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How To Prevent Sleep Apnea In Babies

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Sleep Apnea In Babies: Causes Symptoms And Treatment

What if we could prevent infant apnea?

The magic of getting a newborn in hand is just beyond words. Everything seems so new and strange in the first few months. But then, sometimes, a few mothers start facing issues with the sleep pattern of the babies. It is important to understand sleep apnea in babies. Few babies sleep for a long time while there are others who are disturbed with their sleep.

This disturbance during sleep can be due to sleep-related breathing disorders in babies. It is not as simple as it sounds. If not discovered in time, it can cause various complications. A partial reduction in breathing that occurs during an infants sleep is called hypopnea. On the other hand, complete pauses in breathing are called apneas. In this article, we will speak about the symptoms, causes, and treatments.

What Are The Signs Of Sleep Apnea In Babies

Its important to know the signs of sleep apnea in babies.

If your baby is making grunting or snoring sounds while sleeping, has pauses during breathing for 15 seconds at a time, and/or wakes up gasping after these episodes it could be an indication that they have this condition.

How common are cases? Its estimated to affect about one out every five hundred babies.

Tips For Getting Better Rest With Sleep Apnea

Choosing the right pillow can help those with sleep apnea get better rest, but there are many other factors worth exploring. In addition to practicing good sleep hygiene and finding the best mattress, there are some practices that those with sleep apnea should pay close attention to.

Using a CPAP ProperlyFor those who have been prescribed CPAP therapy, using the machine nightly is very important. Various small steps can help improve the efficacy of the machine, including ensuring the mask fits properly and washing your face before putting on the mask.

Cleaning CPAP ComponentsEnsuring that the CPAP components are cleaned frequently is important for safety, sleep quality, and general hygiene. CPAP masks, in particular, require frequent cleaning in order to reduce the buildup of body oils. A clean CPAP mask will provide a tighter seal, reducing the risk of air leaks.

Working With a DoctorSleep apnea is a long-term condition for many sleepers, and its severity can change over time. Family doctors and sleep specialists can tailor recommendations to each patient. For example, they may customize pressure settings on CPAP units based on your needs. Patients should make appointments with a sleep specialist every few years, particularly if sleep issues arise.

Maintaining a Healthy WeightBodyweight can have a substantial impact on the severity of sleep apnea symptoms. Excess weight, particularly near the throat, can cause airway restriction and other breathing issues.

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How To Choose A Pillow For Sleep Apnea

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The pillow you choose will affect your comfort and quality of rest. For CPAP users, a quality model can reduce the frequency of mask air leaks and uncomfortable pressure on the face. Factors such as support, pressure relief, loft, and firmness all affect the overall performance of a pillow, so shoppers should carefully consider them. For those with sleep apnea, aspects such as contouring, pillow shape, and CPAP-specific design features should also be kept in mind.

Is Sleep Apnea Common In Babies

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Infants born prematurely that are smaller in size are more likely to have infant sleep apnea. However, it has also been found in larger preterm or even full-term infants.

Sleep apnea occurs in less than four percent of babies under the age of six months. During the first month after birth, it occurs in 84 percent of infants who weigh less than 2.2 pounds.

The main types of sleep apnea are:

  • Obstructive sleep apnea, the more common form that occurs when throat muscles relax
  • Central sleep apnea, which occurs when your brain doesnt send proper signals to the muscles that control breathing
  • Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, occurs when someone has both obstructive sleep apnea and central sleep apnea

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What To Consider When Purchasing A Sleep Apnea Pillow

The following criteria can influence the performance, comfort, and quality of a pillow, so theyre worth assessing when shopping for new pillows. There are many pillow options on the market, but sleepers can easily narrow down their options by focusing on the factors that are most important for those with sleep apnea.

Sleeping PositionSleeping position has a substantial effect on pillow performance, particularly for CPAP users. Side and stomach sleepers often experience pressure from their mask pushing into the pillow, which can cause both discomfort and air leaks. Those who sleep on their side or stomach may benefit from a CPAP pillow with indents or cutouts to accommodate their mask, while back sleepers can also utilize cervical and wedge pillow designs.

ShapeThe shape of a pillow and how well it retains its shape are important considerations for those with sleep apnea. Side sleepers often prefer contoured designs, which can comfortably accommodate the shoulders and neck. Specialty shapes, such as wedge pillows and CPAP pillows, are also worth considering for certain sleepers. CPAP pillows allow space for the mask and hose, making them popular with side and stomach sleepers, while wedge pillows elevate the upper body, which may appeal to back sleepers.

SupportSupport measures how well the pillow holds up the neck and head and keeps the spine aligned. Some materials, like polyfoam and memory foam, tend to be more supportive than others.

What Causes Obstructive Sleep Apnea In Children

There are several causes of obstructive sleep apnea in children:

  • Enlarged tonsils and adenoids: A widely recognized risk factor for childhood OSA is enlarged tonsils and adenoids. Tonsils and adenoids are glands located at the back of the throat and are part of the immune system. The tonsils and adenoids may be enlarged due to genetics, frequent infections, or inflammation. When enlarged, these glands constrict the airway, making breathing during sleep more difficult.
  • Childhood obesity: OSA in children is also frequently caused by obesity, which also constricts the airway. Obstructive sleep apnea occurs in 60% of obese children.
  • Other risk factors: Other causes of OSA include having a small jaw or an overbite, the use of sedatives or opioids, and tongue and throat muscle weakness due to conditions like Down syndrome or cerebral palsy. Having nasal allergies, being around adults who smoke, and having a family history of obstructive sleep apnea are also found to be risk factors for childhood OSA.

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Diagnosing Sleep Apnea In Children

Experts at Hassenfeld Childrens Hospital at NYU Langone employ a variety of resources to diagnose sleep apnea in infants and children. Sleep apnea is a chronic condition in which breathing pauses from time to time during sleep as a result of a partial or complete blockage in the airway. These pauses can last for a few seconds or longer, interrupting normal breathing and sleep patterns.

Sleep apnea can occur at any point during childhood, from infancy through adolescence. It is most common in young children who have tonsillitis or adenoiditisenlargement of infection-fighting tissues in the back of the nasal cavity and throatcaused by infections or allergies.

When swollen, tonsils and adenoid tissue can block a childs small airways. Being overweight also increases the risk of sleep apnea in children, because extra tissue in the airway can block air flow.

Children with unusual facial anatomy, such as small nostrils, a cleft lip or palate, a small jaw, or choanal atresiain which the cartilage that separates the nasal passages doesnt form properly during the babys developmentmay have difficulty breathing through one or both nostrils. In most instances, choanal atresia causes a blockage in only one nostril. However, in infants with a blockage in both nasal passages, the condition can be life threatening.

Neuromuscular disorders, such as cerebral palsy or muscular dystrophy, allow the tongue to fall back into the throat, blocking the airway.

What We Can Do

How To Stop Snoring and Sleep Apnea in Children – Dr Paulose FRCS (ENT)

Even though we may not know what causes your baby’s breathing pauses, there are some things we can do to help prevent complications. We can:

  • Give your baby medicine to reduce the breathing pauses.

  • Teach you how to make your babys environment as safe as possible.

  • Teach you what to do if your baby stops breathing at home.

  • In very rare instances it may be necessary to place your baby on an apnea monitor to detect pauses in breathing. Although the monitor is placed to detect both apnea and bradycardia, it does not cure apnea and may not prevent SIDS or death.

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What Is Pediatric Sleep

A child can stop breathing during sleep if something is blocking their air flow. This causes oxygen levels in the body to fall, triggering the brain to wake and take a breath. This condition is known as obstructive sleep apnea . It may happen for a few seconds at a time and occur multiple times during a sleep cycle. This disorder can be dangerous and lead to complications, including behavioral, heart, and lung problems, or in rare instances, it can be life-threatening.

Obstructive Sleep Apnea Treatments

The first line of treatment for obstructive sleep apnea is a change in lifestyle changes. Reducing alcohol intake, losing weight, quitting smoking, and avoiding sedative medications are all starting points for treating sleep apnea . However, lifestyle modifications do not always resolve the issues therefore, one or more of the below options are considered in treatment plans.

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Sleep Apnea Oral Appliances

Splints or other oral appliances are sometimes used in conjunction with other obstructive sleep apnea treatments. Patients often prefer them because they are less âinvasiveâ than CPAP, but sometimes they do not work as well. These splints are mouth guards that keep the passages open and protect the teeth and gums. It holds the lower jaw down and forward to keep it in a more forward position, while simultaneously holding the tongue further away from the airway.

Sometimes, modifying airway anatomy is necessary to treat obstructive sleep apnea symptoms. These types of surgeries will vary depending on the cause of the condition and the patientâs anatomy. The various operative procedures include:

  • Tonsillectomy and adenoidectomy
  • Nasal surgery such as turbinectomy or straightening a deviated septum
  • Reduction or removal of uvula or soft palate
  • Reduction of the size of the tongue base
  • A procedure that surgically moves the jaw forward, pulling the tongue away from the back of the throat
  • Hyoid suspension, where one of the neck bones is pulled forward
  • Bariatric surgery for morbidly obese patients

What If I Dont Treat My Sleep Apnea

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Sleep apnea can be a serious condition. If left untreated, it can cause a number of complications and health problems due to decreased oxygen levels and increased inflammation. Some of these can be life-threatening.

Sleep apnea increases the risk of several health problems, including:

  • Asthma
  • Atherosclerosis
  • Atrial fibrillation

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How Is Obstructive Sleep Apnea Treated

When obstructive sleep apnea is mild, doctors might check a child’s sleep for a while to see if symptoms improve before deciding on treatment.

When big tonsils cause sleep apnea, doctors will refer families to an ear, nose, and throat doctor . The ENT might recommend:

  • removing the tonsils
  • removing large adenoids

These surgeries often are effective treatments for obstructive sleep apnea.

For other causes, a doctor may recommend continuous positive airway pressure therapy. In CPAP therapy, a person wears a mask during sleep. The mask may cover the nose only or the nose and mouth. It’s connected to a machine that pumps air to open the airways.

When excess weight causes obstructive sleep apnea, it’s important to work with a doctor on diet changes, exercise, and other safe weight-loss methods.

Is Obstructive Sleep Apnea A Recurring Disorder

Patients with untreated obstructive sleep apnea have a higher recurrence of atrial fibrillation after cardioversion than patients without a polysomnographic diagnosis of sleep apnea. Appropriate treatment with CPAP in Obstructive Sleep Apnea in children is often related to lower recurrence of atrial fibrillation.

Weight gain is one of the most critical factors of relapse of obstructive sleep apnea after medical therapy. Also, in patients who were using CPAP, recurrence was noticed when they tried to withdraw the device. In 70% of the cases, obstructive sleep apnea recurred after five nights of CPAP withdrawal. Upper airway collapsibility and neuromuscular tone, pharyngeal edema and infection, nerve breathing drive, sleep phases, and posture may perform a part.

In addition, according to a new study Obstructive Sleep Apnea in children increases the risk for Pulmonary embolism recurrence. Aging, lack of exercises and overweight problems are few of the underlying conditions causing the relapse of recurrence of obstructive sleep apnea.

Although achieving and sustaining weight reduction are challenging, the outcomes are very helpful when children can do so. Besides, following a better lifestyle and effective home remedies can help prevent and manage the condition.4,5

  • Pediatric obstructive sleep apnea Symptoms and causes
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    What Are The Ways To Prevent Obstructive Sleep Apnea In Children

    Sleep apnea is a serious and sometimes life-threatening condition because it continuously affects the ability to sleep well thus resulting in severe health hazards when left untreated. A new study states that losing your fat or maintaining a healthy weight can alleviate symptoms of obstructive sleep apnea.

    Early identification and therapy are vital to prevent problems that can influence childrens development, cognitive advancement, and performance. The primary cause of obstructive sleep apnea is overweight or obesity problems. Clinical studies show that 60% of obese children are diagnosed with this disorder and are typically characterized by snoring, recurrent partial or complete obstruction of the upper airway.1

    Therefore, when you are exploring ways to prevent or stay away from this condition there are few things that need to be taken into consideration

    Maintain A Healthy Weight Parents find themselves in a difficult and confusing position when they are told their child needs to lose weight when he/she diagnosed with health complications. Obesity and extra weight are harmful to almost EVERY organ in the body. Being overweight can lead to many diseases, including heart disease, diabetes, high blood pressure, stroke, asthma and even some types of cancer. To help your kid sustain a healthy weight, help them stabilize the calories they eat from diets and drinks with calories exhausted through physical activity and normal growth.

    Sleep Apnea Causes And Risk Factors

    How do I know if my child has sleep apnea? | Sleep Apnea in Children – Nina Shapiro, MD

    While anyone can have sleep apnea, certain factors increase the risk:

    • Sex Men are much more likely to have sleep apnea than women, although after menopause, frequency in women increases.
    • Older age While sleep apnea can occur at any age, it is more common as you get older. According to the Wisconsin Sleep Cohort study, its prevalence peaks when people are in their 50s and 60s and then plateaus.
    • Weight The risk of sleep apnea is much higher in those who are overweight, and higher still in those who are obese.
    • Anatomical differences Physical attributes that can contribute to sleep apnea include a small upper airway, a small or receding jaw, a long soft palate, a high tongue position, a deviated septum, and enlarged tonsils and adenoids.
    • Smoking According to a study conducted by Center for Tobacco Research and Intervention, University of Wisconsin, Madison, smokers are three times more likely to have sleep apnea than those who have never smoked.
    • Neck circumference greater than 17 inches in men or 16 inches in women.

    Allergies or other medical conditions that cause nasal congestion and blockage can also contribute to sleep apnea.

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    Ontogeny Of Sleep Architecture And Arousal

    Wulbrand and colleagues studied arousal in normal infants in response to airwayocclusion, and observed that all challenges resulted in astartle characterized by neck extension, EMG activation, and heart rateacceleration an augmented breath was consistently present and only 45% of occlusions demonstrated cortical arousal,although most were less than 3 seconds in duration . However, this sequence of movements may be ineffectiveat uncovering the face or result in a more obstructed facial position . In response to spontaneous airwayclosure during sleep, only 18% of NREM and 12% of REM sleep obstructions terminatewith EEG arousals . Even in the absenceof cortical arousal, startles and augmented breaths have been observed totemporarily interrupt spindle activity, suggesting involvement of thalamic neurons. Also, augmented breaths ininfants are associated with marked increases in pharyngeal dilator activity . Thus, the preponderance of data supportsthe concept that airway opening mechanisms in infants are primarily a function ofbrainstem reflexes, independent of cortical arousal. Sleep deprivation is associatedwith an increased arousal threshold that may impair ventilatory control mechanisms,resulting in increased obstructive sleep apnea . Infection seems to increase the arousal threshold as well as upperairway resistance, thus augmenting OSA in infants .

    Make Sure Your Mask Fits Correctly

    When it comes to CPAP therapy, one size does not fit all. Its very important to get a mask that fits correctly and is comfortable for you.

    There are many different types of masks available, including ones that cover the full face and ones that cover only the nose. Masks also come in a range of sizes, to accommodate different face shapes. There are also options that allow you to sleep in any position, accommodate glasses, and stay on if you toss and turn.

    Be sure to discuss your options with your doctor and schedule follow-up appointments to check the fit, evaluate your treatment progress, and adjust or switch your mask if necessary.

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