My son can't be summed up easily, but I'll attempt it. He is currently 4yrs11months. He started rocking his head at about 2 weeks old, and banging at about 3 months. He was a lump (not even rolling) at 8-9 months old but never qualified for EI services. At 13 months he started walking, and at 14 months he was kicked out of his first daycare. He was a never-ending behavior battle, and still is. At 18 months he had PE tubes in his ears. At 19 months he cracked the back of his head during a temper tantrum resulting in staples. At about 2 he started with the specialty Dr train; neuro diagnosed hyperkensis and sensory integration dysfunction. GI diagnosed milk/dairy allergy. At 2yr9mo he started special ed preschool. At 3yr3mo he had his tonsils and adenoids out for assumed OSA (family history) and they were large. At 3yr9mo he had upper/lower scopes to rule out more severe issues and was treated with assumed reflux. Also had sleep study around the same time. (I'm going to post and ask specific sleep results below). Sleep study showed mild OSA with mild sleep fragmentation with recommendations being Observation. Just after sleep study was diagnosed with asthma. He can now tolerate dairy, but we still avoid to an extent.

His current diagnoses are; PDD-NOS, ADHD combined type, severe SPD, ODD, asthma, severe speech delay, mild OSA (I know a lot of these overlap each other, and I think I'm forgetting something!)

On to the sleep report.

Sleep architecture
TIB- 502.0min
TST- 421.0min
Sleep efficiency 83.9%
Latency to sleep onset 47.5min
Latency to first stage R 132.5min
5 periods of stage R

Staging and body position
N1- 3min 0.7%
N2- 86.5min 20.5%
N3- 999.9min 52% (numbers copied from report, I realize the 999min is wrong)
Stage R- 112.5min 26.7%

Resp. Parameters
20 apneas in total (1 obstructive, 19 central)
38 total hypopneas
AHI 8.4 in stage N
AHI 8.0 in stage R
Total AHI 8.3
RDI 8.4 in N
Rdi 8.0 in R

End Tidal CO2
ETCO2 was above 50 mmHg for 99.9 % of TST
Peak ETCO2 47mmHg

Oximetry
Mean SpO2 96.5%
Minimum 80.0%

Arousal and Limb
38 arousals in total (5.4 events/hour)
30 were spontaneous (4.3 e/h)
8 associated with resp. events (1.1 e/h)
0 associated with limb movements
0 limb movements in total

ECG- no cardiac arrhythmias

So what are your "expert" (not a Doc) opinions on this report? Where do we go from here? I've also noticed sleep terrors, confusional arousals, rythmic movement disorder (all are unofficially diagnosed), and he is 100% diapers at night.

Thanks all in advance! Sorry if something doesn't make sense, it's late!

After I typed this, I re-read the report and noticed what I think are serious discrepencies (sp?) in it. If you'd like a scan of the actual report, let me know!

I'm really trying to figure out what to do next with my little man. Everyday bring battles, and he's rarely happy.

I just sent you a private message. Please read it and respond as you wish.

I am assuming that your son sees a neurologist and probably a pulmonologist. Are either of them sleep disorder specialists? Generally when the results don't appear black and white, a sleep specialist is the best one to know where to go from here.  

As for sleep terrors, these are normal in kids this age. He should probably outgrow them in the next year or so. Just as a side note, Isaac's night terrors are gone now since he started c-pap.  

The apnea themselves are not terrible (I'd love to see results like this unassisted by c-pap, but probably never will), so there might be something else  that is causing this sleep efficiency to be low.

Does your son take any vitamins? If so, you might get one with iron and see if he does better with his sleep.  

Tiffany

Mom to Isaac, my 3 year old hosehead for 4 weeks now! and to Esther Rose, my little princess who is having her first sleep study in a month!

I didn't see am PMs. Thank you for the response.

His pulmo is head of peds sleep and pulmo. His neuro does not do sleep, but I have an appointment with a neuro sleep Doc.

His night terrors started at 8 months old. They have decreased and he averages 1 per month, but not always one every month.

We didn't do vitamins due to his allergy and I couldn't afford the "safe" dairy free ones. I will start him on something this weekend now that he has outgrown. When he passed milk, I totally forgot about vitamins being easier to get, so thanks for that info!