Short-term respiratory arrest in sleep in infants. How does apnea manifest in children: symptoms and causes of respiratory arrest in a dream

Julia Ivanovna Zhavinina
Nurse of the highest category in the functional diagnostics department
diseases of the nervous, muscular systems KGBUZ
Diagnostic Center of Altai Territory
656063 Altai Territory, Barnaul,
st. V.Kashcheeva d. 7, apt. 131 + 7-962-822-5225
[email protected]

Now I am turning to parents whose children hardly wake up in the morning, fall asleep in the classroom, and fight during breaks, snarl with teachers and poorly learn the school curriculum. Or maybe your heir has enuresis or does he speak in his sleep, suffer from nightly fears and sweat a lot? Dear mothers and fathers, I think in such cases you will lead your child to a neurologist, psychologist, psychiatrist, or even “treat” him to no avail with a belt. And if you notice that your child, against the background of his peers, looks small or is gaining weight, despite his diet and active lifestyle, then to the endocrinologist! I already hear your question: "What do you propose to do?" I suggest first to listen to how your child sleeps!

Did you know that 10-15% of children aged 2 to 8 years old snore in their sleep. How is snoring formed? During sleep, the muscles of the soft palate and the walls of the pharynx gradually relax. They begin to vibrate when passing a stream of air and create a sound phenomenon of snoring. But snoring is different! What happens if your child has enlarged tonsils, adenoids, the facial skeleton is deformed, or he suffers from allergic rhinitis, i.e. diseases accompanied by narrowing of the upper respiratory tract? Then a further deepening of sleep and a decrease in muscle tone leads at a certain moment to a complete decline in the pharynx and the development of an acute episode of suffocation, which leads to an awakening of the brain and, as a result, a deterioration in sleep quality. I have now described Obstructive Sleep Apnea Syndrome (OSAS), a serious, potentially life-threatening condition. In the morning, the child may complain of dry throat, headache. But not all snoring people have sleep apnea, although the risk of its development in snoring is much higher than in non-snoring.

Also, children often have central apnea - lack of air flow due to a temporary lack of impulse from the central nervous system to activate respiratory effort. This form of apnea occurs in children with impaired central respiration regulation mechanisms and requires serious and prolonged monitoring by specialists (neurologist, somnologist).

Severe forms of obstructive sleep apnea syndrome in children have sad consequences. In the deep stages of sleep, somatotropic hormone is produced, and with poor sleep, there are no deep stages of sleep, and the production of “growth hormone” is significantly reduced, so the child lags behind his peers in growth.

A decrease in blood oxygen saturation at night leads to a decrease in academic performance, as the attention and intelligence functions suffer. Obstructive sleep apnea syndrome in children causes learning problems due to hyperactivity and attention deficit, and if the child cannot learn normally at the age of 5-12 years, then it will be almost impossible to make up for this gap in the future.

Fluctuations in blood pressure during apnea change the hemodynamic system, which subsequently leads to the early development of cardiovascular diseases.

The activation of striated muscles that occurs by the time apnea is completed is a trigger for sleep congestion, drowsiness, and changes in intra-abdominal pressure provoke episodes of enuresis.

And if a child is diagnosed with attention deficit hyperactivity disorder, parasomnia, minimal cerebral dysfunction, nocturnal enuresis, then it is necessary to conduct a comprehensive sleep study - polysomnography. At the same time, oxygen saturation, snoring, excursion are recorded chest (which allows to differentiate obstructive apnea from central), sleep EEG indicators.

There is a method for diagnosing OSAS that is simpler, but quite accurate - this is pulse oximetry - a method of prolonged non-invasive saturation of hemoglobin in arterial blood with oxygen and pulse.

The diagnosis of obstructive sleep apnea syndrome is considered confirmed if 1 or more episodes of apnea-hypopnea per hour of sleep are recorded.

It is very important to consult a doctor on time and accurately establish the diagnosis, because Obstructive Sleep Apnea Syndrome (OSA) and primary snoring are treated. The doctor who deals with sleep problems is a somnologist. Such specialists work in many large medical centers. Treatment tactics depend on a combination of the causes and severity of snoring and OSA. The treatment methods are diverse, they can be divided into the following categories:

1) General preventive measures and situational relief of snoring:

weight loss;

provide sleep on your side, as during sleep on the back, tongue retraction occurs, especially in patients with facial skeleton deformation (retro- and micrognatia). To do this, sew a pocket between the shoulder blades on nightwear and put a tennis ball in it;

ensure the elevated position of the head. The elevated position of the body reduces the retraction of the tongue even in the supine position, and the fluid in the body shifts downward, which leads to a decrease in swelling of the mucous membrane at the level of the nose and pharynx and an increase in their lumen. But do not use tightly packed pillows! The head should be located as parallel to the body as possible, so it is better to use flat pillows or special contour pillows;

Muscle training tongue and lower jaw:

A. Pull the tongue forward and backward as much as possible. In the extended state, hold for 1-2 seconds and pronounce at that moment a lingering sound “and”. This exercise provides an increase in muscle tone of the soft palate and palatine tongue.

B. Press the chin with your hand and force the lower jaw back and forth. With this exercise, we train the muscles of the lower jaw, pushing it forward. Perform all 2 exercises 30 times in the morning and evening.

B. Strongly clamp with your teeth and hold for 3-4 minutes a wooden or plastic stick. Perform this exercise before bedtime, as This exercise causes tonic tension in the chewing and pharyngeal muscles, which lasts for 20-30 minutes, which significantly reduces snoring in the initial stage of falling asleep.

Use an ultrasonic humidifier in the bedroom. During the heating season in winter, humidity drops below 30% at optimal rates of 60%.

2) Relief of nasal breathing. To do this, you can use special nasal strips to expand the nasal passages of YurizRight.

3) The use of intraoral devices

4) The use of pharmacological agents that alleviate snoring. Nasonex Nasal Spray - locally tones, has anti-inflammatory and antiseptic properties. Nasonex is safe and approved for use in children from 2 years old.

5) The use of electromechanical booster devices - these are devices in the form of wristbands that pick up the sounds of snoring and send weak electrical or mechanical impulses that irritate the nerve endings on the arm and thus awaken the patient’s brain.

6) Surgical treatment of snoring and OSAS - elimination of obvious anatomical defects at the level of the nasopharynx. But it is necessary to carefully consider the benefits and potential risks of surgical treatment, so the decision to surgical treatment snoring and OSA should be taken by a qualified ENT surgeon.

7) The use of respiratory support device-CPAP therapy. This method is effective in severe forms of obstructive sleep apnea syndrome. The essence of the method is to maintain a constant positive pressure in the upper airways, which will prevent the walls of the airways from subsiding and vibrating.

Unfortunately, currently there is not enough available information about the effect of OSAS on the health of the child and little attention is paid to diagnosis. And, meanwhile, parents listening to the sleep of their angels can prevent serious complications, and timely access to a specialist will significantly improve the quality of life of the child.

Bibliography:

Obstructive sleep apnea syndrome and other sleep disorders. The course of multimedia lectures. R.V. Buzunov. - M., 2012

Syndromes of sleep apnea. A.P. Zilber. - Petrozavodsk, 1994 .-- p. 184

Obstructive sleep apnea syndrome. Yu.I. Feshchenko. L.A. Yashina et al. - Kiev, 2009

Snoring and obstructive sleep apnea syndrome in adults and children. Practical guide for doctors. R.V. Buzunov, I.V. Legeida, E.V. Tsareva. - M., 2012 .-- p. 121

Snoring and sleep apnea in pediatrician practice. M.G. Poluektov. - M., 2010.

For the correct and full development of the baby, his brain and other organs must receive a sufficient amount of oxygen. Regular nightly respiratory arrests that last more than 20 seconds can lead to hypoxia and even death. Therefore, pay attention to the child’s dream. If he snores, sleeps with his mouth open, is naughty, consultation with an otolaryngologist is necessary.

In newborns and older children in a dream, the time interval between inhalation and exhalation may stray. Distinguish between regular, irregular, periodic and pathological breathing, in which it is held from 20 seconds to 2 minutes.

Intermittent breathing in a child’s sleep is a sign of nocturnal apnea. This feature occurs due to the lack of tone of the upper palate and tongue. After exhalation, the pharyngeal walls close, a barrier is formed for oxygen to enter the body.

It's important to know! The episode of nocturnal apnea in children of all ages is respiratory arrest, in which there is no movement of the chest. For the entire period of sleep, from 2-3 to 30 stops are noted. At the moment, the child may wake up, spin in the crib, tremble, scream or even turn blue.

Long apnea up to several minutes provokes oxygen starvation of the brain, disruption of all body systems. Due to hypoxia, neurons die off, so the child has a developmental delay or psycho-emotional deviations.

It is necessary to monitor the baby's sleep for up to a year, since there is a risk of sudden death syndrome. If you experience snoring, constant shuddering, and waking up, consult your pediatrician. Apnea can develop due to a respiratory illness that can be eliminated with antiviral drugs and a nose wash.

Attention! If, in addition to regular respiratory delays, the child begins to pale skin, turn blue lips and eyelids, it is urgent to call ambulance. If the flow of oxygen stops, coma and death will ensue in six minutes.

Features of the development of the syndrome of nocturnal breath holding in children

Respiratory failure at night is a symptom of many diseases of the upper respiratory tract, heart, and digestive tract. Most often, apnea occurs in premature babies due to the immaturity of the central nervous system.

The initial stages of the syndrome may not be noticed, which leads to a constantly open mouth, malocclusion. Therefore, it is necessary to closely monitor the sleep of babies up to a year. Loud sniffling, snoring, whistling or gurgling at night is not the norm for a healthy child.

Direct Causes and Risk Factors

The respiratory arrest in a child’s sleep is manifested due to obstruction in the nasopharynx. There are congenital pathologies and acquired diseases that cause apnea. This syndrome can even occur due to improper posture, an uncomfortable pillow or mattress. The main causes of nighttime disorder include:

Premature babies, newborns with Down syndrome, or cleft or wolf lip are at risk. The syndrome also develops in the presence of congenital pathologies of the structure of the skull, obesity. If the mother during the pregnancy suffered an infection or was treated with antibiotics, the child’s areas of the brain responsible for breathing can still be damaged in utero.

Mechanism of occurrence

Apnea may appear suddenly due to allergic reactionpoisoning by poisons, toxins or develop gradually due to infection, virus. Holding the breath occurs when foreign bodies appear in the nasal passage.

When examining the condition of the nasopharynx of a sick child during sleep, muscle spasms with complete closure of the partitions are noted. The baby can not breathe from 20 seconds to several minutes. The syndrome also develops when the larynx overlaps with a pathologically large tongue. because of general weakness muscles note a lack of tone in the palate and tongue. In this case month old baby not able to regulate the breathing process.

If the central nervous system malfunctions during sleep, impulses responsible for the process of oxygen consumption do not enter the brain. In this case, apnea may occur suddenly. If the child periodically holds his breath before bedtime, it is necessary to reduce the emotional stress in the evening.

With obstructive disorders, the syndrome develops gradually. Reduction of the airways is due to the appearance of bronchial obstruction. The child cannot fully exhale through the nose. Running process provokes a complete stop of breathing.

Associated symptoms

Apnea occurs at night, most often it is late night or early morning. There are delayed inhalation or exhalation or deep breathing, accompanied by a constant movement of the chest. The following symptoms of the disease are characteristic for a newborn baby:

• blueness skin integument and mucous membranes;
• frequent waking up with crying, screaming;
• open mouth in sleep and in the afternoon;
• moodiness during wakefulness;
• unnatural posture for sleeping, tilting the head back;
• intermittent, uneven breathing;
• snoring, whistling, gurgling, dry cough, shortness of breath.

In older children, respiratory failure can be detected more quickly by the following signs:

• teeth grinding in a dream;
• in the daytime apathy, drowsiness, headaches;
• dry mouth
• enuresis, frequent urination;
• malocclusion, the formation of an "adenoid" face.

Also, some one-year-old children during wakefulness have difficulty swallowing, often choking, spitting up.

It's important to know! Identify Apnea on initial stages possible by observing a child at night. The most indicative will be the morning hours after the end of the deep sleep phase.

Types of Apnea

The respiratory arrest in a child’s sleep has various forms. Apnea is classified depending on the main causes of the triggering syndrome: a violation in the central nervous system, the appearance of obstruction in the upper respiratory tract.

1. Central. This type most often develops in premature and weak children. Nerve impulses responsible for uninterrupted breathing are not recognized or sent to the brain. A child can forget how to breathe at any moment. In this case, there is a risk of sudden death.
2. Obstructive. In the upper respiratory tract is an obstruction to the passage of air, so the baby sleeps and is awake with an open mouth. Most often, children have adenoids, enlarged tonsils, inflammation of the lymphoid tissue. Mucosal edema develops with a runny nose and allergies.
3. Mixed. Holding your breath occurs for several reasons at once. This species has common symptoms of central and obstructive apnea. It occurs due to low immunity and immature nervous system.

Clinical types of apnea are also distinguished: sudden death syndrome, congenital hypoventilation, ronopathy (snoring).

Advice! The severity of the disease is determined by the number of episodes of nocturnal respiratory arrest. If you counted more than 30 interruptions, you should immediately consult a doctor.

Diagnosis of respiratory disorders

First of all, parents can determine the presence of apnea. Observe your baby’s breathing at the beginning of sleep, and also from 4 to 6 in the morning. If you hear snoring, whistling, sobbing, you should consult a pediatrician.

If breath holding is detected, it is recommended to use a stopwatch to measure the duration of one episode of apnea. If you stop prematurely for 10 seconds or more, you must examine the child. Children's doctor should refer to the otolaryngologist, cardiologist, neurologist and surgeon. Specialists study the history of the disease, especially the course of pregnancy and childbirth.

For an accurate diagnosis, polysomnography is prescribed. This technique allows you to determine the cause of any sleep disturbance. Also, after consulting the surgeon, the child can be sent for an X-ray of the skull, on which a congenital or acquired pathology of the structure of the nasal passages is revealed.

Treatment of pathology in children of different ages

Respiratory failure in a dream is a serious pathology, night apnea, which appeared in children up to a year, is especially dangerous. During this period, the child’s body is actively growing, the brain is developing, and skills and abilities are acquired daily. With a constant lack of oxygen, hypoxia appears, it leads to the death of neurons.

Apnea treatment begins after examination by an otolaryngologist and surgeon, a thorough diagnosis of the functioning of the central nervous system. Depending on the type of syndrome, conservative therapy is prescribed using a drop, sprays, tablets or surgery.

Reason for urgent medical attention

A child with nocturnal apnea should always be under the control of parents. Temporary episodes can develop into complete interruption of breathing. In this case, it is urgent to provide first aid and call an emergency team. Alarming symptoms of worsening condition:

• pallor, cyanosis of the skin and mucous membranes;
• epileptic seizure, convulsions;
• heart rate less than 90 beats per minute;
• unnatural posture;
• lack of reaction to what is happening.

To prevent such a serious condition and death, consult a doctor in a timely manner. Short-term respiratory arrest should not exceed 10 seconds, the episode itself does not repeat more than 2-3 times per night.

Quick help babies at home

When breathing stops completely after 6 minutes, brain cells die. These injuries are irreversible, in the absence of emergency care death occurs. Therefore, if there are alarming symptoms, immediately call a team of doctors. Before their arrival, the following manipulations must be done:

1. Try to wake up and bring the child to feelings.
2. Spray forehead, arms and legs with cold water.
3. Make artificial respiration. Throw back the baby’s head, close the nose and gently inhale the mouth into the mouth. The procedure should last no more than 2 seconds, since the lungs of the child are much smaller than in adults.

When a rash appears, Quincke's edema must be given antihistamines as soon as possible. The most effective, based on feedback from parents and doctors, is Fenistil. Drops are given already from the second month of birth.

In an extreme case, before the ambulance arrives, a closed heart massage is performed. During the above procedures, be sure to open the child's mouth and hold his tongue so that the baby does not choke.

Modern methods for eliminating apnea in a child

Many methods have been developed for the treatment of apnea. Their main task is to remove pathological symptoms and restore breathing as soon as possible. Depending on the cause of sleep disturbance, the following therapy is prescribed:

1. Taking medication. If the cause of uneven breathing is respiratory disease, antiviral agents are prescribed. Antispasmodics are taken to increase the tone of the palate and tongue, eliminate the complete closure of the walls of the larynx. For decreasing allergic edema - antiallergenic drugs. Through medicines they treat apnea provoked by a violation of the central nervous system.
2. Physiotherapy. With obstructive apnea, inhalations are prescribed, treatment with special devices that regulate the flow, pressure, humidity. For newborns, stimulation of the respiratory center or mechanical ventilation are performed.
3. Surgical intervention. It is prescribed for enlarged adenoids, tonsils, the presence of polyps in the nasal passages, congenital or acquired skull pathologies.

If apnea is a consequence of obesity or food allergies, a special diet is prescribed for the child. To normalize weight, it is necessary to undergo a massage course, daily exercise therapy, depending on age.

The danger of nighttime respiratory arrest in children of different age categories

If your child holds his breath in a dream, sleeps with his mouth open, often wakes up, it is recommended to visit an otolaryngologist and a neurologist. The most dangerous apnea for children born ahead of schedule or weighing less than 2 kilograms. The consequences of prolonged episodes of respiratory arrest at night:

• irritability, the child often cries, is naughty;
• headaches;
• attention deficit disorder;
• heart failure;
• hypoxia;
• pulse disturbance;
• epilepsy;
• physical and emotional developmental delay;
• diabetes.

Nighttime breath-holding attacks for a nursing baby are often fatal. An infant can forget how to breathe in one moment. Therefore, parents are advised to pay attention to the nature of breathing: extraneous sounds, the duration of inspiration and expiration, the number of episodes of apnea per night.

To prevent the development of apnea syndrome in your baby, it is recommended that you lead a healthy lifestyle during pregnancy. Stop smoking, alcohol, eliminate junk food with food additives and dyes. Do not tolerate viral and infectious diseases on foot.

Respiratory arrest - at night is a dangerous pathology that is more common in children. As a rule, at risk are more babies whose respiratory system is not yet fully developed.

There are many reasons why apnea occurs in children, and some can provoke a most dangerous condition until death. Therefore, mothers and fathers should know how to provide first aid to the baby, and how to prevent the occurrence of new attacks in the future.

Why does the child hold his breath in a dream? The reason for this is apnea syndrome. This pathology is characterized by sagging of the oropharynx during a night's rest at the moment when the pressure drops. Then, there is a sharp reduction in air intake and breath is held. Such attacks last about a minute and adversely affect the condition of the baby.

Important: During sleep, the child may experience up to one hundred attacks per night. In this case, the child will tremble in view of which there can be no question of normal rest.

The forerunner is snoring. This condition provokes a deficiency of air in the child due to which dangerous defects form over time, such as:

• growth retardation;
• abnormal bite formation;
• mental retardation;
• cerebral hypoxia;
• disturbances in the psycho-emotional background.

Intermittent breathing in a child’s sleep requires immediate therapeutic removal. It is important to understand that such a condition can provoke diseases much more dangerous than the above.

Types of defect in children

The delayed breathing called apnea has three types:

• central idiopathic look. There is a pathology due to a malfunction of the respiratory center. In this condition, muscle mass does not contract due to a lack of signal;
• . In this condition, the attack attacks due to obstruction of the airways. As a rule, in most cases, children under one year of age are exposed to this form;
• and the third type is mixed form. If this type occurs, first a central form of apnea is observed, which becomes obstructive. It is worth noting that the third type is observed in isolated cases out of a million.

Important: Snoring is a good cause for concern. When this symptom occurs, parents should show the child to the doctor as soon as possible. Moreover, if a similar condition is observed regularly, it is necessary to conduct an extended diagnosis.

Each of these types of apnea has a specific therapeutic technique. In view of what, in this condition, you should not resort to dubious treatment methods. Otherwise, you may aggravate the existing problem.

Symptoms of the disease

In order to detect and eliminate nighttime respiratory arrests in infants in time, parents need to monitor the quality of rest and behavior in a dream. In addition, knowledge of the symptoms will help to timely identify the problem, namely:

• during good sleep the child has a breath hold of more than 10 seconds;
• snoring appeared;
• the baby breathes through the mouth;
• during sleep, anxious behavior is observed;
• strong sweating is observed;
• periodically in the daytime, the baby complains of a headache;
• developmental lag.

Important: The first sign of an attack is a blue face and fingertips in a child. In addition, weakening of muscle tone is observed, and the pulse is also slowed down.

During an attack of apnea in newborns, hypoxia occurs. This provokes waking. In addition, older children may get frightened by the release of adrenaline into the blood. Against this background, appetite may worsen and developmental delay may occur.

Why is respiratory arrest

Factors causing nocturnal respiratory arrest are classified according to the type of syndrome. As mentioned above, there are two main and third transitional type.

So, the causes of the appearance of the central form:

• injuries of the brain and spinal cord in infants received during childbirth;
• early patrimonial activityas a result of which a premature baby was born;
• epileptic seizures;
• biological fluid glucose deficiency;
• gas exchange failure;
• diseases of viral and bacterial origin;
• the use of a number of pregnant drugs;
• sepsis.

As for the obstructive type, such a violation provokes the following reasons:

• defective development of the language;
• laryngeal muscle spasm or laryngospasm;
• pathological development of bones;
• trauma muscle mass larynx;
• abnormal enlargement of the tonsils;
• obesity and accumulation of excess weight in the cervical zone;
• anomaly of the lower jaw.

Important: You can identify a seizure in a baby by observing how he sleeps. If the breathing is intermittent and after inhalation a short snoring is heard, and then there is a slight stop of breathing, it means an attack. In this case, the sleeping child may toss or turn or try to change the sleeping position.

To defeat night apnea is possible only by eliminating the cause of its development. In view of what, parents need to see a doctor. Remember, strictly adhering to the prescribed therapeutic measures, you will defeat not only nighttime respiratory arrest, but also concomitant pathologies.

Establishing diagnosis

The diagnosis begins with the identification of the problem by the parents. The following symptoms should be suspicious:

• restless and;
• baby’s moodiness;
• loss of appetite;
• lethargy and drowsiness in the daytime.

With such symptoms, parents should immediately consult a doctor. The first action of a specialist is a thorough study of all the diseases that the baby has had. In addition, heredity is subjected to a detailed analysis.

Then, there comes the turn of estimating body weight and the weight index of the cervical spine. Also, in some cases, you may need to consult a cardiologist, neurologist, and otolaryngologist. The fact is that in some cases, symptoms such as weakness and shortness of breath in the mouth also occur with adenoids.

Parental actions during an attack

Nocturnal breath holding in children of different ages can provoke asphyxiation. And this condition is already fraught with death. In view of what, parents need to know how to behave when identifying such a condition. So, when you urgently need to call emergency care:

• slow heart rate, less than 90 beats;
• the appearance of a bluish color in the area of \u200b\u200bthe wings of the nose, around the mouth and on the limbs;
• involuntary drooping of limbs.

Important: So that breathing does not stop, it is recommended to carefully ventilate the baby’s bedroom, eliminate overheating of the newborn, by over-wrapping and try to do air baths as often as possible.

In addition, parents must complete the following before emergency care arrives:

• do artificial respiration;
• put the baby in a horizontal position;
• inspect the language, for its retraction;
• take your mouth with your fingers, cover your nose and blow in air until the child has movements in the chest area.

If there is no pulse, mom or dad should perform a heart massage while simultaneously breathing air into the baby's mouth. Massage is performed until a doctor arrives.

What may be the consequences of pathology

The consequences of such a pathology result in dangerous complications, especially when it comes to one-year-old children. With this condition, against the background of oxygen deficiency, the following defects develop:

• often babies develop hyperactivity;
• the impossibility of concentration is formed;
• pathological conditions of the heart muscle;
• increased drowsiness and arrhythmia;
• natural development and growth slows down.

In addition, with the advanced stage, there is a high risk of developing ischemic pathology, heart attack and stroke due to impaired functioning of the heart muscle. Also, children suffering from short-term breath holdings are more likely to receive various injuries.

Treatments for Apnea

The treatment of the pathology under consideration begins with the elimination of the root cause that provoked this dangerous condition. For these purposes, use the following methods:

• if the problem is malocclusion, you will need to correct it by surgical correction;
• with obesity, a nutritionist consultation and a gradual decrease in body weight are necessary;
• in the case when night stops of breathing are dependent in nature. In other words, apnea occurs when the child takes a certain sleep position, you need to wean the baby to sleep in this position.

Important: If the culprit is overweight soft tissue, it must be partially excised. In the event that apnea is provoked by a defect in the nasal septum, correct the problem in childhood impossible.

In this case, compliance with maintenance therapy will be required until the adulthood of a small patient.

In some cases, surgery is contraindicated. Therefore, the doctor may recommend CPAP therapy. This method allows you to block the interruption of breathing due to mechanical ventilation. CPAP therapy eliminates the possibility of hypoxia and creates optimal conditions for the normal supply of oxygen to the brain.

Operational way

Surgical treatment of apnea is indicated when the cause of the pathology is the presence of acquired or congenital airway defects. In such conditions, the following types of manipulations are shown:

• with abnormal development of tonsils, tonsillectomy is recommended;
• if dyspnea is provoked by adenoids, an adenoidectomy is prescribed;
• surgical correction is indicated to eliminate the curvature of the nasal septum;
• less commonly, but tracheostomy may be recommended if the culprit is apnea obstructive pathology or abnormal development respiratory tract;
• and last method, which is also resorted to in rare cases, uvulotomy, excision of the tongue.

In general, the effectiveness of surgical intervention reaches 100%. However, a month after the manipulation, a second examination of the breath will be required.

CPAP therapy

As already mentioned above, this method is resorted to when surgery is contraindicated for any reason. With this type of treatment, a mask with a hose is put on the baby before going to bed, through which the air produced by the device enters.

Using this method, inhalation and exhalation becomes uniform and deep. However, it is worth emphasizing that the device should work continuously during the daytime and at night.

Unfortunately, CPAP therapy gives a short-term effect. It is worth stopping the use of delay equipment and uneven breathing return again. There are positive aspects to this. Using this method of treatment, parents have the opportunity to block hypoxia until the facial skeleton is fully formed.

Of course, treating a child with this method for a long time, however, reviews say that with CPAP therapy you can forever forget about apnea, subject to the complete formation of the facial skeleton.

Komarovsky about apnea in children

The famous pediatrician Komarovsky believes that parents will be able to alleviate the condition of the child during nighttime respiratory arrest if they follow the following rules:

• daily ventilate not only the nursery, but the entire housing;
• wash floors and remove dust more often, giving it no chance to accumulate;
• remove all carpets and other dust-collecting items from the nursery;
• install a humidifier in the room;
• to moisten the nasal passages, instill a saline solution;
• give your child a plentiful drink.

Important: According to Komarovsky, the reason why there is apnea in children, dry air and a large accumulation of dust.

These simple rules will prevent the development of adenoids and protect against tonsil atrophy. In turn, the child will not experience snoring as the main harbinger of apnea.

Preventive actions

So, we examined why apnea occurs and how to overcome this pathology. It remains to summarize and note, to prevent the development of this dangerous condition is much easier. To do this, follow these tips:

• put the baby to sleep on one side;
• use bedding made from natural fabrics;
• get an orthopedic mattress;
• ventilate the room more often and do not confuse the baby.

Teach your children from a young age to lead a healthy lifestyle and then such a dangerous disease as apnea does not bother your family.

Does the child hold his breath in his sleep - is this serious? The respiratory rate of children in a state of sleep is constantly changing: suddenly begins to breathe faster, then the rhythm slows down, and there is a stop for a few seconds.

After such differences, everything stabilizes, and everything returns to normal. Sometimes it’s enough to change the pose of the sleeping person, and his breathing is evened out.

Catastrophically not getting enough sleep parents are increasingly faced with impaired sleep. They are observed in 15% of children.

In every 6th family, a child does not sleep well. In order to prevent a delay in the development of the baby, not only specialists, but also parents should know about sleep problems in children.

The reasons

One of the ways to assess the level of work of the respiratory system is to calculate the frequency of its rhythm. Due to the special structure of the chest, the breathing of infants differs from adults, signs of arrhythmia are observed in newborns.

Regular rhythm control makes it possible to notice deviations in time and recognize the onset of the disease.

In medicine, there is a special term for this phenomenon - periodic breathing. For babies who are not yet six months old, holding their breath is the norm. If the 6-month milestone is long behind, but the problem remains, you need to consult a doctor.

Periodic breathing is 5% of the time that the baby spends in a dream. If the mother had a premature birth, then this figure doubles.

The delay may be accompanied by a bluish tint of the skin around the mouth, and blue limbs. Such symptoms are quite common, but if the blue color spreads to the baby's forehead and body, this may indicate oxygen deficiency. The kid becomes lethargic, he lacks breathing.

If there is concern that the baby is not breathing, you need to wake him with careful touches. If there is no reaction, this may mean respiratory arrest, and an urgent medical call is needed.

The intermittent breathing of the baby does not give cause for alarm. But children with repeated stops are at risk for complications and sudden death.

Symptoms may accompany rhythm disturbance: whistling, wheezing, gurgling. These are characteristic of infectious diseases. An increase in rhythm is one of the criteria for diagnosing pneumonia, which is often asymptomatic in babies.

Children hold their breath, and then often breathe if they have a fever. When shortness of breath is observed in parallel, these are signs of a pulmonary or cardiac pathology requiring inpatient treatment of the patient.

Acceleration happens with false croup: the baby often coughs, exhaling air with noise. Attacks of obstruction in bronchitis pass with an acceleration of the rhythm of breathing.

Slowing (bradypnea) in infants is not so common and is a symptom of serious brain damage (meningitis).

The increase in respiratory fluctuations that occurs with strong emotions or physical exertion does not need to be observed. If the baby is interested in something, carried away, he can often breathe.

Running, jumping, outdoor games, vigorous walking also accelerate the rhythm of breathing. If this rule is violated, the child should be examined.

Periodic breathing counting is especially necessary in early childhood, when many pathologies are asymptomatic, and respiratory rate can be an important tool for detecting disorders in the early stages.

Apnea

A pause in the process of breathing in a dream is called apnea. Nocturnal apnea is manifested in blueness, oxygen deficiency, impaired activity of the cardiac system.

At light form illnesses, breathing returns automatically, but the more blood is saturated with carbon dioxide, the more the brain suffers from a lack of oxygen.

This situation threatens to turn off consciousness. If the victim is not provided with urgent qualified help, he may die. Fatalities are most often recorded at night, when it is more difficult to control the baby’s breathing.

The causes of childhood apnea are problems with the central nervous system, overheating in violation of the thermal regime. If you suspect apnea, you should record the frequency of his breathing and the duration of pauses. You need to show your observations to a pediatrician who will select a specific treatment.

There is the concept of sudden infant death syndrome when babies unexpectedly die in their cradle. A great influence on this issue is played by heredity: according to statistics, brothers and sisters are at risk.

Special studies have shown that children with respiratory breaks in a dream hardly wake up at the stage of slow sleep.

Prevention

To avoid the effects of breath holding, it is important to follow preventative measures:

1. Regular ventilation of the room, comfortable temperature, humidity.
2. Lack of pillows in the baby's crib; do not place the baby on the stomach.
3. Constant monitoring of the state of health of the baby in the first year of life.
4. If respiratory arrest is detected, it is advisable to examine the baby in the hospital.
5. It is important to treat colds to the end, since often they are the cause of apnea.
6. During scheduled examinations, the pediatrician must be informed of all the nuances of the baby's well-being, including his complaints. To calm you can do an ultrasound of the brain (dopplerometry).
7. Only a doctor can give a correct assessment of the state of health after examining the respiratory tract and heart. Sometimes he recommends purchasing a ventilator.

Why does the child hold his breath in a dream? The reason is a complete or partial obstruction, which holds the air and does not let it into the baby’s lungs. This leads to insufficient oxygen saturation of the blood, a decrease in muscle tone. A similar difficulty may arise due to growing tonsils or adenoids, it is necessary to clarify with the otolaryngologist.

You can continue the list of obstacles with a respiratory allergy, an infection of the nose, ear, throat, and obesity. The appearance of obstructive sleep apnea syndrome is facilitated by the structural features of the nose and throat. With all the symptoms of a nervous and endocrine system they do not have much effect on the development of apnea.

Snore

Many babies with delayed symptoms also experience snoring - intermittent and quite loud. Pauses in breaks can reach 30 seconds. Such children sleep restlessly: they cry out, wake up, rush about in bed, fall asleep again in the most atypical pose - head down.

At an unconscious level, they are trying to get rid of the obstruction that makes it difficult for air to enter the lungs. With such a problem, the deep sleep phase is practically inaccessible to them.

If the baby makes different sounds in a dream, you can check with your pediatrician for the best sleeping position for him. Often, mucus is collected in the nasopharynx of the baby, causing snoring.

If whistling and wheezing are observed after an infection, this may mean that the airways have not yet returned to normal.

Incomprehensible breathing causes bronchiolitis - a viral infection that fills the lumens in the lungs with mucus. The snoring child, entertaining and touching parents, is terrifying for doctors.

One of the causes of childhood snoring is a new fashion for conservative treatment of tonsils. A specific children's menu (soda, chocolate, fast food) is another reason for sleep disturbance.

What to do

If pauses during breathing in a dream exceed 15 seconds, urgently need to prepare crumbs to the hospital. Before the arrival of an emergency baby, cardiopulmonary resuscitation must be done so that the baby can breathe again.

If the child began to hold breaths not in a dream, doctors will recommend the removal of adenoids and tonsils. Consult an ENT specialist, neurologist-somnologist, pediatrician.

Every sixth child today has trouble sleeping. The baby may be disturbed by insomnia and drowsiness, nightmares and enuresis, headache and weather dependence, dry mouth and excessive sweating, motor disinhibition and fatigue, snoring and apnea.

All these problems that negatively affect the baby’s body are associated with the features of his breathing. Expert Opinion on New Treatment Methods for Baby Sleep Disorders on this video

According to experts, walking or singing at night in children 2-4 years old is the norm, the main thing is to protect such a child during sleep, not laying him on the top floor of a bunk bed.

Useful on the topic - why a child sweats his head in a dream. By 2 and a half years, respiratory arrest attacks usually stop, but sometimes persist up to 6 years.

Measuring respiratory rate in children

In infants, breathing is shallow, jerky, with an alternately slowing and accelerating rhythm. Uneven breathing is the norm for a newborn baby, both for those born on time and those who are premature. During the first month of life, the baby's breathing is leveled and gradually completely stabilized.

Count the rhythm of the baby's breathing when it is absolutely calm. In infants, it is convenient to observe the chest. Doctors use a phonendoscope to listen to breathing, but if you simply put your hand on the chest of the child, you can record all of its contents.

The baby must be distracted so that he does not get scared or interfere with the count. The norm for babies up to a year will be 50-60 breaths per minute, from a year to 3 - 30 breaths, 4-6 years - 25. With the number of sighs significantly exceeding the norm, we can conclude that there is shallow breathing with all the ensuing consequences.

Breathing is one of the main life functions of a person. If it seems completely ordinary, it is worth harboring it for half a minute to realize the true value.

Holding your breath and oxygen starvation can cause another delay - in development. This is expressed in hyperactivity disorder and attention deficit disorder. The kid is not able to sit still, cannot perceive information. All this creates problems with his education, the child grows up mentally retarded.

Conclusion

Russian psychologists do not support the advice of Western colleagues not to pay attention to the cry of their child. This behavior of parents enhances and develops fear of crumbs. If the child holds his breath in a dream, doctors recommend sitting with him for half an hour before going to bed. Then the night will be calm, including for parents.

Restless, intermittent sleep and snoring can be symptoms of such a serious illness as.

Respiratory function is one of the most important in the body, and even such a short termination of it sometimes leads to grave consequences.

Our article tells about what the syndrome of night apnea in children and adolescents is, what are the ailments.

Temporary respiratory arrest - apnea - often occurs in children and adolescents.

Symptoms in Toddlers and Adolescents

The development of this pathology is accompanied by a steady complex of symptoms, the appearance of at least several of them should already alert parents.