Sleep Study Update from ENT Appointment Today

Well, now I know for sure, Little Man and Beans should play the lottery. ;) They'd be winners for sure. Now let me explain...

I blogged before about the nurse's summary of the boys' sleep studies. I went in today figuring I knew what to expect. Hahaha. Every time I go in thinking this I come in reminding myself never to do it again. It wasn't bad news per se, just complicated. What's new right?

We discussed Little Man first. The nurse had told me that his sleep issues weren't caused by apnea. Apparently that was wrong. Quite wrong. Little Man's body has learned to deal with the apnea. He rarely goes into slow wave sleep or REM sleep because as soon as he does he obstructs, stops breathing and desats (oxygen levels drop). He does wake up around 10 times/hour that wasn't directly related to respiratory events. That could be neurological or could be his body trying to avoid the apnea. The ENT said he's partially obstructing quite frequently. He had a technical name for it but I can't remember it right now. It's also possible/probable that his hypotonia contributes to the apnea. The muscle tone when you're asleep is what holds your jaw in place and keeps your airway from collapsing. When the tone is low like his, the jaw can drop back and the airway collapses in on itself. Obviously a problem.

Next we went over Beans' results. He also is having obstructive sleep apnea, though he doesn't drop his oxygen levels as low as Little Man. He does have numerous arousals and awakenings through the night and his incidence of apnea increases greatly when he's in REM sleep. It's possible/probable that his dysphagia (swallowing difficulties) and/or subglottic stenosis (narrow airway) contribute to his apnea.

Both boys have normal size lower jaws but their submucus palates are long or too far back (can't remember exactly what he said here). In 99% of kids who have sleep apnea it resolves when they have their tonsils and adenoids out. Both boys had theirs out years ago so they get to fall in that lucky 1% that doesn't (hence the lottery comment). They love to be in that tiny fraction I'm convinced.

So what's the plan? Well we're starting with one month of nasal steroids to eliminate any congestion/inflammation that could be contributing. Then another ENT appointment. If things aren't better then they'll have x-rays to check on their adenoids. Apparently they can regrow. If they have, they'll be removed. If they haven't then the boys will be referred to an oral surgeon. I'm not sure exactly what we're looking at in that case, but I'm hoping that these results and follow ups let all of us get some good sleep. Can you imagine if you never, ever had a good nights sleep? If every night you woke numerous times in the night? If your brain had learned not to go into deep sleep to keep you breathing? No wonder they tend to be crabby little men. Here's to a happier, better sleeping 2010!!