Obstructive sleep apnea happens when there is a partial or complete blockage of the pharyngeal pathway of air during sleep which causes episodes of apnea for hypopnea. It may cause many symptoms in the children like arousal from the sleep, crying in the night, hypersomnolence in the daytime, feeling of fatigue in the morning, reluctance to get awake or going school, etc.
How Does Obstructive Sleep Apnea Affect A Child’s Body & What Triggers It?
Even though obstructive sleep apnea is a lesser found condition in children, it can cause various short- and long-term effects which can be physical or psychological. Firstly, the symptoms of obstructive sleep apnea are itself very distressing to the childlike habit of snoring which is found in the majority of children suffering from this condition, restless sleep, episodes of apnea in the night, hypersomnolence etc. These can also generate a few of the physical as well as psychological symptoms in the children because of higher vulnerability.
Physical effects include gastroesophageal reflux disease, heartburn, increased night-time urine frequency, increased heart rate, blood pressure, weight gain, headache, night sweating etc. Obstructive sleep apnea also causes a variety of psychological effects in the children like lethargy, increased sleepiness during the daytime, irritability, forgetfulness, loss of concentration, lack of attention, depression, anxiety, headache, insomnia, etc.
It can also lead to an unexplained increase in the weight which can form a vicious cycle superimposing itself on childhood obesity.
What Triggers Obstructive Sleep Apnea?
There can be many causes responsible for obstructive sleep apnea in children. These causes can be classified into local causes and central causes. Local causes are those which occur at the site that is in pharynx like tonsillitis, structural deformity of the inhalation pathway, increased local soft tissue due to any cause, etc.
Craniofacial abnormalities are a more prominent cause among the children because of presentation as a structural deformity due to the asymmetry of the pharynx like cleft palate, low jaw location, hypognathia, temporomandibular dislocation, etc. Exposure to cigarette smoke in childhood age is also associated with an increase in the incidence of obstructive sleep apnea.
Central causes are those in which the muscular function gets weak because of the loss of neurotropic innervation of the pharyngeal muscles like cranial neuropathy, neuromuscular junction diseases, spinal cord defects or compression, brainstem involvement, brain injuries, obesity and full stomach patients, in anesthesia, etc.
Some metabolic causes can also be responsible for this condition which also accountable under the central causes like sedatives, alcohol and related beverages, depressant drugs, central muscle relaxants, inhalational anesthetics, etc.
Whether due to local or central causes, the main defect is in the narrowing of the pathway for the air entry which causes the snoring habit and difficulty in breathing during sleep time. Childhood obesity is also a very common cause for obstructive sleep apnea in children whose incidence is on a sharp rise in recent times due to the increase in the incidence of obesity among children.
There are various causes of obstructive sleep apnea in the children and are classified into peripheral/local or central causes. Genetic abnormalities and chromosomal discrepancies can result in various hereditary syndromes like down syndrome, treachers Collins syndrome, etc. which can be associated with obstructive sleep apnea because of craniofacial anomalies.
Central causes like neuropathies, neurotropic disorders and various other causes of weakness of muscles can also be responsible for this condition. Passive smoking, childhood obesity, metabolic causes, drug effects etc. can be a few of the other causes which can be listed.
Obstructive sleep apnea not only affects the child physically but also creates a depressing effect on the mental aspect of a child by creating psychological symptoms as well. It is very important to take care of the condition in its early stage and counter the causes and risk factors for preventing the full-blown obstructive sleep apnea.
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