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Sleep Apnea No Treatment for Child
#1
Good morning. My son recently was referred for a sleep study by his ENT. He is 5 years old. Results came back as follows:
Apne/Hypoapnea Index: 3.7
REM Index: 13.7
Cent Apnea: 17
Obst Apnea: 0
Mixed Apnea: 1
Hypoapnea: 10
Avg 02 Sat Baseline: 98.3-100%
Lowest 02 Sta 87%

The MD has stated he does not require treatment. Is this normal/ok for him to experience apnea, w/o being treated?
Thanks
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#2
From what I have read, most people have some apneas. It is only after they reach a certain frequency or duration that they become a medical concern. By convention that is an AHI above 5.0. So by that measure your ENT is correct that he does not require treatment. His blood O2 got a bit low, but nothing really alarming. And you would need to know for how long it was this low. The numbers you have here are just a high level summary.

A sleep doctor should have interpreted the sleep study. Have to received his report? If not, ask for it. You might want to consult directly with the sleep doctor on this matter.

You also don't mention why the sleep study was done. Is he snoring? Is the ENT looking at tonsil/adenoid surgery?
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#3
I have not spoken with the sleep MD. Have an appointment with ENT next week. He has already had a T&A, but he is snoring, restless sleep, grinding teeth, waking up tired, sleeping with neck hyper-extended. The sleep clinic will not let me speak with the MD who interpreted his report. I have to talk with ENT.
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#4
Here are some studies on childhood sleep apnea

https://sciencelife.uchospitals.edu/2012...eep-apnea/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004500/
2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
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#5
(09-15-2016, 09:57 AM)keela1979 Wrote: Good morning. My son recently was referred for a sleep study by his ENT. He is 5 years old. Results came back as follows:
Apne/Hypoapnea Index: 3.7
REM Index: 13.7
Cent Apnea: 17
Obst Apnea: 0
Mixed Apnea: 1
Hypoapnea: 10
Avg 02 Sat Baseline: 98.3-100%
Lowest 02 Sta 87%

The MD has stated he does not require treatment. Is this normal/ok for him to experience apnea, w/o being treated?
Thanks

An Index is the number of events divided by the therapy time.
Therefore in this example the therapy time can be calculated by dividing the TOTAL events (17+1+10) by the noted AHI (3.7) resulting in a calculated therapy time of 28/3.7 (7.567) hours. Using the Mixed, Hypo and Central events, and this calculated therapy time, individual indices can be calculated. The sum of these three indices when added together gives the AHI, which should be less than 5.0. (1.3214 + 2.246 +0 = 3.5674) This figure correlates well with the AHI above (3.0) when allowing for Mathematical roundings etc.

Although I am not a Medico of any type, my curiosity over a long period of time has led me to the conclusion that Sleep Indices are a misunderstood measure, the professionals rarely take the time to educate the patient and hence the misunderstanding.

I hope my little rambling has been of assistance.


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#6
Hi keela1979,
WELCOME! to the forum.!
Hang in there for more responses to your post and I wish you and your son good luck as you go through this situation.
trish6hundred
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#7
Central apnea "events" can be caused by holding your breathe while turning over. Personally I would want to know how long the "apneas" are lasting, they must last 10 seconds to be counted. Now if they were lasting 2 minutes that would get my attention. O2 levels of 87% is indeed pretty low, I have heard of 60% so not catastrophic, but lower than it should be.

You will learn more at your meeting. Oh and also look to see when the apneas are happening, there are events known as sleep/wake junk that are not true apneas and occur during entering and exiting sleep. They will be counted in the total.
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#8
The scale for AHI is completely different for children vs. adults. Anything over 1 is considered significant in children and requires treatment. The first line of treatment for children is surgery, either tonsillectomy/adenoids or expansion sphincter pharyngoplasty.

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#9
This is what the information I have read has stated. Anything above 1 is abnormal and should be treated. As I stated earlier, he has had a T&A so I don't know what the next step is. This is the reason I don't understand why they are saying he is "ok". I am so upset at this point. My five year old tells me he is tired everyday 1.5 hours after waking up. I feel terrible. We meet with his PCP and ENT next week. Hoping to get some answers.
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#10
(09-16-2016, 09:59 AM)keela1979 Wrote: This is what the information I have read has stated. Anything above 1 is abnormal and should be treated. As I stated earlier, he has had a T&A so I don't know what the next step is. This is the reason I don't understand why they are saying he is "ok". I am so upset at this point. My five year old tells me he is tired everyday 1.5 hours after waking up. I feel terrible. We meet with his PCP and ENT next week. Hoping to get some answers.

Does he have trouble breathing out of his nose (i.e. does he mouth breathe)? Does he have a recessed lower jaw? Mouth breathing and poor tongue posture can/will cause the lower jaw to grow vertically instead of projecting forward (long face syndrome), which will cause airway issues. In addition to the ENT, I'd take him to a maxillofacial/orthognathic surgeon who can diagnose any jaw growth abnormalities. Orthodontists should be able to spot retrognathic jaw growth as well. If the ENT doesn't find anything wrong, try to get a second opinion from another ENT that specializes solely in OSA who can perform a drug-induced sleep endoscopy test (if you need a referral, contact this Dr. http://www.sleep-doctor.com/about-dr-kezirian/).

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