HI

After reading lots of your posts, just wondering whether my soon to be 4 year old daughter could have sleep apnea.

She is :
always irritable, irrational; uncontrollable behaviour and continually complaining she's tired; wakes numerous times during the night (and even on the rare occasion she sleeps through complains she's tired all the next day) never sleeps during the day regardless of what sort of night she had the day before.  When she wakes during the night she is wide awake.  
She sleeps with a dark room (but with a nightlight) and door open in case of night terrors which I've heard are common at this age.

However, don't seem to snore (my husband said she does sometimes) and seems to sleep flat on her back with her mouth closed.

My husband and I are at wits end - just not sure if she has it and like everyone don't want to pay $$$ for a sleep study if doesn't even sound like it is sleep apnea - appreciate any of your thoughts.

Can an ENT tell if her adnoids are enlarged and how is this done? woudl this be enough for us to think it could be? or would more tests be required?

Thank you so much
Donna

Hi Donna and welcome,
There are so many " signs" for sleep apnea and not all kids have the same ones... My son has significant sleep apnea and also periodic limb movement disorder as well.... he sleeps all night and rarely snores much louder than the normal heavy breathing... He is tired and irrational at times but i am lucky enough that at this time he is just to dam tired to get behaviour issues.. he likes his quiet time watching tv.. which oftern will turn into an afternoon nap... but from the afternoon nap comes the terrible afternoon pattern of whinging and he is very easy up set with his sisters taunts.. ( they know how to push the button)..

Brandan's sleep results were never sent to the right refering dr and we were told that they would contact us to dicuss treatment if it were needed... no one callled so no treatment pretty much!!! now that he is so thin and starting school i demanded a review and only then did they discover the first test results... all stops straight to the hospital for tonsil and ad's removed hopefully this month...
I know that it is alot of $$$ for the sleep test but just think if she does have it you will have a "new" child in a short time after treatment... and there are long term issues if it is not treated. I have read a few studies that suggest their behaviour issues stay with them as they have "learnt" to behave this way for so long... treat it now before she heads off to kindergarten as it will be much easier for her to learn if she is not tired all the time... and hey think of you too.... we are all in the same boat... tired kids= tired parents... give your self a break... let us know what you decide...
sorry for the spelling.. not my strong point at all

There are several sign of sleep apnea, and not every child will have the same ones. I would talk with your pediatrician about your concern that she isn't breathing when she sleeps and about her behavior during the day. Ask about the possibility of sleep apnea and if a sleep study would be appropriate.

Keep in mind that there are two different kinds of apnea and also the possibility of hypopneas. The two kinds of apnea are central and obstructive. Our son sleeps a lot like your daughter and has central sleep apnea. Central sleep apnea is where the brain "forgets" to tell you to breathe when you are sleeping. It can also mean that there is significant reflux (which can be silent) and the brain is preventing her from breathing when there is danger of her aspirating on her reflux. The other kind is obstructive. This kind is typical of adenoids and tonsils being enlarged, and can even be the muscles (larynx and others) in the throat relaxing too much during sleep and blocking the airway. The only way to know what kind there is is to have a sleep study done. A pediatrician or neurologist or pulmonologist can order one. One a 1-2 year old, they cost about $3600, but if depending on your insurance, it is covered like a lab (not necessarily like an MRI, but more like bloodwork). Our insurance covers it 100%, and our son has them twice a year.

Hypopneas are when there is just really shallow breathing that stays shallow and is accompanied with drops in the oxygen levels in the blood.

I am not a doctor or sleep specialist of any kind. I am simply a mom of a child with apnea that has yet to be explained or outgrown. We have become very educated in apnea because my younger brother, mother, and father in law have all had sleep studies done and all have significant obstructive hypopneas, but not apnea. There is so much unknown and the only good way to know anything is to have a sleep study done. You can spend the money and have some peace of mind that she doesn't have apnea, which would probably spur a neurologist to see if there are other reasons for her irrational behavior during the day. If it does show apnea, then you have clearly spent money and now have some answers and ways to treat it (as long as it's obstructive).

I do hope this helps...

thank you both very much!  I will be following up with a ped this week.

Donna,
I know that sleep apnea (or more specifically sleep deprivation) can cause behavior issues and even sometimes result in an incorrect diagnosis of ADHD.  However, since your daughter is wide awake during the night-time wakenings and also alert during the day, I would want to look into ADHD as well as possible causes of anxiety or sensory integration disorder.

good luck