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Often mentioned for adults, sleep apnea is also present in children and would be harmful to their development. Specialists call for early detection of this pathology.
“Its pediatric prevalence comes out between 2 and 5% in most studies, sometimes more”underlined the pneumo-allergist Madiha Ellaffi during a webinar organized on the occasion of the 22nd National Day of Sleep, March 18.
According to Inserm data, the percentage rises to 8% for 20-44 year olds, and more for older people. 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.
A message that “does not pass enough in families”
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 institute OpinionWaycarried out with a thousand parents, revealed a population of 6% of snoring children.
“Often I hear people say: hey, he snores like his grandfather… No, a child who snores is not normal”ensures theAFP 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 about sleep apnea”insists the doctor, for whom “this message does not pass enough in the families”.
“We cannot imagine the lost potential”
Often unsuspected in children, this pathology is “very damaging”points out André Stagnara, rehabilitation manager at The Householdpediatric follow-up care facility 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 about twenty seconds: an apnea, which is repeated several times per hour.
“He does this all night. However, it is during REM sleep (dream) that we record the learning of the day: the micro-awakenings 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”.
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.
Time to diagnosis and lack of resources
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 registration beds, exist in France: in Paris (Robert-Debré hospital) and in Bron (HFME), where the waiting time reaches “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 The Household 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 does not mean anything”, concludes the practitioner. We found a pneumo-pediatrician, which is a gift from heaven, we are not going to offer her a one-year fixed-term contract…”.