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Is APNEA gone?
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Post Is APNEA gone? 
Please I need help with my 7 month old's results from his 2nd sleep study. Little background...kiddo got whooping cough that caused apnea among other things.  Although from the minute he was born he never slept more than 2 hours at a time.  Currently on Zantac/Prevacid/lactulose for reflux as they feel that could be cause of OSA and chronic cough.  Not a big spitter though.  Developmentally normal.

Here is sleep study results where neurologist feels he may just not be a sleeper and we should just adapt our lives to a child that sleeps 7 hours a night waking 4 times at least and naps 2x/day at 30-45 min each!
Is the dr correct??

Age at sleep study    3 months    6 months
Central Apnea                7             10
Central Apnea Index      1.2/hr    1.3/hr
Mixed Apnea                0               0
Obstructive Apnea        1               0
Obstructive Hypopnea        27               7
Obstructve Apnea Hypopnea Index    4.8/hr    .9/hr
AHI                               6/hr    2.3/hr
O2 Saturation Awake         98    97
O2 Desaturation Sleep Low    82    80
NREM O2                        82-99    87-99
REM O2                       84-99    80-99
O2 >89                       96.4%    96.8%
ET CO2- awake               37-41    34-45 mmHg
ET CO2-sleep               41-44     34-45 mmHg
CO2 retention               normal    normal
Leg movement index        3.1/hr    0/hr
Sleep efficiency                88%    89%
Sleep architecture
       REM                      29%    18.1%
       N1                       0%     0%
       N2                    22.6%    58.8%
       N3                   48.4%    23%
Latency to REM     34.5 minutes    109.5 minutes
Arousals                  Normal    abnormal
Arousal index          11.3/hr    13.6/hr
Arousal+awakening index    11.9/hr    16.5/hr
Snores                     Mild             absent


3 month conclusion-moderate obstructive apnea with sleep fragmentation and mild hypoxemia. Apnea monitor, pulse ox monitor, and o2 at home.

6 month conclusion- minimally abnormal study.  Many arousals were accompanied by mom nursing.  Improved sleep quality may occur without mother intervention.  No monitoring or O2 needed at home.
(Did not hook up lines to arms and legs this time to even record any movement but got 0 movements!  Snored rather loudly for first hour and last.  Told to nurse as often as needed to get him back to sleep as    is a sleep study).


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Is his neurologist a sleep specialist, too?

At only 10 centrals all night, I'd be comfortable coming home without monitoring and moving on with life. We did that with our son at 10 months old. Here's some of his story:

At age 4 months, he had 72 centrals and 0 obstructives in 9.2 hours of sleep, waking every 2-3 hours to nurse.  He had been on an apnea monitor and we continued its use after this study.

At age 10 months, he had 11 centrals and 0 obstructives in 8.7 hours of sleep, waking every 2-3 hours to nurse. We had given the monitor back at 8 months of age for a variety of reasons. This study was classifed as "normal" and we were sent on our merry way, thinking we'd never be back in a sleep lab again.

However, at 21 months, his centrals episodes were back and at 30 months, they were back with a vengeance. He was placed on a pulse oximeter at home and eventually started c-pap (just 3 weeks ago at age 3 years, 4 months.).


Honestly, if your mommy gut is okay with it, then I'd say "see ya later" and count your blessings.  However, if its not okay with these findings and the doc's opinion, then get another one.  Isaac's last sleep specialist (a pulmonologist) thought we were overreacting and that Isaac was fine. 3 months later at a new neurologist's office who specializes in sleep disorders and Isaac is given the opportunity for c-pap. He is a different kid and we are thankful we followed our guts on this one...

Keep asking questions until you are satisfied that you understand his situation and condition and are confident of the "plan" in place to care for him.

Tiffany Acuff

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