 monitoring OSA is considered in children with snoring or risk factors. If symptoms of OSA are present, diagnostic tests are done in a sleep laboratory, where is used overnight polysomnography, which includes oximetry and end tidal CO2 monitoring. A polysomnography at home is under evaluation. Polysomnography can help in confirming the diagnosis of OSA, but the diagnosis also requires that the child has no heart or lung disease that could explain the polysomnographic abnormalities. An analysis of sleep stages and the impact of position during polysomnography may also help view the article in the obstruction of the upper airways. Thus can help to determine the initial treatment (eg. As ongoing CPAP with auto-titration or oral or surgical devices) the results of polysomnography. Patients with OSA are evaluated based on the clinical judgment with other tests. Among the other tests ECG, chest x-ray, ABG and imaging may include upper respiratory tract. Therapy adenotonsillectomy or correction of congenital micrognathia Sometimes CPAP and / or weight loss A Adenotonsillektomieist generally effective in children who are otherwise healthy and enlarged tonsils and / or adenoids. An adenoidectomy alone is not usually effective. The risk of perioperative airway obstruction higher in children with OSA than in children without OSA, which are subjected to adenotonsillectomy. This close monitoring is important. For children who are otherwise healthy, have the complex anatomical abnormalities, genetic conditions that alter the control of the airways, or cardiopulmonary complications, a doctor who has experience in the treatment of OSA in children should be consulted. An adenotonsillectomy can be effective or give some relief. Depending caused by the anatomical anomaly, the OSA, an alternative surgical procedure can be indicated (z. B. Uvulopalatopharyngoplastie, operations on the tongue or in the middle face). CPAP can be applied to children who are not candidates for surgical correction or continue to have after a adenotonsillaren operation OSA. A weight loss can reduce the severity of OSA in obese children and has other health benefits but is rarely as monotherapy adequate treatment for OSA. A nocturnal O2 supplementation can help prevent hypoxemia until the final treatment can be achieved. Corticosteroids and antibiotics are not indicated in the rule. Summary Risk factors for OSA during childhood include anatomical cause obesity (including craniofacial) abnormalities, genetic abnormalities, substances and disorders hypertension or hypotension. Learning and behavioral problems are potentially serious complications. OSA in childhood is diagnosed by caregivers confirmed symptoms and the results of polysomnography due. The anatomic causes of obstruction can be corrected (for. Example, by Adenotonsillectomy or correction of the micro-Genie). CPAP and / or weight loss should be considered when surgery is not indicated or is not completely effective. More information American Sleep Apnea Association Stop Bang Questionnaire