It’s mostly mentioned for adults, but sleep apnea is far from rare in children. This pathology, which is harmful to its development, is characterized by pauses in breathing of 10 to 30 seconds that worsen the quality of sleep and life of those affected. Specialists call on parents to be vigilant and encourage early detection.
The pediatric prevalence of sleep apnea in most studies is between 2 and 5%, sometimes more, pulmonologist-allergist Madiha Ellaffi underlined during a webinar organized on the occasion of the 22nd National Sleep Day, March 18.
According to Inserm data, the percentage rises to 8% for 20-44 year olds, and more for the oldest. But for this doctor from Albi, co-founder of the Idea Society that promotes care for young patients, sleep apnea “affects at least one in twenty children”† A proportion that is 100 times greater than that of so-called rare diseases.
Beware of snoring in children
Nighttime snoring, a clinical sign of a possible obstructive sleep syndrome, is not sufficiently taken into account, according to specialists. However, a recent OpinionWay Institute survey of 1,000 parents found that a population of 6% had snoring children.
“Often I hear people say: ‘Hey, he snores just like his grandfather’… No, a child who snores is not normal”, assures AFP Patricia Franco, head of the pediatric sleep department at the Woman Mother Child Hospital (HFME) in Bron, near Lyon. There may be occasional discomfort, for example a stuffy nose. “But if the child snores for a long time and intensely every night, you should think about sleep apnea”the doctor insists, for whom? “This message is not getting across enough in families”†
“We can’t imagine the lost potential”
This pathology, which is often not suspected in children, is very harmful, emphasizes André Stagnara, rehabilitation manager at La Maisonnée, a pediatric aftercare facility in Francheville (Rhône). He plays the nighttime recording of a four-year-old child: we hear ‘a kind of thumping’, the air enters the lungs with difficulty. Then the sound decreases and breathing stops for about twenty seconds: an apnea, which repeats several times an hour.
“LHe does this all night. However, it is during REM sleep (dream) that we record the learning of the day: the micro-wakes associated with low oxygen uptake will alter the child’s psychomotor development”summarizes the practitioner. “You cannot imagine the lost potential”.
“To learn how to hold a spoon, articulate, tie your shoelaces, read, write, etc., you need good sleep so the brain can do its job of sorting and filing”, galore Dr. Ellaffi. And “To sleep well, you need to breathe well.”
In addition to snoring, restless nights, trouble waking up, dark circles in the eyes, pale complexion, daytime fatigue, lack of attention at school, hyperactivity or hot temper are other signs and conditions in the child that should encourage parents to consult, advocate the specialists.
Lack of specialists
Nasal drops or anti-allergic treatment, removal of tonsils or hypertrophic adenoids, oro-maxillo-facial physiotherapy to reposition the tongue, surgery of the nasal septum or orthodontics, “continuous positive pressure” ventilators… Reactions to sleep apnea, more or less severe , varies from case to case.
It is still necessary to access the diagnosis. In France, there are two children’s sleeping units, each with three registration beds: in Paris (Robert-Debré hospital) and in Bron (HFME), where the waiting time is “easily a year”, says Patricia Frank. Since 2019, she has been working on establishing a regional care network to better meet demand. Since 2011, there has been an interuniversity diploma with 20 winners per year, and sleep training is developing in pediatrics. The fact remains that there are still very few specialists.
Services like La Maisonnée manage also recordings but they are “totally insufficient in number”, is pointed out. For André Stagnara, the solution is to open extra beds and remotely monitor children with hearing aids. The Francheville structure is carrying out a project in this direction, which the Regional Health Service has committed to finance for a year of experimentation. “It makes no sense, complains the practitioner. We have found a pneumo pediatrician which is a godsend, we are not going to offer her a one year CDD…”