SLEEP-DISORDERED BREATHING IN CHILDREN

The first series of children with obstructive sleep apnoea syndrome wa s reported in 1976, Later it became apparent that children may have br eathing disorders during sleep without frank apnoea or 'hypopnoeas', T his pattern could be detected by measuring the oesophageal pressure. T his led to the concept of sleep-disordered breathing as a spectrum tha t combines obstructive sleep apnoea syndrome and the upper airway resi stance syndrome. Studies that do not take into account this spectrum m ay misclassify symptomatic patients as 'primary snorers', The exact pr evalence of sleep-disordered breathing in children is unknown taut may be as high as 11%, There is a familial predisposition to sleep-disord ered breathing, Nasal obstruction and mouth breathing influence facial growth, which may further lead to difficulty in breathing while aslee p. Symptoms include an increase in total sleep time, nonspecific behav ioural difficulties, hyperactivity, irritability, bed-wetting and morn ing headaches, Clinical signs include failure to thrive, increased res piratory effort with nasal flaring and suprasternal or intercostal ret ractions. Also, abnormal paradoxical inward motion of the chest may oc cur during sleep, Excessive daytime sleepiness and obesity are not alw ays present, Untreated children may develop cardiovascular complicatio ns, The condition is treatable with continuous or bilevel positive air way pressure, and may be cured with surgery.