I say should we be concerned because the neurologist, board certified sleep specialist says no.  But my gut says yes.

We have a 6 year old boy who had a sleep study about two weeks ago.  It showed 13 events of central apnea and no other events (1.8 events per hour).  Total sleep time: 7.4 hours, only 81% of monitoring time.

Events were 10-37 seconds long.  ETCO2 up to 43.  Desats: 1 event to 70.3%, 1 event b/w 80-85%, and 11 events b/w 85-90%.  None of the events were in REM sleep.

He had 17 awakenings and 97 arousals, only 5 of the arousals were respiratory, and 2 were from limb movement, so the other 90 were spontaneous.

He had 41 LMs, 26 PLMs, 2 LM w/ arousals, 5 Periodic limb movement sequences.

They also note that "the EEG findings were characterized by the recoding of 14 and 6 positive spike wave pattern during periods of REM sleep.  This is s a finding of uncertain diagnostic significance, and has been reported in asymptomatic children in this age group.  The EEG background activity was within the range of normal variation.  There were no epileptiform abnormalities.  No lateralizing features were recorded."


What I see in my son is that he isn't getting enough sleep.  Even though he usually sleeps 10 hours a night.  My husband had mild OSA that was handled entirely by T&A removal at the end of June 2006.  We honestly thought that he had obstruction as well, though we hear no snoring...unless he has a plugged nose.

My younger son has a seizure disorder, and we are concerned about genetic factors affecting the older one as well.

We have an MRI scheduled, but they will only do it under General, and don't have a spot until mid September!

TIA.

Hi Tia and Welcome!

I am sorry no one has responded to you.  It is probably because we don't know the answer.  I want to note that obstructive sleep apnea is usually characterized by snoring, but we have many posters who don't snore.  Have you considered getting a second opinion?  Be sure to find a doc who is accredited in sleep disorders (look at the beginning posts in this section.

Vicki


_________________
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

As an adult recently diagnosed with SEVERE mixed sleep apnea I have to say run don't walk to the next doctor on your list for a second or third opinion if need be.  I have suffered from central apnea since an infant.  Sometimes while awake and often while sleeping.  Unfortunately my pediatrican said to my Mom (who was a NICU nurse at the time), "don't worry it is just a preemie thing."  Mom of course in response said, "oh ok, makes sense" and never gave it another thought.  

I was born at 27w5d gestation weighing 2lb3oz back in 1967.  They didn't have baby heart monitors, let alone vents, or any of today's wonder machines.  I survived severe respiratory distress syndrome (back then called hyaline membrane disease) and did well through toddler/childhood with 'typical' preemie issues.  Bi-winterly hospitalizations for pneumonia.....likely RSV (another unknown of that time period), asthma and never hitting beyond the 10th percentile.  

I struggled all of my years in school and was diagnosed ADD (zero hyperactivity) in my teens.  Would be sleepy all of the time.  Couldn't stay focused in school to save my own life. As a young adult, I was lucky to pass on the party scene   because I never could stay up beyond 9:00pm without paying the sleepy price for days afterwards.  

At age 21 I had my first baby....pregnancy very complicated...exhaustion set in....was treated for depression even though I wasn't suffering emotional issues, just exhaustion, they called it depression.  Weight at that time about 105.  I quit the meds before they could even begin to work. At age 25 baby number two......again complications.  Weight at this time about 110.  Age 29 baby number three.....complications this time led to 34 week delivery.... Weight at this time 120.  8 months later diagnosed with severe post partum depression.  I was seriously so exhausted nothing in my life made any sense and I didn't want to do ANYTHING.  Mole hills became mountains and I could barely function.  They put me on meds and although my mood improved I was so exhausted daily that I quit PPD meds because it did nothing to help me with the exhaustion that was causing me to be more depressed...and also in 5 months on the depression drug I gained a whopping 50lbs.  At age 32 (170lbs) I had baby number 4 another preemie this one younger and very critically ill at birth.  My exhaustion was overwhelming and caused lots of daily problems including a 4 week stint in the hospital for complications from the delivery.  

All the different doctors who saw me had their different opinions of what caused all of the above.  They always do.  After all I have been through I have learned to know my own body and to listen to it.  That includes my children's.   I can say 100% positive that all of the above was due to an entire lifetime of untreated sleep apnea.  I can remember all the way back to early grade school, the feeling of exhaution, having to go to the school office to lay down and rest, missing out on neighborhood fun with the other kids because I was just 'too tired'.  

My untreated childhood central apnea has led me down the road of, deciding against college because I just couldn't keep up, exhaution, repeated placental abruption during pregnancy, obesity which caused the addition of OSA, depression, high blood pressure, fibromyalsia, etc.  FIND TREATMENT FOR YOUR CHILD.  I know I am nobody to you, but I know in my gut that your child needs help...and it is NOT nothing.  I have been there done that.  Listen to your own gut.  That is Mom's 6th sense and it is ALWAYS right!

I want to add here a bit of food for thought....and I hope someone with a medical background will see this and respond....

I started CPAP in May.  I did it less than 1 week.  I got very ill.  My apnea was clearly worsened as well as other complications.  I quit the machine and did not tell my doc until yesterday at acheck-up.  That was when my doctor told me that I had CSA not OSA and that my recent weight loss was NOT going to help me, that  only the machine would.  So off I went to see the med equpiment guy for a different mask and he told me that if I have CSA rather than OSA, that I am totally on the WRONG machine, so I have a note in to the doctor for Monday. However.......

I have recently at 39 years of age decided to go back to school.  Due to my ADD and sleepiness issues I went to a psychiatrist to get meds for ADD.  Listening to my background, my most recent diagnosis's, and already having all my "depression" history in his file he put me on Dexadrine.  I am finally full of energy and raring to go.  I have been on it a bit over 2 weeks.  Results were immediate about 15 minutes after the first dose.  The unexpected part is that I have been waking up rested and remembering dreams.  I haven't dreamt in years.  So my sleep is clearly cycling more normally.  I have not woke up once to pee or for any other reason and I have been a life long very light sleeper.  Any little noise in the house or even from outside and I am up.  Not anymore.  The reason I find this interesting, is the whole preemie apnea thing and my current meds.  My last preemie had Apnea's and Brady's in NICU.  They treated the Apneas with caffiene....a stimulant.... just like the dexadrine that I am currently taking.  All my reading so far has told me there is no treatment or effective treatment for central apnea.  I am betting money this is just not true.  I am also betting money the stimulant I am on is currently reminding my brain (just as caffiene does for newborns) to fire while I am sleeping and that is why I am finally waking up rested for the first time I can remember in 39 years.

Sorry I get winded at times, but I think the whole picture needs to be seen, for these doctors to 'get it'.  I have been there and I do NOT want your child to go through all that I have.  There has to be help for him.  Don't give up.  That doctor is wrong!

send me an e-mail....I too have son with unknown cause epilepsy...normal MRI... always abnormal EEG's...mostly febrile and petit mal (aka absence), however a few very intense grand mals.  I think a lot of this stuff can be all connected by the doctors if doctors would just take notice and really listen to people.

Thank you both for your responses.  I'm sorry I wasn't able to get back as we have been pursuing finding out what is wrong.  It became fairly clear that the 1st doc didn't really know what he was talking about.

Two weeks after I posted, my 6 y old didn't eat all day, and by that evening, he was slurring, stuttering, and mixing up his words.  We went straight to the ER for a CT scan and EEG.  CT scan was normal.  EEG showed diffuse brain disfunction.  Evidently this is indicative of a metabolic disorder.  And the more I have read, my ped and I have come to believe that both boys share a metabolic disorder.

Both of their EEGs show slowing, and the 6 y old's sleep study showed spike and wave patterns.  Both of these can be indicative of hypoglycemia....hypoglycemia can cause central sleep apnea.

We had an MRI for him on Tuesday which was normal except for a question about whether or not he has a Chiari malformation.  On Monday morning he will have an EEG of his brain stem...to make certain that it is working.  And both boys will be admitted to a children's hospital (different from the one we have been using) where they will have a full neurology and genetics workup.  It seems we have not been even seeing neurologists who have any experience with metabolic disorders up until this point.  And genetics...well...I will just say that they were basically less helpful in 6 hours than the new folks have been in 20 minutes.


Thank you again for the encouragement to get another opinion...it's all pretty overwhelming...

TIA was "Thanks in Advance".

K.

You guys are way out of my league for understanding all of the numbers and specifics...HOWEVER...if your boys come up negative for hypoglycemia, as I always did, might they be hyperinsulemic as I am?  
I have never heard that hypoglycemia causes CA.  My child has a chiara, and the docs are looking a a dx of mixed SA.  She also shows all of the signs of being hyperinsulemic.  
If you have any quick pointers on where I can find articles linking hypoglycemia and CA I would be very, very grateful.  I do know that on a Chiara group website they posted the results of a very small study linking Chiara and SA.
I am so glad that I stopped to read your posts.


_________________
Joy

http://www.rtmagazine.com/article.php?s=RT/2003/06&p=3
http://neonatal.peds.washington.edu/NICU-WEB/apnea.stm
http://www.sleepreviewmag.com/article.php?s=SRM/2006/05&p=14
http://tinyurl.com/qfq3d

Also, I have this on my notepad, but I'm not sure where it came from:

Central Apnea causes:
hypoglycemia
metabolic disorders
infection, infarction, or compression of the brain stem

Risk factors:
males
heart disorders: atrial fibrillation or congestive heart failure
stroke or brain tumor
neuromuscular disorders: ALS, spinal cord injuries, muscular dystrophy
high altitude