Apnoea / OSA

Question 1

What is paediatric apnoea and its causes?

Answer 1

Temporary cessation of breathing - common in very low birthweight infants until they reach 32 weeks gestational age

Central:

• Prematurity
• Head trauma
• Toxin-mediated

Obstructive:

• OSA due to tonsil/adenoidal hypertrophy
• Obesity

Mixed:
- Gastroesophageal reflux

Mx = breathing usually starts again after gentle stim, respiratory stimulant caffeine, CPAP (freq ep)

Question 2

Outline the types of apnoea

Answer 2

Central apnea is a result of inadequate medullary responsiveness and thus results in no or poor muscle coordination for breathing.

Obstructive apnea is when there is an obstruction of the airway passages and therefore poor to no air exchange.

Mixed

Question 3

What is OSA?

Answer 3

Involves cessation or significant decrease in airflow in the presence of breathing effort

Characterized by recurrent episodes of upper airway collapse during sleep

OSA that is associated with excessive daytime sleepiness is commonly called obstructive sleep apnea syndrome

Question 4

How does OSA present?

Answer 4

Night time:

• Snoring (loud, habitual, bothersome to others)
• Witnessed apnoea’s, which often interrupt the snoring and end with a snort
• Gasping/choking sensations that arouse from sleep
• Nocturia
• Insomnia
• Restless sleep

Daytime:

• Nonrestorative sleep (waking up as tired as when they went to bed)
• Morning headache, dry or sore throat
• Excessive daytime sleepiness (EDS)
• Cognitive deficits
• Personality and mood changes