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Pls help me with my 4 yr olds sleep study
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Post Pls help me with my 4 yr olds sleep study 
My son stops breathing at night while sleeping. At first we thought it was from his abnoids being so big. He had those taken out (which was not a good surgery, he had an asthma attack in the middle of it and for a little while afterwords he was on oxgyen and had a bp of 35/15). He is 4 and also has a history of bad ears. He has had 3 surgerys for tubes since he was 2. His new ped. said he thought it was from his tonsils being so big. His new ENT said his tonsils are normal size and that there is a seizure disorder that he suspects he has. So he referred his to a ped. neurologist. That apt. is Feb. 8th but in the meantime he had a sleep study done on him. Not only does he stop breathing while sleeping he also has episodes at night where he will wake up crying. When I go into his room he will be sitting up in bed with his eyes still closed just a crying and crying. When you try to talk to him he will not respond. If you pick him up or touch him at all he will cry louder. Then after awhile he will all of a sudden stop crying, leg back down and fall right back to sleep. Of course on the night of the sleep study he did not do this. I also noticed that on the nights he does this later on after this happens he will wet the bed. This tends to happen at least 4 out of 7 nights. He is overly tired during the day and very onery. There has been a couple of times that he has also passed out for no apperent reason. Here are the results of his test:

Patient had a total sleep time of 525 min. Sleep onset was at 7 minutes. Sleep efficiency is normal at 99%. 1% of sleep in stage 1, 63% in stage 2, 7% in stage 3, 13% in stage 4, and 16% in stage REM.

patient demonstrated a few obstructive apneas or hypopneas throughout the study, through the patient did demonstarte more frequent central apneic episodes. Central apneic index was 16 in the entire study, giving an index of 3 per hour. The obstructive apnea index was 0.9, with only 4 demonstrated throughout the entire study. There were 3 obstructive hypopneas throguhout the entire study, giving an obstructive hypopnea index of 1.2. Patient's oxygen saturation remained above 91% throughout the entire study.

Patient demonstrates a few obstructive apneas and hypopneas and does not meet criteria for a diagnosis for obstructive sleep disordered breathing. Patient did demonstrate some central apneic episodes, but also these did not occur on a frequent basis.

When they called me to tell me the results, they said they do not know why he is doing this. That they know it is not caused by an obstruction or his tonsils and since they are unsure of why he is doing this they don't know if it is something to be worried about or not. Can anyone break this test down for me and tell me if all of it is normal  or what and if any of it is something to be worried about. Also does anyone know what could be causing this?

Thanks so much for your time and help!

Also don't know if it has anything to do with it or not, but a quick history of his backround: During me pregnancy with him from about 5 mnths to 7 I was always going in the hosp. for preterm labor where they would give me a shot to stop it. From 7 mnths on I was on the pill form and complete bedrest. I spent one night in the hosp. b/c my heartrate shot high while his went low for awhile. Then during labor at one point his heart stopped all togther. Got it started agian but then everytime I would have a contraction his heart would drop low agian. They had to break my water for me and it came out green. It took 3 times of giving me the epideral for it to work (First time it only numbed one side of my body and second time somehow I pushed it out of my back all toghter, the anstelogist said he had never seen or heard of someone doing that before. By the time he got it in the 3 time I was numb up to my chin.). The dr had me push when I was only dialated to around a 5 or 6 b/c of his heart dropping real low during contractions. I tore really bad, so she cut me from end to end. He got stuck in the birth canal and it took vacuuming him 3 times for him to come out. When he finally did he had the cord wrapped around his neck and was holding on to it with one hand. They had problems getting him to turn from purple back to normal but eventually did. He had to be on a soy formula. From a couple mnths old on he was always getting bad colds and ear infections to the point that he was tested for RSV at least 10 diff. times and cystic fibrosis 2, also allergies 2, all coming back normal. He does have tibia torsion. Had to have emergency tubes put in his ears when he was 2 b/c he was immuned to all types of meds from reaccuring ear infections and they tried everything they could, even shots of ricoflin mixed with oral meds. The ear infection overtook his whole body to where he was throwing up, so weak he could hardly hold up his head and had a fever of 103. Has had 2 more times of putting tubes in ears since then. Don't know if any of this has to do with anything...lol.


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As far as the results of your child's sleep, the time spent in each of the sleep stages is pretty normal for the sleep lab.  As far as the apnea, the results show that it was in the mild to very-mild range.  The significant part here is that the obstructive index is fairly low (.9).  This indicates that most of the breathing problems your child is having are probably not coming from an obstruction in the airway (tonsyls/adenoids,etc.).  Keep in mind that your child is still growing, and changes in the structure of the airway can occur with time (children with mild apnea are not always adults with apnea).  Also, adenoids and such tissue in the airway can grow back over time!  
One of the most common definitions of Central apnea: The part of the brain that signals the body to breathe "forgets" once in a while, and a person can stop breathing for a few/several seconds.  This is usually less serious than obstructive sleep apnea.

The tubes are difinitely significant when it comes to your child's sleep.  This time of year is peak time for ear problems.  You probably already know a lot of the following.  During an ear infection, fluid gets trapped in the ear.  Pressure from the fluid trapped in his middle ear gets worse when he lies down, potentially making it difficult for him to fall and stay asleep. Toddlers are particularly susceptible to ear infections because their Eustachian tubes are shorter, and somehow more prone to allowing fluid to become trapped.  Also, children with ear problems are often much more likely to develop sleep problems.  They get used to waking up repeatedly at night and having their parents attend to them and comfort them back to sleep. It's also difficult for parents to know when the ear infection has cleared and the night wakings have simply become a habit. As much as possible, try to stick to your regular sleep routine/habits when the child is sick. It is just fine to get up and go to him in the middle of the night if he needs you, but avoid bringing the child into your bed or letting him fall asleep anywhere but his bed.

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