I was hoping that there would be someone here who was familiar with central apnea that would be willing to tell me a little more about it.  My son (4) had his first sleep study almost a month ago and had 55 centrals (along w/obstructive hypopneas and sleep apneas).  He has another sleep study scheduled for the middle of May and I think they're wanting to use a cpap or a vpap on this one.  I'm familiar w/the c-pap but haven't heard of the v-pap before.  Any one familiar with it?  Can centrals be treated?  Can they go away?  Do they cause any problems like obstructive sleep apnea can?  

My ds has had his tonsils and adenoids removed already.  What other surgeries are common for fixing or treating sleep disorders?  

Does anyone have a child who's airway seems to collapse when they're sleeping in their car seat?  

Thanks for any advice.  This seems to either be a really slow board, or I'm just not asking the right questions, but I'd really like to hear from some of you.

Shelee,

My son, age 2 years, has central sleep apnea without obstructive apnea, with very few hypopneas, and has not undergone any surgeries. He is not on a machine. We have been told that unless they have obstructive apnea, the c-pap and bi-pap are not effective. However, if they have a combination apnea (both obstructive and centrals) or just obstructives, that the c-pap machine can work beautifully. It is not foolproof and you still have to convince your son to use it.

I would pose those questions to your pulmonologist or neurologist. How many obstructives and hypopneas did he have in the same period as the 55 central sleep apneas?  Doctors love to tell parents that central sleep apnea gets outgrown. Most of us moms and dads here would like nothing more than to shake some sense into them because they are NOT outgrowing it. Our son will have periods where his sleep quality is really good, but then will have periods, like tonight, where he takes 2 two hour naps and still goes to bed at 6:30pm for the night because the quality of his sleep is so poor.

To my knowledge, there are not any other surgeries, but again, I don't know a thing about obstructive apneas. As for the car seat issue, is your son still in a 5-point harness? If not, I would highly recommend it and then purchase the neck huggers that go on the actual straps of the car seat. They look like small pillows, and seem to really help keep their heads from flopping too much when they fall asleep.

I am not sure what other problems you are talking about when you ask "Do they (central episodes) cause any problems like obstructive sleep apnea can?". The only real problem we have with Isaac is that he needs a lot more sleep than his peers. Otherwise, he does not seem to have any other issues associated with the apnea itself..

I hope this helps. Generally when posting questions, the more information you can provide the better. If there is a lot of vagueness people won't know what you are looking for and will just move on to the next post...

Tiffany

Hi Shelee,

I just saw your question, but have to go to work.  I will answer you better tonight.


Susanne and her minihosehead Christina

Hi Shelee,

I just re-read both of your posts and have some info for you.  Please remember that I am just a mom not a doctor (although I play one all the time).

I am sorry that you need to be here.  You are now a member of a very elite club.....parents of apnea kids.  There are not a lot of kids with apnea (at least that has been detected) so there is not much support.  This is the best place that I  have found, it is not perfect but at least you get an answer .... usually.  If you send me a message I will tell you where not to go, I would just say but I don't want to be rude.

I looked at the report you posted.  This is what it is telling me

6 obstructive apneas -- your son wanted to breath but for some reason was unable to because his airway had closed.  They determine this by looking at how hard he is trying to breath (measured by the chest/belly straps) and how much air is moving in and out of his nose (funny thing under his nose)

26 obstructive hypopneas -- again your son tried to breath and was partially sucessfull.   He was moving air, but not enough to be an effective breath .  His breath was too shallow and too long. (in my daughters case it took her 39 seconds to complete 1 breath because of a hypopnea)

55 central apneas -- his brain did not send the signal to breath.  This means there was no effort to breath and no air moving in or out of his nose.

Obstructive apneas and hypopneas can be minimized with a cpap machine, because all that is needed is keeping the airway open.  He is already putting in the effort so all he needs is a little help.

Central apneas have no effort, so a cpap won't help because breathing requires the diaphram muscles moving in addition to the throat being open.  Chris does not have any central apneas so this is not her thing.  I don't know if they go away.  I would assume that any breathing issues that cause oxygen drops can cause problems in children regardless of the cause.

The AHI is the Apnea/Hypopnea Index and covers all central and obstructive events.  In a child any index is reason for concern (as per our ENT last friday).  An AHI of 10.7 means that there are an average of 10.7 apnea/hypopnea events per hour.  In an adult it takes an AHI of 5 to get a diagnosis of apnea.

Chris just went to the neuro and ent to find out why she has apnea.  She has no known risk factors other than reflux.  I was told that there is no surgery for children above and beyond T&A.  I was told that when she is older (at least 16) that they could do a jaw advancement surgery if that appeared to be the problem.  Right now she has had her adenoids out and that is all they can do.  We have been told that as she grows and her airway gets larger that she might outgrow her apnea, but for now she is on cpap.  I hope they are correct but realistically if they can't even tell me why she can't maintain her airway how can they know that she will when she is 10 or 12????  She is happier and healthier on cpap and there she will stay until they can prove without a doubt that it is gone.....

Chris is beyond the car seat stage, but I would imagine that if he were to sleep in his car seat and his head fell forward or in an awkard angle that he might have a problem.

Hope this helps.  Feel free to ask anything.

Susanne and her mini-hosehead Chris (child of great mystery and intrigue as well as OSA/RLS/PLMD/Reflux/Asthma/soft tissue cancer survivor and other entertaining things)

Thanks for all of the information!!  The more I know, the less scary everything seems.  (Not that apnea isn't scary, but having so much information w/out understanding it seems worse somehow)....  My son does have a car seat that was designed for special needs kids.  It's very supportive and doesn't allow his head to fall to one side or the other.  I did manage to show the video clip of him sleeping in the car to the pulmo and she said that it was "very telling"...??  It looks like he's obstructing more when he sleeps upright and is having more centrals when lying down at a 30 degree angle.  The next step is to do a pulse/ox test while he's in the car.  Beyond that, I think we're looking at oxygen.  

It's so hard to ask the "right" questions when I have almost no idea what I'm asking about.   I never expected any apnea problems to show up during his sleep study.  We were mostly wanting to know why he wakes up crying/screaming/thrashing around several times each night.  You've been a big help to me.  Thanks for being patient.  I really appreciate all of your responses.  It's nice to know that there are other out there who do understand what we're going through.  (hugs)

I just read this whole thing again. My son does wake up screaming and thrashing and crying inconsolably. Why? We think he wakes up and isn't breathing and gets scared. The cry that he initially comes out with once he catches his breath sounds like his "terrified" cry. We have actually witnessed apnea events where he will open his eyes (darting back and forth) but isn't breathing.  Once he catches his breath, he screams like nothing you've ever heard before.  I don't know if this is what's wrong, but it might be??

Tiffany,

That sounds like what my son does at night as well.  During his first sleep study, the crying/screaming coincided with some of the longer pauses in breathing.  It makes sense...I'd want to cry too if I went for 30 seconds without taking a breath.  Hugs to you and your son.  I hope you're able to get things figured out with him.  

Sheila