Sleep-disordered breathing in children

C L Marcus1

  • 1Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, Maryland, USA. cmarcus@welch.jhu.edu

Insights

Childhood sleep-disordered breathing, including obstructive sleep apnea, is common but often missed. Early diagnosis and treatment of these sleep-related breathing disorders can prevent serious health issues like neurocognitive deficits.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Child Health

Background:

  • Sleep-disordered breathing (SDB) is prevalent in children.
  • Obstructive sleep apnea syndrome is a common form of SDB.
  • Complications include neurocognitive deficits, growth failure, and pulmonary hypertension.

Purpose of the Study:

  • To highlight the significance of SDB in children.
  • To discuss the diagnostic challenges and new syndromes like upper airway resistance syndrome.
  • To emphasize the importance of polysomnography in evaluating SDB.

Main Methods:

  • Review of current literature on pediatric sleep-disordered breathing.
  • Discussion of diagnostic tools, particularly polysomnography.
  • Description of emerging sleep-related respiratory syndromes.

Main Results:

  • SDB, including obstructive sleep apnea, is frequently undiagnosed in children.
  • Upper airway resistance syndrome is a newly described condition.
  • Polysomnography is crucial for accurate diagnosis.

Conclusions:

  • Despite being common, SDB in children is often unrecognized.
  • Advances in diagnosis and management can significantly reduce associated morbidity.
  • Timely intervention is key to improving outcomes for children with SDB.

Related Concept Videos

Breathing01:05

Breathing

The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
Alterations in Respiration II01:30

Alterations in Respiration II

There are numerous types of normal and abnormal respiration. Based on ventilatory movements, breathing patterns are classified as regular, deep, or shallow. Examples include Biot's breathing, Cheyne-Stokes respiration, Kussmaul's breathing, hyperventilation, and hypoventilation. Each pattern is clinically significant and aids in evaluating patients.
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include...
Other Pulmonary Disorders01:17

Other Pulmonary Disorders

Respiratory disorders encompass a range of conditions with varying levels of severity. Asthma, marked by chronic airway inflammation and hypersensitivity, is one such condition. It can lead to airway obstruction due to factors like bronchial spasms, mucosal edema, increased mucus secretion, or epithelial damage. Asthma triggers are diverse, ranging from allergens to emotional upset, and treatment focuses on both immediate relief through bronchodilators and long-term inflammation suppression.
Physical Assessment of the Respiratory Tract II: Inspection01:27

Physical Assessment of the Respiratory Tract II: Inspection

Physical assessment of the respiratory tract through inspection is a crucial step in understanding the patient's respiratory health. It provides insights into the functioning of the respiratory system, the musculoskeletal structure, and even the patient's nutritional status. This comprehensive approach involves observing several vital aspects: chest configuration, breathing patterns, respiratory rates, skin color, and use of accessory muscles.
Chest Configuration
The chest configuration can...
REM Sleep Behavior Disorder01:15

REM Sleep Behavior Disorder

REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
RBD is significantly associated with...
Sleep Apnea01:21

Sleep Apnea

Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...