When the grandchild snores like its granddad


Grandchildren know from experience that their father and grandfather both snore, especially the latter, and they certainly understand that itís a normal part of ageing. The fact that they themselves may also snore and experience a number of interruptions in their breathing during the night is something they probably wonít know.
Nowadays, an ever increasing number of children snore. And parents should keep a careful eye on the situation, because snoring is often a sign of "sleep apnoea". These breathing interruptions are a very serious problem and health risk. Associated as it is with the obesity epidemic, sleep apnoea is becoming ever more common in childhood.

If breathing interruptions last longer than 10 seconds, the term apnoea is applied. ďApnoea" is derived from Greek and means without breathing. The temporary cessations in breathing, which are mostly due to an excessive relaxation of the tongue or palate muscles or an enlarged throat or tonsils, cause the oxygen saturation of the blood to decrease and the carbon dioxide content to increase. Before this reaches life-threatening proportions, the sympathetic nervous system is activated and stress hormones such as adrenaline and noradrenaline are released. This has the effect of briefly waking up the sufferer and allowing breathing to resume. An interruption in breathing is therefore followed by a deep breath, which opens the narrowed airways and can be heard as a loud snore. The arousal reactions from sleep are usually so brief and incomplete, however, that the person concerned cannot remember them the next morning. But the interruptions in breathing do prevent the occurrence of the important phases of deep sleep.

The consequences of the shortened periods of deep sleep and the reduced oxygen content are serious. The early symptoms are difficulty in waking and daytime sleepiness, often associated with learning disabilities. Paradoxically, hyperactivity and aggression frequently occur too, as well as a marked moodiness. A daytime increase in blood pressure occurs as a consequence of the activation of the sympathetic nervous system and this also promotes early damage to blood vessels over time. The lack of restful sleep induces, in turn, an increased secretion of ghrelin, the appetite-stimulating hormone, and a reduction in leptin, the appetite-suppressing hormone. Both factors increase the risk level for the development of obesity, which brings with it insulin resistance, inflammation propensity and metabolic disorders - which shows why "adult onset diabetes" in childhood is an increasingly common consequence of sleep apnoea.

In the current edition of Lifestyle Telegram, two recent studies are presented which address this issue.