Hi,

My name is Emma and I am new to this forum. My daughter Lily was first diagnosed with Sleep Apnea about a year ago and since then its been a never ending saga. I am hoping that someone on here may be able to offer me some advice as I am going out of my mind with worry and am not sure what to do.

In November last year Lily was diagnosed with OSA after having a sleep study in a sleep lab. She had a T&A (and had severe bleeding complications the resulted in a further two operations - another story). We thought that that would be it. However many of her symptoms persisted. We went back to the specialist and in August this year she had another sleep study.

The sleep study showed the following:

+ quiet sleep baseline respiratory rate was 18p/m, heart rate 100pm, oxygen saturation 97.2%.
+there was mouth breathing and soft snoring but no evidence of OSA. A normal number of central apneas were noted, 3.4/hr and the duration of the apneas was within normal limits (longest apnea 15.7 secs) but they tended to cluster during REM sleep resulting in the lowest Oxygen saturation recorded at 79%. Gulping was noted.
+sleep was fragmented by frequent arousals, 12.3 p/h. Sleep efficiency was 82.4%. Stage 1 sleep compromised 0.1%, stage 2 31.1%, stage 3 and stage 4 50.8%, REM sleep 18% (normal structure).  There were 11.4 periodic limb movements p/h of sleep.

Doctor's recommendations:
+There is no evidence of OSA
+ There is evidence of Periodic Limb Movement Disorder
+This pattern of central apnea is associated with gastro-oesophageal reflux as is gulping in sleep.

I guess the results are ok, however my biggest concerns are:

1. the oxygen desaturation of 79%; and
2. I really do not understand how central apneas can be associated with GERD? Would it not be OSA?

Lily is not on a monitor or CPAP however is taking medication for reflux and melatonin and iron supplements to help with periodic limb movements.

I would appreciate any advice, guidance or support.

Many thanks,

Emma

Emma,

I am sorry you are worried over your daughter, but glad you have found your way here. There several parents that have been there and done that and can offer some encouragement.  I do hope you find the answers you are seeking and the mental relief you need!

I do want to address your concerns.  

1. The oxygen saturation (osat) of 79%. I wouldn't be terribly concerned as long as it was less than 15 seconds in duration and she bounced right back up into the 90s.  And only if it happened once during the night.  

2. How GERD and central apnea are related...What happens here is that when the reflux gets high enough in the esophagus, the brain perceives a danger of aspiration and "instructs" the body to stop breathing until it determines that the danger has passed, when it will then give the body a "go ahead" to continue breathing. Obstructive apnea can be associated with reflux, but only if it is causing an actual obstruction of the airway.

The iron should help tremendously with the limb movements and the reflux meds should help with the apnea (at least if their theory is right).

You are on the right track.  What is her next step in this process?

Keep asking questions and let us know how she is doing...

Tiffany Acuff..

Mom to Isaac, my 3 year old who can read, but not remember to breathe when he sleeps and to Esther Rose, my 6 month old beauty, who currently has croup!

aelo wrote:

Hi,

My name is Emma and I am new to this forum. My daughter Lily was first diagnosed with Sleep Apnea about a year ago and since then its been a never ending saga. I am hoping that someone on here may be able to offer me some advice as I am going out of my mind with worry and am not sure what to do.

In November last year Lily was diagnosed with OSA after having a sleep study in a sleep lab. She had a T&A (and had severe bleeding complications the resulted in a further two operations - another story). We thought that that would be it. However many of her symptoms persisted. We went back to the specialist and in August this year she had another sleep study.

The sleep study showed the following:

+ quiet sleep baseline respiratory rate was 18p/m, heart rate 100pm, oxygen saturation 97.2%.
+there was mouth breathing and soft snoring but no evidence of OSA. A normal number of central apneas were noted, 3.4/hr and the duration of the apneas was within normal limits (longest apnea 15.7 secs) but they tended to cluster during REM sleep resulting in the lowest Oxygen saturation recorded at 79%. Gulping was noted.
+sleep was fragmented by frequent arousals, 12.3 p/h. Sleep efficiency was 82.4%. Stage 1 sleep compromised 0.1%, stage 2 31.1%, stage 3 and stage 4 50.8%, REM sleep 18% (normal structure).  There were 11.4 periodic limb movements p/h of sleep.

Doctor's recommendations:
+There is no evidence of OSA
+ There is evidence of Periodic Limb Movement Disorder
+This pattern of central apnea is associated with gastro-oesophageal reflux as is gulping in sleep.

I guess the results are ok, however my biggest concerns are:

1. the oxygen desaturation of 79%; and
2. I really do not understand how central apneas can be associated with GERD? Would it not be OSA?

Lily is not on a monitor or CPAP however is taking medication for reflux and melatonin and iron supplements to help with periodic limb movements.

I would appreciate any advice, guidance or support.

Many thanks,

Emma

Hi Emma,

Since I was a youngster I have had trouble going to sleep.  I also tend to produce acid in my stomach during that time.  I sometimes wonder if my body "remembers" the apnea and has this as sort of a worry habit.

I have been trying to watch what I eat near bed time.  I have also made it a priority to eat more veggies.  What I have noted with some surprise is what spinach does to me.  Raw or cooked a cup or two of the stuff eaten within two hours of bed time just seems to calm the stomach altogether.  Instead of feeling the acid burn I feel calm.

So now most nights I have a veggie soup or salad with spinach.

Bon Appetit!

Todzo