Everyone has brief pauses in their breathing pattern called apnea. Usually these brief stops are completely normal.
Sometimes, though, apnea can cause a prolonged pause in breathing, making the breathing pattern irregular. Someone with apnea might actually stop breathing for short amounts of time, decreasing oxygen levels in the body and disrupting sleep.
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:
- obstructive
- central
- 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:
- snoring (the most common) followed by pauses or gasping
- labored breathing while sleeping
- 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 is delivered by having the child wear a nose mask while sleeping.
Central Apnea
Central apnea occurs when the part of the brain that controls breathing doesn't start or properly maintain the breathing process. In very premature infants, it's seen fairly commonly because the respiratory center in the brain is immature. Other than being seen in premature infants, central apnea is the least common form of apnea and often has a neurological cause.
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.