Sleep apnea in children: how to treat?

What is Sleep Apnea?

l’sleep apnea is defined by a partial or total upper airway obstruction of the child, at night, during his sleep. Result: for a few seconds, several times a night, there is a pause in breathing.

l’sleep apnea touch between 2 and 5% of the children.

What are the symptoms of sleep apnea in children?

A distinction is made between symptoms that are present during the day and symptoms that occur at night. “We always think about snoring, but a child should not snore and suffer from sleep apnea,” says Dr Madiha Ellafi, a pulmonologist-allergist. This is why the combination of one or more day and night factors should alert parents and prompt them to see a doctor for verification. »

Daytime Symptoms

“Here are the signs that a sleep apnea and what we as parents should pay attention to »says the allergist-pulmonologist.

Your child has trouble standing up the morning. He is grumpy and still tired.

• He complains of a headache upon waking.

• He is hyperactive, he cannot concentrate.

• He is muti-dys (dysorthographic, dyslexic, dyscalculia).

• He has concentration problemsattention, memorization in school.

• He has a fail to thrive.

• He is aggressive with his siblings, his classmates.

Nocturnal Symptoms

• Your child suffers from snoring.

• He has a restless sleep.

• Him sleep with your mouth open.

• He sweats a lot.

• He suffers from parasomnias (sleepwalking, nightmares, nightmares).

• Him gets up at night to drink.

What Causes Sleep Apnea?

“The causes of sleep apnea in children are many”, warns Dr. Ellafi.

allergy

“The main cause ofsleep apnea in small children is respiratory allergy, explains Dr. Ellafi out, and especially for mites. It is one of the first allergens that babies encounter. It could also be a food allergy with an intolerance to cow’s milk proteins. »

The increase in the volume of the tonsils and tonsils

If it is normal, in case of infection, to almonds grow, the latter, once the disease is cured, must regain their size. ” In case of’sleep apnea, the tonsils remain large between two infections because they are overstimulated by various factors, says the allergist-pulmonologist. Whether it’s allergies, indoor and outdoor pollution, but also genetics, morphology. »

overweight

This is not the most common cause. Frequent. However, “overweight is a growing risk factor”warns Dr. Ellafi, especially with ‘coca babies’. » You should know that the gain of a few extra pounds in children also affects a few extra grams in the tongue and can cause an obstruction of the airways at night because it is soft and goes backwards.

The Warning Signs

There is a typology of children who can be suspected of having a syndrome of:sleep apnea. How to recognize them? dr. Ellafi describes them as follows: “It is a child with an adenoid face, that is, elongated, always or often open his mouth (he breathes through his mouth), fine nostrils, pale skin and dark circles. »

Who to consult?

If the parents suspect that sleep apnea with their child, they should first consult their pediatrician or attending physician. He can refer them to an ENT specialist, a lung specialist, an allergist.

For a long time, the only treatment was surgery. “Today, the approach is multidisciplinary with long-term management with the goal of clearing the airways and giving the child a restorative sleep »specifies the allergist-pulmonologist.

Treatment depends on the child’s history after questioning about his/her history. “An ENT assessment with a nasofibroscopy is essential”says Dr. Ellafi. This examination makes it possible to see whether the nasal mucosa is of the allergic type or not, to distinguish the turbinates, the vegetations and to appreciate the full volume of the tonsils.

• If the child is breathing with reflux, the treatment will be that of gastroesophageal reflux. It is accompanied by advice on food hygiene: “a bottle in the evening is not recommended from the moment the infant has switched to solid food, i.e. between the age of 4 and 6 months”specifies the allergist-pulmonologist.

• The pacifier should also be avoided.

• A dust mite bedding is recommended.

• A musculo-fascial rehabilitation (tongue physiotherapy) by a physiotherapist or speech therapist may be necessary to restore the proper functioning of the tongue.

• A Orthodontic treatment can be considered, generally from 7 – 8 years old, “when the first permanent teeth appeared”the doctor says. Before it’s too early when there are only baby teeth.

• A adenoidectomy or a tonsillectomy with enlarged tonsils it may be necessary. “This is the case when their congestion is greater than 50%. Below that, we recommend daily nasal cleansing to unclog the airways”explains Dr. Ellafi.

• The non-invasive continuous positive airway pressure ventilation (PPC) is recommended in case of severe apnea. “It has a great advantage to equip children, warns the pulmonologist-allergist. Effectiveness is observed from the first nights. All you need to do is give the child the necessary explanation and ask him to keep his mouth shut so that there are no air leaks. »

Diagnosing and Treatingsleep apnea early in the child, especially ensures that the child can sleep well. This limits the risk that the latter will be too severe in adulthood and lead to complications. “It is therefore recommended that children who have suffered from apnea be vigilant as they grow up and do not hesitate to consult in case of return of symptoms”advises Dr. Ellafi.

Organizations to help

• French Association for Sleep Apnea and Orthotics: 23 rue Vernet, 75008 Paris.

• Sleep Apnea Alliance: 8 rue Tronson du Coudray, 75008 Paris.

• Respiratory health France: 115 rue Saint-Dominique, 75007 Paris.

An app for kids

“A Marmotte Sleep” was created by Dr Madiha Ellaffi. This smartphone application dedramatizes the disease thanks to its playful universe. This application provides therapeutic education for children as well as maxillofacial rehabilitation exercises.

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