Often mentioned in adults, theSleep Apnea is far from rare in children and harmful to their development, warn specialists, calling for early detection of this pathology.
At least one child in twenty
Its pediatric prevalence is between 2 and 5% in most studies, sometimes more, underlined the pulmonologist-allergist Madiha Ellaffi 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 Ideas association which promotes the care of young patients, sleep apnea “concerns at least one in twenty children”a proportion 100 times greater than that of so-called rare diseases.
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Signs that should alert
Nocturnal snoring, a clinical sign of a possible obstructive sleep syndrome, is insufficiently taken into account according to specialists, while a recent survey by the OpinionWay institute, carried out among a thousand parents, revealed a population 6% of snoring children.
“Often I hear people say: hey, he snores like his grandfather… No, a child who snores is not normal”assures Patricia Franco, head of the pediatric sleep unit at the Woman Mother Child Hospital (HFME) in Bron, near Lyon.
There may be occasional discomfort – a stuffy nose for example. “But if the child snores every night, in a prolonged and intense way, you have to think regarding sleep apnea”insists the doctor, for whom “this message does not get across enough in families”.
Besides snoring, restless nights, difficulty waking up, dark circles in the eyes, pale complexion, fatigue during the day, lack of attention at school, hyperactivity or irascibility are other signs and disorders, in the child, which must encourage the parents to consult, plead the specialists.
“Lost potential” in child development
Often unsuspected in children, this pathology is very damaging, points out André Stagnara, rehabilitation manager at La Maisonnée, a pediatric follow-up care establishment located in Francheville (Rhône).
He plays the nocturnal recording of a four-year-old child: we hear “a kind of cornage”, air entering the lungs with difficulty. Then the sound decreases and breathing stops for regarding twenty seconds: an apnea, which is repeated several times per hour.
“He does this all night. However, it is during paradoxical sleep (dream) that we record the learning of the day. The micro-arousals associated with low oxygenation will alter the psychomotor development of the child”summarizes the practitioner. “We cannot imagine the lost potential”.
“To learn how to hold a spoon, articulate, tie your shoelaces, read, write, etc., you need quality sleep so that the brain can do its job of sorting and archiving”, abounds Dr. Ellaffi. And “To sleep well, you have to breathe well. »
A diagnosis that sometimes takes a long time to make
Nose drops or anti-allergy treatment, removal of tonsils or enlarged adenoids, oro-maxillofacial physiotherapy to reposition the tongue, nasal septum surgery or orthodontics, respiratory system “continuous positive pressure”… The responses to sleep apnea, more or less severe, vary depending on the case.
It is still necessary to have access to the diagnosis. Two children’s sleep units, each with three recording beds, exist in France, in Paris (Robert-Debré Hospital) and in Bron (HFME). Waiting time reached there “easily a year”says Patricia Franco.
Since 2019, she has been working on the creation of a regional care network to better meet demand. An inter-university diploma has existed since 2011, with 20 winners per year, and sleep training is developing in paediatrics. The fact remains that specialists are still few in number.
Services like La Maisonnée also manage recordings, but they are “totally insufficient in number”it is pointed out.
For André Stagnara, the solution involves the opening of additional beds and the use of remote monitoring of children with hearing aids. The Francheville structure is carrying out a project in this direction, which the Regional Health Agency has agreed to finance for a year of experimentation.
“It makes no sense,” laments the practitioner. We found a pneumo-pediatrician, which is a godsend, we are not going to offer her a one-year fixed-term contract…”
