Unusual OSA Suspects

Obstructive sleep apnoea is a serious condition in which a person starts and stops breathing during sleep. The typical person with obstructive sleep apnoea is male and overweight. However, surprisingly enough, recent studies say that sleep apnoea can affect anyone, thick or thin, young or old. Even the Sleep Association of American estimates that about 1% to 3% of otherwise healthy children under the age of 8 suffer from sleep apnoea.

An article from http://nursing.advanceweb.com has talked about extraordinary signs and symptoms of sleep apnoea affecting both the young and the old as well as on how to handle this breathing problem.

• Behavioural problems were 4-5 times higher in children with incident sleep apnoea and six times higher in children who had persistent sleep apnoea. Compared to their peers who never had sleep disorder breathing (SDB), children with sleep apnoea were more likely to have parent-reported problems in the areas of hyperactivity, attention, disruptive behaviours, communication, social competency and self-care.

• Children with persistent sleep apnoea were also seven times more likely to have parent-reported learning problems and three times more likely to have school grades of C or lower.

• Sleep apnoea contributes to difficulties with hyperactivity, learning and behavioural and emotional dysregulation in the classroom

• All children/adolescents should be screened for snoring. When parents take their child for an annual wellness check, this should be one of the questions they're asked.

• Polysomnography can be performed in children/adolescents with snoring and symptoms/signs of OSAS; if polysomnography is not available, then alternative diagnostic tests or referral to a specialist for more extensive evaluation may be considered.

• Adenotonsillectomy is the first-line treatment of patients with adenotonsillar hypertrophy.

• Objective testing should be performed in patients who are high risk or have persistent symptoms/signs of OSAS after therapy.

• Continuous positive airway pressure must be performed if adenotonsillectomy is not performed or if OSAS persists postoperatively.

• Weight loss should be another tool for patients who are overweight or obese.

• Intranasal corticosteroids are an option for children with mild OSAS in whom adenotonsillectomy is contraindicated or for mild postoperative OSAS.

• When weight isn't to blame, skeletal structure is suspect. Most children with persistent obstructive sleep apnoea have smaller jaws than normal. In certain conditions, the tongue size can be modified or the jaws made bigger.

• The more popular orthodontic routes of treatment are the mandibular advancement device (MAD) or the tongue retraining device (TRD).

• MAD, the most popular device, resembles a simple mouth guard someone would wear while playing hockey or football. The device forces the lower jaw forward and down slightly, which keeps the airway open during the night.

• The TRD, on the hand, is a splint for the tongue, holding it in place to keep the airway as open as possible.

• Functional orthodontics can be started in school-aged years to not only straighten teeth, but also to enlarge the jaws and the airway. Palatal expansion is another option for some children.

Read more here:

http://nursing.advanceweb.com/Lifestyle-for-Nurses/Health-Wellness/Unusual-OSA-Suspects.aspx

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