Totally off Topic - Sleep Apnea

[SledMamma]

AAAAAAAAAND maybe you don't have sleep apnea at all. Perhaps it is an anatomical issue- either just an unfortunate propensity towards snoring or else one that is more serious and needs to be corrected with devices, appliances, surgery, repositioning, laser treatment etc., It is best to know definitively, and the testing (although annoying) is free! Like gm3d said, he had no clue he suffered from it and none of the typical symptoms. I can't tell you how many patients get settled on CPAP machines and say to me that they had no clue they weren't sleeping for so many years. It's like the old COPD patients who come huffing and puffing through the doors of the hospital and when you ask if they feel short of breath, they say, "NO, why"? They have lived with it for so long it is normal... and then you get them on the road to treatment and they are amazed...

The drop in oxygenation for some people during an apneic even is downright scary when you see a summary of a testing session. The compensatory mechanism when your lungs are unable to provide oxygen by breathing is that your heart works harder to deliver that oxygen to your vital organs. Imagine the workload on a heart that is running full tilt while sleeping to overcome the lack of oxygen in your blood??? At 400-500 events per night, that is one overworked ticker (and this is at night, when your body's systems are supposed to be in a restful state)!! Now multiply that by the number of years that your body has silently dealt with the issue, unbeknownst to you?!?! Its no wonder the long-term effects are deadly. Trust me... you would rather know.

And, if you are right and you just snore like a freight train, then you can get your husband some earplugs and you can BOTH sleep easier

 

[malibumama]

Thanks for that info SM! A lot easier to understand than what the doctors throw down and I don't need a translator either.

Our son who is 5, only has "some apnea" but its the "sleep disordered breathing" that can be just as worrisome that bothers me. He does not sleep, is drenched with sweat, and is generally restless. Had a sleep study done and stops breathing around 7 times an hour and oxygen levels fall to 70%. He apparently gets very little REM and the doc says he is too little for a cpap machine? Is this common or should I be fighting a little harder to get one? He has history of severe acid reflux, aspiration and cleft 1 esophogus.

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[SledMamma]

Thanks for that info SM! A lot easier to understand than what the doctors throw down and I don't need a translator either.

Our son who is 5, only has "some apnea" but its the "sleep disordered breathing" that can be just as worrisome that bothers me. He does not sleep, is drenched with sweat, and is generally restless. Had a sleep study done and stops breathing around 7 times an hour and oxygen levels fall to 70%. He apparently gets very little REM and the doc says he is too little for a cpap machine? Is this common or should I be fighting a little harder to get one? He has history of severe acid reflux, aspiration and cleft 1 esophogus.

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Any CPAP machine will work for kids-- it is just a pressure applied to their airways to keep them from collapsing during inhalation and exhalation. Whether you are an adult or a child, the basic amount of pressure is 6cmH20 and ALL CPAP machines can provide that. (As a person gets larger, the amount of pressure needed to 'splint' the airway open increases) We even have them for the little tiny premature chicken wings in the NICU... The problem with children past infancy, once you find an in-between size mask, is getting the kids to successfully wear them. In my 8 years as an RT, I have seen two kids go home with CPAP units from the peds unit. Both of these children were severely handicapped and almost totally immobile as a result of the syndrome. In both cases, the CPAP was considered an interim measure to keep the children from dying in their sleep. I know: it is as awful as it sounds. (There is a reason that I am not a peds RT- I only go in there when I am paged: too close to home).

This is what a baby on a CPAP machine looks like (No, I didn't break the confidentiality of my patients by photographing them: this is my youngest when she was born 8 weeks premature)

The bigger issue is that in order for CPAP to work, you have to keep your mouth closed. Most kids, and alot of adults, can't do that. From infancy, a child is an obligate nose-breather. But, as a child grows, that changes and they become little mouth breathers!! You can get chin straps to hold the mouth closed at night and keep air from escaping, but this is extremely dangerous in children. If the child was to vomit (as we know they are apt to do), they would aspirate their own vomit and could potentially die, or suffer from a terrible chemical pneumonitis in their lungs. The incidence of aspiration grows higher with severe acid reflux issues like your little guy has. It grows even higher with the complication of cleft esophagus, because there is almost always a lack of smooth muscle and sphincter control as well as additional anatomical abnormalities that complicate the picture... cleft esophogus rarely appears as a single problem all by itself.

This is all a good way to say that CPAP is not common in children for lots of reasons. It is concerning that your sons Sp02 drops so low during sleep, and he may be eligible for nighttime oxygen to help counteract the problem. This is accomplished by having a nocturnal oximetry prescribed by your physician and administered overnight by a homecare RT. If the Sp02 drops below 80% for a specified amount of time, he would qualify for nocturnal 02 that is paid for by Alberta Health. This is worth looking into, in my opinion. That extra oxygen may help him to sleep better, and at the very least will help to lessen the workload of his heart during hypoxic periods.

I am curious how well controlled your sons acid reflux is? Is there any possibility that he would sleep with his head slightly elevated, as this often helps in kids with severe GERD. Also, has he had a radiographic swallow test performed recently? There could be more going on with him than just night sweats and restless sleep?? I feel for your predicament: you hate to subject your kids to invasive medical testing and just want them to "sleep like babies"... Keep asking me questions, I will definitely do my best to point you in the right direction.

 

[malibumama]

Ill PM you this weekend with some history SledMama. Maybe you can help point us in a better direction or at least we will know what to ask our doctors for.

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[SledMamma]

Ill PM you this weekend with some history SledMama. Maybe you can help point us in a better direction or at least we will know what to ask our doctors for.

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Sounds great!

 

[gm3d]

A worthwhile thread for sure! Awesome job Sledmomma. Hats off to you for being able to care for people. Takes a special person and not for everyone! Cheers!

 

[sunshinesmiles]

A worthwhile thread for sure! Awesome job Sledmomma. Hats off to you for being able to care for people. Takes a special person and not for everyone! Cheers!

Thanks gm3d.................I was tired of reading mumbo jumbo online and thought getting other people's real life stories would help me out. Sledmamma has certainly amazed and dazed me...........I love her input !!!! I see that I should get the testing done for sure !!! Which I will, everyone has helped me with that decisison, I have a son to live for !!! And nice to know for sure Alberta Health dosen't cover the CPAP Machine.... so I know what I'm up against and the cost !!! It's nice to hear the different stories of people's dealings with this issue..............as internet provides basic stats like over weight are more prone, blah blah blah.............my god malibumama's 5 year old suffers from this !!! Why's that kinda stuff not on the net, that kids and regular people can suffer !!!