Introduction
Almost half of children’s life is spent asleep. Therefore, it is important for the clinicians to know the effect of sleep on respiratory diseases. (Marcus, 2001) Sleep disordered breathing may lead to serious and miserable complications such as sleep fragmentation, cognitive and behavioral changes, growth retardation, pulmonary hypertension and cor pulmonale. Unfortunately the prevalence of sleep related breathing disorders is high (3-12% of pediatric population); obstructive sleep apnea syndrome alone affects 3% of children.(Church 2012) Before the development of sleep studies, pediatricians mainly depended on history and physical examination for the diagnosis of sleep disorders. Researchers have tried to formulate clinical score questionnaires as an alternative to polysomnography. For the first time in 1984, the role of history and physical examination in the diagnosis of OSAS was assessed by Brouillete. However, several studies have demonstrated that clinical presentation alone cannot differentiate sleep related breathing disorders such as primary snoring from OSAS. Brietzke SE (Brietzke, Katz et al. 2004) showed that only 55.8% of patients were identified by clinical presentation as OSAS; were confirmed by polysomnography later. This unreliability could be caused by several factors; the most significant one is inaccuracy of history as some parents may overestimate difficulties in
Being the first-born baby, I was very independent. Sleeping until noon and being attached to my pacifier was a daily thing for me. Since I slept so much, my mom kept a constant watch on me. One day she noticed that I wasn’t breathing like I should, so she took me into the doctor. My mom was told that I had sleep apnea. Sleep apnea is where people take short pauses, while breathing can last seconds or even minutes. The doctor suggested that my mom do sleeping tests on me, which was easy for her because I slept all the time.
Thesis: Sleep Apnea is becoming more of a dangerous disease that more people are starting to be diagnosed with. It is extremely important that Sleep Apnea is emphasized so that more people are aware of it.
Obstructive sleep apnea is a serious, potentially life-threatening condition. It is characterized by repeated cessation of breathing while sleeping, due mostly to complete or partial pharyngeal obstruction. Objectively, it is recognized by a combination of symptoms and laboratory results. These include repetitive apneas and hypopneas, which are accompanied by hypoxia, sleep arousals, and hemodynamic changes.9–12 Moreover, activation of the sympathetic nervous system during respiratory events potentiates vasoconstriction and often triggers increases in blood pressure and heart rate.10,13 Obstructive sleep apnea is also associated with several cardiorespiratory problems (e.g., loud snoring, loud gasps, and daytime breathlessness).14,15
Mental illness is also a factor to look at for differences because there seemed to be a greater number of people who had mental illness that also had obstructive sleep apnea compare to people without mental illness. More research was available on obstructive sleep apnea and some of the research suggested many people do not realize this medical condition is an issue. The problem is normally diagnosed when something significant happens, such as problems living everyday life, relationships issues created, or a medical event occurs. Sometimes a loved one will raise awareness of an issue to an individual suffering from sleep apnea through observations made like obnoxious, increasingly worse snoring or the loss of a job due to lack of sleep. Individuals seek medical support from a physician and usually go through testing in a sleep clinic to diagnose the sleeping disorder. Diagnosis is critical for obstructive sleep apnea because left undiagnosed the sleep disorder can lead to several medical problems which could even potentially be death due to lack of oxygen. Specifically if the airway is obstructed for long enough while sleeping, then a person could potentially suffocate from lack of air.
Sleep Disordered Breathing (SDB) is a common medical disorder that is increasingly recognized in children – almost 30 million American children are living with SDB. SDB can range from frequent loud snoring to Obstructive Sleep Apnea (OSA) a condition involving repeated episodes of partial or complete blockage of the airway during sleep.
Sample size: To observe a pressure difference of ± 2 cm WC for the observed mean oropharyngeal pressure during sleep, we required a sample size of 12 readings in each group for a two sided significance with a power of 80% and a Confidence Interval (CI) of 95%. Sample size was calculated based on the study by De Paoli et al10.
Childhood OSA has different clinical manifestations as snoring, witnessed apnoeas, labored breathing, restless sleep and others. (3) Nocturnal enuresis (NE) – i.e. intermittent nocturnal bedwetting in children ≥5 years old –is a complex problem that associated with increased prevalence in males, low socioeconomic status and educational level of parents, attention deficit/hyperactivity disorder (ADHD), familial history of enuresis, or psychological issues as separated parents, sexual abuse, and death in the family.(4-7) NE has been recognized as a manifestation of childhood OSA. Alexopoulos et al (8) reported in their study that subjects with habitual snoring were at increased risk of primary NE compared to those without
3. Identify at least five signs or symptoms of obstructive sleep apnea (OSA), and star those symptoms that S.R. is having.
With at least 25 million adults in our nation suffering from sleep apnea, the findings add to the importance of addressing sleep issues and disorders, and getting them treated as soon as possible. Characterized by include
The aspect of vulnerability is a huge part of being human. This can come in many forms, including vulnerability with oneself. The main idea of the song “Sleeping Sickness” by City and Color is the self vs self battle that comes with anxiety and depression. “The worries that occupy the back of my mind” is an example of a synecdoche and demonstrates how thoughts can entirely take over one’s life. It suggests that his mind is occupied with these worries and therefore he can not focus on anything else. “Maybe I'll sleep when I am dead but now it's like the night is taking sides” shows how overwhelming thoughts that come along with both anxiety and depression can even affect one's sleep. When the day is not there to distract these thoughts they
Obstructive sleep apnea (OSA) is the common sleep disorder, occurs when the brain send signals to the muscles. Moreover, the airway is partially or completely blocked during sleep due to relaxation of the tongue and airway-muscles. People with OSA is commonly associated with snoring. Individuals with OSA can also result in excessive daytime tiredness, morning headaches, mood and behaviourial changes.
The first and most researched sleep disorder is sleep apnea. Sleep apnea does not affect children as often as it effects adults, but it is still a rising concern. Sleep apnea occurs in about 2 per cent of children, mainly between the ages of one through eight. But it can also show up in older children and even infants. (Klein). Research says that young blacks are more at risk than young whites. (Fritz p 83). Children with sleep apnea briefly stop breathing many times during the night due to an obstruction in the respiratory tract. Most of the time it is related to enlarged tonsils and adenoids or to obesity. As the child will gasp for there breath during sleep, they awaken for a few moments to regain there normal breathing and then they immediately return back to sleep. Because the child will be awoken by this many times during the night, this cause sleep deprivation. (Common Sleep Problems AA). The physical symptoms of sleep apnea are excessive daytime sleepiness, snoring, restless sleep, heavy and irregular breathing, excessive perspiring during the night, bad dreams, sleeping with there mouth open, sleeps in strange positions, morning headaches, learning problems, excessive irritability, depression, changes in personality, difficulty
Sleep disorders alter ones sleep pattern and often results in the inability to either sleep or sleep soundly. They often cause you to feel restless, tired, fatigued, and irritable. It is estimated that nearly 75 percent of adult Americans experience sleep disorder symptoms at least a few nights per week. At the same time, sleep disturbances in some form are seen in as many as 25 to 30 percent of infants and children (“Sleep Disorders” 2013). Clearly a huge conundrum in the world, sleep disorders affect an inordinate amount of people. Millions of people suffer or have suffered from a sleep disorder at one point in their lives and if mistreated can impact organ systems functioning negatively. Physical disturbances, medical issues,
This is a prospective case series study that enrolled 66 children aged 5 − 18 years who were presented with nocturnal enuresis (NE). The study was conducted in two centers; Pediatric Sleep Centre (Rome, Italy) where 28 children enrolled and Alexandria Main University Hospital (Alexandria, Egypt) where 38 children enrolled. All children with evidence of urinary tract infection, urinary tract anatomical abnormalities, associated chromosomal syndromes, intellectual disabilities, major craniofacial abnormalities, epilepsy, psychological issues (e.g. death in the family, sexual abuse) or diabetes mellitus were excluded from the study. All the children primarily presented with NE and were screened for 1st time using sleep clinical record (SCR) for the possibility of OSA. Twelve Egyptian children (18.2%) refused to undergo the polysomnography study (PSG). Accordingly, 54 children (81.8%) agreed to perform the PSG and they were analyzed (figure 1). The diagnosis of OSA was confirmed in case of the presence of SBD symptoms in combination with obstructive apnea/hypopnea index (AHI) ≥ 2 episodes/hour (h) according to European Respiratory Society Task Force published in 2016.(2) The protocol of study was approved by the local Ethics Committee of the two countries and a written informed consent was obtained from the care-givers.
However, obstructive sleep apnea is just the opposite in which, it affects around two to four percent of kids’. The results of sleep