Central Sleep Apnoea in Children

Abstract

Central sleep apnea belongs to a heterogeneous group of sleep related breathing disorders. It is caused by temporary failure in the pontomedullary generating pattern of breathing rhythm, that is very important for successful ventilation. This results in the absence of ventilatory effort during the entire apnea event. Clinically relevant apnea in children is lasting for 20 or more seconds duration, or lasting for 2 or more missed breaths and associated with physiological consequence (arousal, fall in oxygen saturation, bradycardia). Childhood central sleep apnea occurs rare, is caused by failure in respiratory center of various causes (e.g. inflammation, trauma, tumor, congenital malformations). A specific category of central sleep apnea is primary sleep apnea of prematurity and infancy, apnea event is a manifestation of unstable breathing rhythm, that is due to immaturity of respiratory control and peripheral chemoreceptors. The gold standard in the diagnosis of central sleep apnea is polysomnography. Treatment depends on the severity of the condition, a variety of treatments including pharmacological therapies, oxygen and ventilatory support.