| Abstract: | A sleep apnea syndrome has been diagnosed in eight children (age range 5-14). Before undertaking therapeutic trials, sleep and respiration were extensively studied. Sleep and respiration were again analyzed 3 months after tonsillectomy and adenoidectomy (6 cases) or tracheostomy with insertion of valve (2 cases). Sleep induced apneic apisodes in these children who had normal respiration during wakefulness. Three types of apnea (central, upper airway, and mixed) were recorded in each case. The minimum number of apneas recorded during a single night was 75; the maximum was 816. Polygraphic monitoring demonstrated greatly disturbed sleep. Sleep changes were quantitative as well as qualitative. REM sleep percent was decreased, but stages 3 and 4 NREM sleep were also impaired. A relationship between stages 3-4 NREM sleep and respiration was noted: stages 3-4 sleep disappeared when apneic episodes were numerous; no apnea was recorded during stage 4 sleep. Follow-up nocturnal recordings of two tracheostomized children with valve open, then closed, confirmed this "stage 4/no apnea" relationship. Apneas were also noted to induce marked sinus arrhythmia during sleep. |
