Paediatric obstructive sleep apnea is a sleep disorder that affects children. This is a health condition where a child’s breathing is partially or completely blocked during sleep. Paediatric obstructive sleep apnea occurs when the upper airway is narrowed or completely blocked during sleep.

Paediatric obstructive sleep apnea is different from the adult sleep apnea. Adults usually manifest daytime sleepiness due to adult sleep apnea but children show marked behavioural problems. In many of the cases of adult sleep apnea the leading cause is excess body weight or obesity, whereas, in children, the most common cause is an enlargement of the adenoids and tonsils.

It is crucial that paediatric sleep apnea is diagnosed early to prevent later stage complications to the child, including growth, cognitive development and behaviour.

What are the symptoms of paediatric sleep apnea?

There are many symptoms that is manifested when a child is sleeping. These symptoms include some sort of snoring, pauses in breathing, restless sleep, snorting, coughing or choking, mouth breathing, bedwetting and sleep terrors. Most infants and young children do not snore and may instead have a restless sleep.

The effects of sleep apnea in children during the day can be well recognised. The children with sleep apnea may perform poorly in school, they have difficulty paying attention in the classroom, have learning problems, have behavioural problems, do not gain age-appropriate growth and weight, they will be mostly hyperactive.

What are the causes of paediatric sleep apnea?

The primary cause for paediatric sleep apnea is the presence of enlarged tonsils and adenoids. Yet, obesity also plays a key role in children. Sometimes certain craniofacial conditions and neuromuscular disorders can also lead to paediatric sleep apnea.

When to consult a doctor?

If your child is showing signs of restless sleep at night and later shows tiredness in the morning with sure symptoms of hyperactivity or behavioural problems then it is time you sought the right medical intervention for treating the condition.

What are the risk factors?

Apart from obesity, other risk factors for paediatric sleep apnea include Down syndrome, abnormalities of the skull and face, cerebral palsy, sickle cell disease, neuromuscular disease, family history of the disease and low birth weight.

Serious outcomes

Paediatric sleep apnea is not limited to just lack of sleep and behaviour problems in children. It can lead to severe health problems too.  The problems include stunted growth in children, lead to major heart problems and in some cases where proper treatment is not give cause the death of the child.

Experts have been warning parents not to let babies sleep in rockers, cushions, car seats or any other product that holds an infant at an incline. The baby sleeping like that tend to have their head higher than their feet.

Studies have shown that babies made to sleep at an incline will suffer injuries and impair their movements. Their oxygen levels also decreased, which is a dangerous situation. Researchers have found that none of the inclined sleepers were safe for the babies. Babies should be made to sleep on their back on firm bedding and not surrounded by pillows/thick blankets.

How Babies Move

Studies were conducted on how babies move and use their muscles in inclined products. Infants from 2 – 6 months were chosen for the study.

Each infant was placed in a product for  60 sec at a time for safety.

The results showed some  that it was easier for the babies to roll from their backs to their stomach in the test   products. The  study team found that lying on an incline activates the baby’s stomach muscles and makes it easier for them to lift their heads and turn over, even if they have never done it.

What is the danger?

Once the baby flips over, the angle of the sleeper and the soft material that most of the products are made of can make it tough for them to get out of that position. Babies who wind up on their stomachs struggle and get extremely tired. They even lie face down and get suffocated.

There  are reports of thousands of such incidents and deaths from USA where all these took place within a short span of 10-15 years. The parents added that they have never noticed their baby roll-over but found them dead lying in one of these products.

When babies burrow their faces into a soft surface, they end up continuously breathing the carbon dioxide they exhale, eventually leading to suffocation and death.

Other precautions

Sleeping in car seat

In countries like the USA certain regulatory agencies have issued strict instructions on using inclined products for babies. Parents should not use inclined sleep products with a seat back that rises more than 10 degrees. Parents also should take care not to let babies sleep in car seats, bouncers, pillow or a seat that holds them at an angle.

Crib mattress

Parents tend to put a crib mattress at an incline to help with reflux. Though previously some doctors recommended that since babies tend to choke due to reflux. But recent studies show this does not help and may be unsafe.

Blankets & Pillows

In addition to inclined surfaces it is equally dangerous if babies sleep in blankets soft sheets and pillows. They tend to pull it over their face and  are unable to breathe freely.

The safest way for a baby to sleep is on their back, in  a bare crib and on a flat firm surface.

It is observed that our immune system does have the capability to detect the presence of cancer and act on it. This capability is what is used in immunotherapy which is a treatment that uses certain parts of a person’s immune system to fight diseases such as cancer.

How does immunotherapy work?

Immunotherapy works by stimulating or boosting the natural defences of your immune system so it works harder or smarter to find and attack the cancer cells. Immunotherapy also makes use of substances that is produced in a lab that mimics our immune system components and uses them to help restore the immune system.

Immunotherapy works only for some types of cancer. Sometimes the immunotherapy works by itself or it is used in combination with other therapies to treat disease.

What are the functions of the immune system?

The immune system is a collection of organs, specialty cells and certain substances in the body that helps protect the body from infections and other diseases. The immune cells and substances travel through the body to attack foreign substances and germs that cause infections. Likewise, they help protect the body against cancer too.

The immune system has an awareness of all the normal substances in the body and any new substance that the immune system does not recognize raises an alarm. This, in turn, prepares the immune system to attack the foreign substance.

We know that there are limits to the immune system’s ability to fight cancer on its own. This is because even people with healthy immune system are seen to develop cancer.

Why immune system fails?

The immune system sometimes does not recognize cancer cells as foreign because the cells are not that different from normal cells. Sometimes it does recognize the foreign substance but its capacity is so low that it cannot destroy cancer cells. Cancer cells also give off substances that prevent the immune system from functioning properly.

When you talk about the plague disease, you may think that it is something which existed only in the middle ages and in far away lands. You may think that the plague is not in this world anymore, but the truth is different. The plague is a disease that is very much present even today and it is as dangerous  as it was hundreds of years ago.

You should not be shocked and disheartened by knowing that the plague still infects our world. In those days our ancestors did not know what caused plague but today we know what causes it. We also have the treatment for the disease and the know-how to prevent it from spreading.

The Plague Explained

The plague is caused by a bacteria which is called Yersinia pestis and it spreads from fleas. The fleas pick up the bacteria when they bite animals like rats, mice or squirrels. Later when these fleas happen to bite a human they pass on the germs. Plague also spreads with direct contact with animals or people already infected.

Since there are good prevention techniques and treatment available, the plague has become a rare occurrence. The plague is still prevalent in countries like Africa, India and Peru.

What are the types?

Normally three types of the plague are identified. The Bubonic plague, the Septicaemia plague and the Pneumonic plague.

Bubonic Plague: This is the most common type which causes buboes or lymph nodes under the arms, in the neck or groin.

Septicaemia Plague: This type is more dangerous and infects the blood causing bleeding, blackened skin and belly pain.

Pneumonic Plague: It is a  rare form of the disease which affects the lungs and causes pneumonia. It is a very contagious form since it spreads through the air.

What are the plague symptoms?

When a person is infected with the plague the symptoms occur anywhere from 1-6 days time. The infected person will feel very sick and weak and have high fever, chills and headaches. The rest of the symptoms differ and will be according to the type of the plague you are infected with.

What is the treatment?

If you show any symptoms then it is better to see a doctor who will be able to assist you in identifying the plague. Doctors usually do a blood test along with test on samples of spit or fluid from the lymph nodes. If you have been with a person suspected of having plague the doctor will start treatment immediately even if there is no symptoms.

How to prevent the plague?

If  you travel to areas which are prone to cause the plague then stay away from incidents of plague and also away from sick or dead animals. If you happen to live in an area where there has been cases of the plague then fill holes and gaps in the house to stop mice, rats and rodents from entering the house.

Clean all the piles of leaves, wood or rocks where animals may hide. Preferably use a bug repellent to prevent the presence of fleas. Wear gloves while touching animals. Use flea sprays on pets and try not to let pets out-door.

Who and when should you wear a face mask? The health department recommends that everyone over the age of 2 years should wear cloth face masks in public places, especially in areas where it is difficult to maintain the mandatory 6 feet distance.

It is best to wear a face mask if you are sick and if there are other people around, at home also. Caregivers are supposed to use the facemask when cleaning and disinfecting a sick person’s bedroom or bathroom.

When visiting a doctor or a hospital, you should wear a face mask.

Wearing a facemask is in addition to other COVID-19 safety measures. You still have to limit contact with other people, wash your hands often with soap and keep surfaces clean.

Who should not wear a face mask?

Children under two years of age, someone who is having trouble breathing, someone who is unconscious or people who can’t move or take-off a mask by themselves need not wear a mask.

The right way to wear a face mask

Before you put on a face mask, wash your hand for 20 seconds with soap and water. Then, secure the mask either with ties behind the head or loops behind the ears as provided. Adjust to fit the mask properly around your nose and mouth and under your chin.

Take care, there is no space between your face and the mask. Pinch the top edge of the mask to fit it around the bridge of your nose. The mask should fit comfortably and be able to breathe easily through it.

Once you wear it and step out, do not go on touching your mask every now and then.

Cleaning and maintaining the face mask

It is best to wash cloth masks with hot water and detergent after every use. If the mask has a filter, take it out before washing. After taking out the mask from the washing machine, hang it up for drying. Wash your hands when you’re done.

After drying your mask check for any hole or frayed edges that can cause gaps around your face.

Before you use the mask again, check for holes. Be sure it’s not frayed and doesn’t gap around your face.

It is recommended to wash your face mask rather than just putting it out in the sun since there is no evidence that sunlight can deactivate the COVID – 19 virus.

Myths and facts about face masks

Gaps in masks make them useless

A mask that does not fit perfectly may not be totally useless if it has a high filter level. Even cloth masks that fit perfectly can’t stop all particles. But a mask that has a gap won’t work nearly as well as a perfectly fitting mask.

Should wear a mask at home too

It is not required to wear a mask at home unless you yourself are sick or you are caring for someone who is sick.

We should wear a mask when exercising outdoors

Though it is best to wear a mask when you go outdoor, wearing a mask and exercising has its own problems. Some people will feel breathless when they wear a mask and exercise. So, it’s fine not to wear a mask when exercising outdoor if you maintain 6 feet distance with other people.

Masks trap carbon dioxide and viruses

Continuously wearing an N95 mask for several hours can make CO2 linger behind the mask. The presence of excess carbon dioxide will cause headache, dizziness and fatigue. At the same time, cloth and surgical masks generally do not cause so much of a problem.

Yes, mask could trap particles of coronavirus and that is why it is recommended that face masks should not be touched often when wearing them and they should be properly washed once you use them outdoors.