Hello-

My son was just recently diagnosed with moderate Central Apnea.  I am confused and worried and could really some advice and reassurance.  

Bit of history:

My son Jake is 8 months old.  He was born at 37 weeks because I had a cervical cerclage.  He was a very healthy at 8 pounds at delivery and is now a big boy at 27 pds and 29 inches tall.  I had a still born son before him and as a result worry even more.  Although, he displayed zero symptoms of breathing issues, I purchase the Angelcare Movement sensor at 2 months because I was convinced that he would stop breathing at night (mother's instincts are always correct).  The alarm went off when he was 5 months old and I picked him up and he seemed fine.   That morning I did some research and released that he had alot of the signs of apnea.  He snores occasionally and wakes up several times a night (at least 10).  He also arches his back when he sleeps.  My ped referred me to a specialist in the Pediatric Ortholaryngology Dept. at UCLA.  The specialist saw no outward signs of apnea, but ordered a sleep study just to be sure.  The results came back a few days ago, and we were told he has moderate central apnea.  We have an apt on the 25th to see a Pulmonary doctor at UCLA.  After I received this news, I did some more research at found out that 50% of the babies who have apnea also have GERD.  My LO fits the profile for "silent reflux."  He back arches while feeding, burps constantly and has the hiccups at least 3 times a day.  He obviously is thriving and does not spit up excessively, although he often will burp and swallow (so I know something came up).  He had horrible colic and wakes up crying at night, back arching and fussing.  I called my ped and the specialist and they agreed that he should see a Pediatric Gastro as well (I have an apt next week).  No one has ordered an apnea monitor yet, because the home monitor obviously worked and he is 8 months and has made it this far. The oed did put him on Axid 2x per day at 1.5 mil a dose so see if that helped.

I don't know what is the most useful info in the study, but here is the conclusion:

1. Mild sleep Apnea/Hypopnea Index (AHI) of 8.8 per hr
2. Mild sleep related oxygen desaturation
3. Sa02 nadir of 87% from a sleep base line of 96%
4. Mild respiratory related sleep fragmentation with a RAI of 8.81 per hr
5. No snoring was noted
6. ECG/EKG abnormalities were not noted
7. EEG or EMG abnormalities were not noted
8. Average duration of hyponeas were 13.2 seconds
9. Maximum duration of hypopneas was 17.0 seconds
10. Average duration of apneas were 12.4 seconds
11. Maximum duration of apneas was 15.5 seconds.

Do you all have any advice and or suggestions? I can hardly sleep at night :(  Help!  I am no sure how to best advocate for him or what questions I should be asking.  Thanks any advance for any help. It would be greatly appreciated!

ETA: Total sleep time: 393 minutes
        

Respiratory events per hour: Apneas: 12
                                           Hypopneas: 31
                                           Total apneas/ hypopneas: 43
                                           Apnea/hypopnea index: 8.8

Please let me know if you need anymore info. I have wo pages and a graph and I was not sure what to include.

Was your son diagnosed with Apnea of Prematurity?

What was the lowest heart rate recorded during the study?

When you witness an apnea, at home, is it followed by several rapid shallow breaths?

Was your son diagnosed with Apnea of Prematurity?

No, not to my knowledge.  The conclusion on the reports says that he- demonstrated episodes of obstructive breathing as well as central apnic events with an AHI of 8/hr. Mild desaturations were seen.  The fact that he was born at 37 weeks has never been mentioned. The only thing other thing that was complicated in the pregnancy (aside for the cervical cerclage) is that I took blood thinners for an inherited clotting disorder I have

What was the lowest heart rate recorded during the study?

The report says, Cardiac Events: Average heart rate waking: 141.4, NREM (QS): 110.9 and REM (AS) 108.4

When you witness an apnea, at home, is it followed by several rapid shallow breaths?

I have never witnessed an apnea event.  He does wake up coughing sometimes and I assume it happens after that.  The only thing I have witnessed that I felt was unusual- you know when someone has been crying awhile and they suck in air several times.  I have heard him do that a few times.  Is that what you are referring to?  The only time I knew of an apnea is when the alarm went off on his movement sensor.  I picked him up quickly and he was fine and did not gasp for air.

Have you read through this:

http://www.childsdoc.org/fall96/sheldon/sleepdis.asp

It may be one of the better articles that I have read. I hope that you can get some use out of the site.

The results came back a few days ago, and we were told he has moderate central apnea.  
I didn't see any centrals listed....??  Do you know how many he had??

After I received this news, I did some more research at found out that 50% of the babies who have apnea also have GERD.  My LO fits the profile for "silent reflux."  He back arches while feeding, burps constantly and has the hiccups at least 3 times a day.  He obviously is thriving and does not spit up excessively, although he often will burp and swallow (so I know something came up).  He had horrible colic and wakes up crying at night, back arching and fussing.  I called my ped and the specialist and they agreed that he should see a Pediatric Gastro as well (I have an apt next week).
It does sound like he has GERD.  Colic is often undiagnosed reflux and most of the symptoms you've listed could very well be from reflux.  It sounds like you're doing everything you need to as far as getting a good team together to help your son.  I hope that eliminating the damage caused by reflux will also help with the apnea issue.  The meds won't stop the reflux from happening but they will keep it from burning or causing damage.  I would be hesitant about believing that all of his problems are the result of reflux however.  Make up a list of questions that you have or concerns as well to take to each doctor.  It wouldn't hurt to ask if your doctors could work together or consult each other regarding treatment options.  Our son has 11 physicians (mostly specialists) and they're really good at teaming up when needed.  It helps quite a bit.  Find doctors that are willing to listen to you and to answer your questions.  It's difficult to work with someone who doesn't seem to think your concerns are valid.  

shelee wrote:

The results came back a few days ago, and we were told he has moderate central apnea.  
I didn't see any centrals listed....??  Do you know how many he had??

Other than the apnea's I listed up top, it says in the discussion that he- demonstrated episodes of obstructive breathing as well as central apnic events with an AHI of 8/hr.

You were only given the summary report. You need to request the full report (should be between 4-8 pages long). Ask for this, demand this, whatever you need to do. This will show what kinds of episodes she was having and how long they were, one by one.

Tiffany-

I just called the place that did the study and they said it was the full report (it's 5 pgs total)  My report includes one graph and they said that other graphs are stored in the techs computer and the report they gave me is what they give to the doctor's.