breathing habit

8/14/2019 Breathing Habit

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Apnea Breathing Type

Everyone has brief pauses in his or her breathing pattern called apnea. Usually these brief stops in

breathing are completely normal. Sometimes, though, apnea or other sleep-related problems can be a

cause for concern.

Types of Apnea

The word apnea comes from the Greek word meaning "without wind." Although it's perfectly normal

for everyone to experience occasional pauses in breathing, apnea can be a problem when breathing

stops for 20 seconds or longer.

There are three types of apnea:

1. obstructive

2. central

3. mixed

Obstructive Apnea

A common type of apnea in children, obstructive apnea is caused by an obstruction of the airway

(such as enlarged tonsils and adenoids). This is most likely to happen during sleep because that's

when the soft tissue at back of the throat is most relaxed. As many as 1% to 3% of otherwise healthy

preschool-age kids have obstructive apnea.

Symptoms include:
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snoring (the most common)

labored breathing while sleeping

gasping for air

very restless sleep and sleeping in unusual positions

changes in color

Because obstructive sleep apnea may disturb sleep patterns, these children may also show continued

sleepiness after awakening in the morning and tiredness and attention problems throughout the day.

Sometimes apnea can affect school performance. One recent study suggests that some kids diagnosed

with ADHD actually have attention problems in school because of disrupted sleep patterns caused by

obstructive sleep apnea.

Treatment for obstructive apnea involves keeping the throat open to aid air flow, such as with

adenotonsillectomy (surgical removal of the tonsils and adenoids) or continuous positive airway

pressure (CPAP), which involves having the child wear a nose mask while sleeping.

Central Apnea

When the part of the brain that controls breathing doesn't start or maintain the breathing process

properly it's called central apnea. It's the least common form of apnea (except in very premature

infants, in whom it's seen fairly commonly because the respiratory center in the brain is immature)

and often has a neurological cause. An example of normal central apnea would be the short pause that

occurs following a deep a sigh.

Mixed Apnea

Mixed apnea is a combination of central and obstructive apnea and is seen particularly in infants or

young children who have abnormal control of breathing. Mixed apnea may occur when a child is awake

or asleep.

Conditions Associated With Apnea

Apnea can be seen in connection with:

Apparent Life-Threatening Events (ALTEs)

An ALTE itself is not a sleep disorder it's an event that's a combination of apnea, change in color

(bluish lips or face), change in muscle tone, choking, or gagging. Call 911 immediately if your child

shows the signs of an ALTE.
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ALTEs, especially in young infants, are often associated with medical conditions that require treatment

(such as gastroesophogeal reflux [GERD], infections, or neurological disorders). ALTEs are scary to

observe, but can be uncomplicated and may not happen again. However, any child who has an ALTE

should be seen and evaluated immediately.

Apnea of Prematurity (AOP)

AOP can occur in infants who are born prematurely (before 34 weeks of pregnancy). Because the brain

or respiratory system may be immature or underdeveloped, the baby may not be able to regulate his

or her own breathing normally. AOP can be obstructive, central, or mixed.

Treatment for AOP can involve the following:

keeping the infant's head and neck straight (premature babies should always be placed on

their backs to sleep to help keep the airways clear)

medications to stimulate the respiratory system

continuous positive airway pressure (CPAP) to keep the airway open with the help of forced

air through a nose mask

oxygen

Premature infants with AOP are followed closely in the hospital. If AOP doesn't resolve before

discharge from the hospital, an infant may be sent home on an apnea monitor and parents and other

caregivers will be taught CPR. The family will work closely with the child's doctor to have a treatment

plan in place.

Apnea of Infancy (AOI)

Apnea of infancy occurs in children who are younger than 1 year old and who were born after a full-

term pregnancy. Following a complete medical evaluation, if a cause of apnea isn't found, it's often

called apnea of infancy. AOI usually goes away on its own, but if it doesn't cause any significant

problems (such as low blood oxygen), it may be considered part of the child's normal breathing

pattern.

Infants with AOI can be observed at home with the help of a special monitor prescribed by a sleep

specialist. This monitor records chest movements and heart rate and can relay the readings to a

hospital apnea program or save them for future examination by a doctor. Parents and caregivers will

be taught CPR before the child is sent home.

If You Think Your Child Has Apnea
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If you suspect that your child has apnea, call your doctor. If you suspect that your child is experiencing

an ALTE, call 911 immediately.

Although prolonged pauses in breathing can be serious, after a doctor does a complete evaluation and

makes a diagnosis, most cases of apnea can be treated or managed with surgery, medications,monitoring devices, or sleep centers. And many cases of apnea go away on their own.
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