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Published on: December 22, 2016
Central Sleep Apnea and Hypoventilation Disorders in Children
Indra Narang1, Chun Ting Au2, Maida Lynn Chen3
1Department of Pediatrics, The Hospital for Sick Children, 175 Elizabeth Street, Toronto, Ontario, M5G 2G3, Canada.
Sleep Medicine Clinics
|August 7, 2026
Summary
This chapter details pediatric central sleep apnea and hypoventilation disorders, focusing on complex medical conditions and genetic syndromes like CCHS and ROHHAD. It offers insights into causes, diagnosis, and evidence-based management strategies for affected children.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Genetics
Background:
- Central sleep apnea (CSA) and central hypoventilation disorders affect children, particularly those with complex medical needs.
- Genetic syndromes like congenital central hypoventilation syndrome (CCHS) and rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome are key areas of focus.
- Related conditions include Prader-Willi syndrome and hypoventilation due to structural issues like Chiari malformations.
Purpose of the Study:
- To provide a comprehensive overview of pediatric CSA and central hypoventilation disorders.
- To emphasize the impact of complex medical conditions and genetic syndromes on these respiratory disorders.
- To review current knowledge and offer evidence-based management guidance.
Main Methods:
- Literature review and synthesis of current knowledge.
- Focus on pathogenesis, epidemiology, clinical presentation, and diagnostic evaluation.
- Examination of management and treatment strategies.
Main Results:
- Detailed overview of pediatric CSA and central hypoventilation disorders.
- Emphasis on specific genetic syndromes (CCHS, ROHHAD) and related conditions.
- Compilation of current understanding of disease mechanisms and clinical features.
Conclusions:
- Effective management requires understanding the specific disorder, its genetic basis, and clinical presentation.
- Evidence-based guidance is crucial for optimizing treatment outcomes in affected children.
- Further research into pathogenesis and treatment is warranted.
Related Concept Videos
01:21Sleep 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...
The condition is more prevalent among...
01:30Alterations 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...
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include...
01:25Hyperpnea and Hyperventilation
Hyperventilation refers to a higher-than-normal rate and depth of breathing, often associated with anxiety attacks. This excessive breathing surpasses the body's need to expel CO2, leading to a condition known as hypocapnia - an unusually low level of carbon dioxide in the blood. Hypocapnia can constrict cerebral blood vessels, reducing blood flow to the brain, which may result in dizziness or fainting. Early signs include tingling and muscle spasms in the hands and face, caused by falling...
01:17Other 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.
01:21Acute Respiratory Failure-II
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:26Respiratory Volumes and Capacities I
Assessing the respiratory rate and rhythm for a complete minute is crucial for evaluating the breathing pattern. Even a minor increase in the patient's average respiratory rate, by as little as three to five breaths per minute, is an early and vital indicator of respiratory distress. Patients with a respiratory rate exceeding twenty-four breaths per minute require close monitoring to determine the physiological alterations. This careful observation is essential for prompt recognition and...