Apnoea is a potentially serious disorder in which breathing is interrupted repeatedly. There are three kinds of apnoea; obstructive sleep apnoea (OSA), which is caused by a blockage; central sleep apnoea, in which there is no blockage, but the brain fails to signal the muscles to breathe; and mixed apnoea which is a combination of the two.
Central apnoea is most common type of apnoea in babies. In adults and children over 1 year, OSA is the most common type. Any baby can have apnoea, and it is more common in babies who are born prematurely, multiple births and babies with some complex conditions. Born to mums up to 37 weeks pregnant, it’s called apnoea of prematurity, and past 37 week, it’s called apnoea of infancy.
In babies, immaturity of the central nervous system is most likely responsible. Other possibilities include bleeding in the brain, exposure to drugs or poisons, a birth defect, infection, respiratory disease, neurological conditions, like Chiari malformation, gastrointestinal problems – reflux, an imbalance in body chemistry like the incorrect amounts of calcium or glucose, and problems with the heart or blood vessels.
Arnold–Chiari malformation, or often simply known as Chiari malformation, is a malformation of the brain. It consists of a downward displacement of the cerebellar tonsils through the foramen magnum (the opening at the base of the skull), sometimes causing non-communicating hydrocephalus as a result of obstruction of cerebrospinal fluid (CSF) outflow. The cerebrospinal fluid outflow is caused by phase difference in outflow and influx of blood in the vasculature of the brain. It can cause headaches, fatigue, muscle weakness in the head and face, Sleep Apnoea, Sleep disorders, dysphasia (difficulty swallowing), dizziness, nausea, impaired coordination. The blockage of Cerebrospinal Fluid (CSF) flow may also cause a syrinx to form, eventually leading to syringomyelia. Central cord symptoms such as hand weakness, dissociated sensory loss, and, in severe cases, paralysis may occur.
Gastro-oesophageal reflux (GOR)
The term ‘reflux’ refers to a condition, gastro-oesophageal reflux (GOR) and a disease, gastro-oesophageal reflux disease (GORD). If an infant refluxes frequently, then the GP or paediatrician may diagnose them with gastro-oesophageal reflux (GOR). This is a relatively common medical condition amongst children of all ages:
- It often presents with regurgitation or posseting.
- It tends to peak between one and four months of age and normally ends by 12-18 months.
- Although it may cause anguish for parents prior to diagnosis, this form of the condition can often be successfully controlled by simple remedies such as keeping baby upright.
Gastro-oesophageal reflux disease (GORD)
There can be, however, a more serious side to reflux in children when it can cause troublesome and severe, signs and symptoms, or complications. The most common complication is damage to the oesophagus (oesphagitis), or long-term problems and this is diagnosed as gastro-oesophageal reflux disease (GORD). Some of the Symptoms are; Vomiting, Feeding difficulties, Failure to thrive, Irritability, Coughing, Breathing problems or Choking or blue spells.