Obstructive Sleep Apnea At School Aged Children Presented With Nocturnal Enuresis

* Obstructive Sleep Apnea is when the pharyngeal airway collapses or narrows respectively during sleep. It is accompanied by excessive daytime sleepiness and risk for cardiovascular disease. Risk factors for OSA include obesity, large soft palate/tongue, the male sex, and aging.

Introduction: “The National Sleep Foundation” says that a lot of people don’t know what sleep apnea is. Sleep Apnea is a dangerous disease that can lead to death while you’re sleeping.

Studies indicate a strong relationship between poor sleep hygiene and negative health outcomes. An alarming percent of adolescents do not get enough sleep, ranging from

Sleep can be simply defined as "a reversible behavioral state of perceptual disengagement from and unresponsiveness to the environment" (Kryger, Roth & Dement). As far as the sleeping disorders are concerned, they involve the difficulties that are associated to sleeping. When an individual has difficulty in falling or staying asleep, falling asleep at wrong times, falling asleep unnecessarily, or shows other abnormal sleep behaviors, he/she is said to have a sleep disorder.

Sleep disorders alter ones sleep pattern and often results in the inability to either sleep or sleep soundly. They often cause you to feel restless, tired, fatigued, and irritable. It is estimated that nearly 75 percent of adult Americans experience sleep disorder symptoms at least a few nights per week. At the same time, sleep disturbances in some form are seen in as many as 25 to 30 percent of infants and children (“Sleep Disorders” 2013). Clearly a huge conundrum in the world, sleep disorders affect an inordinate amount of people. Millions of people suffer or have suffered from a sleep disorder at one point in their lives and if mistreated can impact organ systems functioning negatively. Physical disturbances, medical issues,

Sleep apnea is a common sleeping disorder where a person has experiences of not breathing during sleep. Over 20 million Americans, mostly overweight men, suffer from sleep apnea. Despite these numbers, sleep apnea is often not treated directly because its symptoms are thought to be those of depression, stress, or just loud snoring. There may be a genetic component to this disorder as it often occurs within families.People with sleep apnea stop breathing for at least 10 seconds at a time; these short stops in breathing can happen up to 400 times every night.

     Sleep is essential to life; it is one of several components, including food and water, which keep the living alive. However, a significant percentage of the human population has considerable difficulty reaching and maintaining Stage IV within their sleeping patterns, the stage that allows the mind and body to fall into a deep and restorative sleep, otherwise known as REM sleep. At the core of this difficulty is a condition known as obstructive sleep apnea, a "serious, potentially life-threatening condition that is far more common than generally understood" (Sleep Apnea). Indeed, obstructive sleep apnea can be very dangerous if it is not properly detected and treated.

Obstructive sleep apnea (OSA) is a major health problem, as more than 22 million adults in the U.S suffer from OSA.1 The prevalence of moderate to severe OSA in older adults aged 65 and over is twice as high as that in middle-aged adults.2 Unfortunately, estimates suggest that 85% of individuals with moderate to severe OSA remain undiagnosed.3 Individuals with untreated moderate to severe OSA are at a greater risk for depression (DEP), mild cognitive impairment (MCI), and dementia compared to individuals with no OSA. In OSA, repetitive intracranial blood flow surges during apneic episodes cause disturbances in microvascular functions, resulting in hypoperfusion4-6 and poor cerebral vasomotor reactivity.7-9 Hypoxemia promotes the development of cerebral small vessel disease (C-SVD).10-13 Repeated rapid alternations between hypoxia and reoxygenation cause oxidative stress,14,15 which alters blood-brain barrier functions and leads to the formation of C-SVD.16-18 The consequences of C-SVD are 1) disruption of neuronal activity in regions involved in the regulation of mood and cognition 11,19,20 and 2) reduction of prefrontal and frontal lobe vascular perfusion,10,21-23 which causes neuronal metabolic deficiencies that may lead to synaptic loss and neuronal damage.24,25 The progression of C-SVD is now known to be associated with new-onset depression,26 MCI,27,28 and an increased risk for dementia.27,29,30 Based on this supporting evidence, we hypothesize that C-SVD may mediate

Nocturnal enuresis is the type of enuresis Jorge is experiencing (happens only at night). (Pillitteri, 2014) The RN should collect information regarding if or how the parents have attempted to correct the problem; if it is a problem with the child or parent; if the child is under a lot of stress at home or school. This information can be used to help identify other ways to correct the problem. If it is not an issue with the child, interventions will not be as effective as if the child wanted it fixed. This information can help identify stressors that the child is under so the parents can help alleviate the problems, whether it be at school or home. A serious discussion with the child may be the only thing needed to help ease the problem. (Pillitteri,

Obstructive Sleep Apnea (OSA), is a clinical condition escorted by frequent episodes of upper airway obstruction during sleep, leading to severe hypoxia. These episodes are interposed with reoxygenation, resulting in intermittent hypoxia (IH) (Morrell and Twigg 2006). OSA is now considered an important and ubiquitous health problem, due not only to its cardiovascular and metabolic morbidity, but also because of the prominent cognitive and behavioral implications of the disease. The neuropsychological impairments are accompanied by increased levels of systemic markers of oxidative stress and inflammation, in addition to gray matter loss in neural sites contributing to cognitive function (Beebe and Gozal 2002; Gozal et al.,

In the textbook, “Psychology in Modules”, sleep is defined as “our periodic natural loss of consciousness” (pg.100) (Myers & Dewall, 2015). I am a person that loves to sleep a lot and consider it as a hobby of mine as it is useful in stressful times to restore and gain energy back after a long day depending on the type of situation that occurred. Based upon the sleeping disorders discussed such as insomnia, narcolepsy, etc.…, I never undergone any of them but the common one that I have seen that most people tend to get is sleep apnea. I would wonder how it occurs to others as in my family, both of my parents snore in the middle of their sleep but my siblings and I don’t. There would be times where they would choke in their own saliva and wake up having trouble

Jorge is experiencing primary nocturnal enuresis. Nocturnal enuresis is described as urinary incontinence while sleeping in a child five years or older. (AAFP, 2017)

Sleep disorders have always surrounded me through family and friends. though I never suffered with any sort of sleeping disorder, I was well aware of how unnerving it can be toothless who suffer from it. I did not know all of the different types there were, and was intrigued when reading chapter three of my psychology book. I had assumed that nigh terrors, which I used to think were the same as nightmares, were over exaggerations of a person’s scary dream. Sleepwalking also held interesting facts that I didn’t know prior. Having a best friend who occasionally sleepwalks, I was always interested in why she would seldom remember both walking and talking. I also appreciated learning about sleep apnea because my father used to struggle with it and would worry my mom about his breathing when he was asleep.

The first and most researched sleep disorder is sleep apnea. Sleep apnea does not affect children as often as it effects adults, but it is still a rising concern. Sleep apnea occurs in about 2 per cent of children, mainly between the ages of one through eight. But it can also show up in older children and even infants. (Klein). Research says that young blacks are more at risk than young whites. (Fritz p 83). Children with sleep apnea briefly stop breathing many times during the night due to an obstruction in the respiratory tract. Most of the time it is related to enlarged tonsils and adenoids or to obesity. As the child will gasp for there breath during sleep, they awaken for a few moments to regain there normal breathing and then they immediately return back to sleep. Because the child will be awoken by this many times during the night, this cause sleep deprivation. (Common Sleep Problems AA). The physical symptoms of sleep apnea are excessive daytime sleepiness, snoring, restless sleep, heavy and irregular breathing, excessive perspiring during the night, bad dreams, sleeping with there mouth open, sleeps in strange positions, morning headaches, learning problems, excessive irritability, depression, changes in personality, difficulty

However, obstructive sleep apnea is just the opposite in which, it affects around two to four percent of kids’. The results of sleep