Sleep Disordered Breathing in Children

Abstract

The sleep disordered breathing (SDB) in children is associated with both cardiovascular diseases and cognitive impairment. A representative case with SDB is witnessed to have frequent snoring, interrupted breathing, and arousal during sleep by caregivers, some of whom may also find paradoxical breathing at apneic phase during sleep, probably leading to funnel chest in severe SDB case. In addition, the affected children may suffer from adeno-tonsillar hypertrophy, or nasal congestion, which may play a pathogenic role. Because of consequent cognitive impairment, school children may not be able to concentrate well in school, leading to poor school performance and/or injury, sometimes resulting in a mis-diagnosis of attention deficient hyperactive disorders (ADHD). Since these will affect future life in those children, the appropriate diagnosis and treatment are essential. The therapeutic approach to children with SDB includes adenotonsilectomy, and anti-allergic drug against nasal congestion, in addition to continuous positive airway pressure (CPAP).

As SDB in children is not well recognized, we described the epidemiologic aspect of SDB in children, after developing a Japanese version of Gozal’s questionnaire. We administered the questionnaire to all the 26,000 primary school children in Matsuyama. This elucidated the prevalence of SDB-related symptoms, as well as those related to hyperactivity and anxiety. Around 10% of children snored 3 nights or more a week, 40% snored 1 to 2 nights per week, across all the grade. They slept 8 to 9 hours a day, but children of higher grade slept less. This epidemiologic data makes us aware of the sleep problems in children, and encourages us to provide them with appropriate diagnosis and treatment.