RE: Re: Gray matter matters/Oxygen/brain damage?

[Guest guest]

I have OSA, and had no speech issues as a child.

Jordan snores, but I do NOT believe he has apnea. We're having tonsils/adenoids

removed, as a precaution.

~K

[ ] Re: Gray matter matters/Oxygen/brain damage?

Whoops -left out the main part of this -the speech part!

How many of you have kids with apraxia that don't have trouble

blowing their nose on command? What age did they learn and did you

have to teach them? Do they ever mess up still and breath in

instead? How many have had a sleep test done on their child and

anyone get back results that there was no sleep apnea/seizures etc?

Seems that all that went through it found something. Should we all

be taking our child for a sleep test?

Another quote from:

Patients With Obstructive Sleep Apnea Have Less Gray Matter

Laurie Barclay, MD

" We propose that early damage to the brain's speech center triggers

problems in the muscles that control the airway. This, in turn,

eventually leads to sleep apnea, " says first author Macey, also

at UCLA. " Because the sleep apnea patients possessed speech

impairments from childhood and their brain's speech center revealed

significant gray matter loss, this brain damage likely originated

early in life. "

According to Harper, patients with OSA often have other symptoms

suggesting subtle brain damage, including problems with memory,

cognition, and motor skills. " The repeated oxygen loss from sleep

apnea may damage other brain structures that regulate memory and

thinking, " he says.

Future research will be to study brain morphology in children with

OSA before they develop secondary hypoxic brain damage.

" Speech impediments may prove an important diagnostic clue for

assessing and treating sleep apnea, " Macey says. " In the future,

doctors may monitor certain brain structures and examine children

for speech or movement problems that may predict a higher sleep

apnea risk. "

Am J Respir Crit Care Med. 2002;166:1382-1387

Laurie Barclay, MD Writer for Medscape Medical News

Reviewed by D. Vogin, MD

[Guest guest]

I have a son who has apraxia, he snores at night once in a while and makes a

snoring noise and takes a deep breath in while he does it. He has been

diagnoised with asthma also. I have an ENT appointment for him in December. He

has a hard time going to sleep at night. He used to wake up several times during

the night until he was put on a steroid neb. He is on a preventaive neb once a

day. He doesn't like to eat food. His speech lady thinks that maybe his

adnoids and tonsils need to be removed. But Can all of this be related?

HE does not have ADHD- he can concentrate on things for along time. He does

however have problems remembering colors, numbers, alphabet etc. Oh MY GOSH -

it's like everything just clicked inside of me. Who tests him for OSA?? What

doctor do I go to for that???

Thanks,

Vicki mother of son 5 apraxia, sensory...

[Guest guest]

I have a son who has apraxia, he snores at night once in a while and makes a

snoring noise and takes a deep breath in while he does it. He has been

diagnoised with asthma also. I have an ENT appointment for him in December. He

has a hard time going to sleep at night. He used to wake up several times during

the night until he was put on a steroid neb. He is on a preventaive neb once a

day. He doesn't like to eat food. His speech lady thinks that maybe his

adnoids and tonsils need to be removed. But Can all of this be related?

HE does not have ADHD- he can concentrate on things for along time. He does

however have problems remembering colors, numbers, alphabet etc. Oh MY GOSH -

it's like everything just clicked inside of me. Who tests him for OSA?? What

doctor do I go to for that???

Thanks,

Vicki mother of son 5 apraxia, sensory...

[Guest guest]

Or I'm wondering if the OSA didn't cause a lack of oxygen to the brain

and.........<someone can fill in the blank.......>

~k

[ ] Re: Gray matter matters/Oxygen/brain damage?

Hey Karyn -it probably isn't for all OSA children. I believe they are

saying speech impairments could (and should) be used as a

possible warning sign of Obstructive Sleep Apnea (OSA) -and that is

what was proven in the clinical trials (two now?) For example -not

everyone with a cold will develop pneumonia, not everyone with high

blood pressure will have a heart attack. In most things outside of

speech -there are risks for things such as this and the percentage of

risk that is known. I'm just thankful that speech is finally being looked

at in a serious way. It's a step in the right

direction.

I'm sure there are many with OSA who don't have any history of

speech delays...but being how laid back society was up till now for delays

that

would be hard to know accurately. In your case specifically -what

is of interest is that you have ADHD -and the most recent studies I

found on this show that:

" Of 27 children and adolescents with ADHD evaluated in this study,

11 were girls and 16 were boys. Compared with 46 controls without

ADHD who were matched for age and sex, those with ADHD had reduced

regional brain size localized predominantly to small areas of the

dorsal prefrontal cortices, as well as in bilateral anterior

temporal areas. The ADHD group also had significant increases in the

gray matter in large regions of the posterior temporal and inferior

parietal cortices. "

http://www.medscape.com/viewarticle/464774?rss

which would mean (in theory) that you would have large amounts of gray matter

in

the frontal region which could in fact have protected your speech?

This may explain why more children with ADHD don't have speech

impairments/or severe speech impairments even though they are out

there -but most are mild speech issues like my oldest Dakota -or

mild ADHD in the case of those with more severe speech impairments.

How many here have children with severe ADHD that need medication

and severe speech impairments like apraxia?

Perhaps (just throwing this out here so don't jump) ADHD can answer

questions into how to help speech impaired children in the future?

There may be some answers in where the gray matter is built up, and

why? Does anyone know if that has been studied -comparing gray

matter in ADHD children who have speech impairments to those who do

not?

I'd be curious. Probably not -but here are just a few links of what

I found on gray matter/OCD and speech. It was only published last

year -so not lots yet:

CAUSE OR EFFECT? GRAY MATTER LOSS IN OSA PATIENTS

[Guest guest]

You're lucky you dont snore. My hubby has sleep apnea and snores like a

freight train if he forgets to put his CPAP on. Now Hope snores like a

frieght train as well, but her sleep study she had came back fine. Since

daddy has it, her neurologist wanted her checked for it while he had her in

the hospital on a 24 hr EEG anyway last year.

Toni

Re: [ ] Re: Gray matter matters/Oxygen/brain

damage?

Vicki

Go to your pediatrician, he'll decide what the next step will be.

Pulmonologists, neurologists and ENTs all can recommend a sleep study. Your

pediatrician will be your best guidance for your next step. Good luck to

you.

I will add that since I have been using the CPAP <sigh> I do feel much

better. My concentration has improved for the most part, although my b/p

still is not as " normal " as it once was. In reading so much information

about OSA and how harmful it can be if left untreated, it's wise for anyone

who suspects that a child OR adult has it, follow through with appropriate

dx and treatment. As I said, I'm a very unlikely candidate for OSA, and I

do NOT snore. When my family doc, who is also a close personal friend of

mine, was treating my high b/p, it seemed unbelievable that even with

combination meds, it just would NOT come down. I was reading an ADHD

article where OSA was mentioned, casually.....did some searching and

basically dx'd myself. There's NO WAY it would have been uncovered,

especially with my only marker being the rise in b/p.

~K

[Guest guest]

Hi Jeanne

My insurance DID cover my sleep test, because the marker with me was high blood

pressure. VERY high blood pressure.

I actually had to have two tests (these are NOT pleasant, trust me)....the first

test is the actual STUDY...you're hooked up to an EKG and EMG, along with

breathing machines, etc. Every epic of your sleep is recorded. After the

pulmonologist reads the study, they then determine whether apnea is present, or

not. In my case it was SEVERE (go figure). I never realized I woke up 24 times

an hour. Most people don't. The second test, was with a CPAP machine (this is

not pleasant either.....) to get a reading as to what level of CPAP you need to

get your airway UNOBSTRUCTED so you don't stop breathing. The machine is not a

wonderful thing either, but either I use it, or wind up with cardiac problems

(mind you, I walk 4 miles a day, and work out with weights 5 times a

week.....surely not the picture of someone with OSA.)

Jordan snores....sometimes very loud. But I don't see him with awakenings or

the typical signs you'd see in a child. In children, the " remedy " so to speak,

is to remove the tonsils and adenoids. I can't IMAGINE trying to do a sleep

study on a little one. All those wires!!!!!!! <sigh>

, those points were very interesting.....makes you wonder if this isn't one

of those chicken or the egg kind of things.....ADHD caused by apnea, or apnea

caused by ADHD brain malformations. Also an interesting study would be to

follow those with genetic ADHD and those with ADHD due to brain/birth trauma

injuries. Makes you wonder what the differences are. ADHD is surely a frontal

lobe kind of thing....hmmm.......something else for me to research <smile>.

Knowing how different all of us are, so amazing when the brain is studied...and

so many things fall into the same " category. "

I've read a lot about kids with OSA and learning disabilities, ADHD being one of

them. Again, here's the chicken and the egg thing.....which is the cause of

what. Be VERY interesting to find out!

Karyn

[Guest guest]

Hope's seizures were while she was a wake and while she was asleep. So were

the abnormal spikes. That was prior to any meds and even while she was

taking the meds, but on the meds they were fewer. For the past going on 3

months now she's been seizure free. She's now totally off of her kalonopin

and we're waiting to see what happens. :-)

Sleep just might play a role in part of it. For some reason I notice that

when Hope starts sleeping a lot (wanting to go to bed early, napping more

and longer) she has another micro burst of speech. sometimes she adds

another 2 or 3 words, sometimes more. Once she falls back into her normal

routine of not napping often and going to bed a little later, her speech

levels off again. She doesn't regress, just doesnt add more words for a

while. It may be something to look into.

Toni

[ ] Re: Gray matter matters/Oxygen/brain

damage?

Hi Toni!

That's why I'm not just counting OSA - Does Hope have seizures while

she sleeps or only when awake? (or did she have seizures while she

slept prior to medication and ProEFA?)

So back to the questions...how can we increase the gray matter/can we?

(and in

addition to EFAs and oxygen -does sleep itself play a role here too?)

[Guest guest]

Vicki

Go to your pediatrician, he'll decide what the next step will be.

Pulmonologists, neurologists and ENTs all can recommend a sleep study. Your

pediatrician will be your best guidance for your next step. Good luck to you.

I will add that since I have been using the CPAP <sigh> I do feel much better.

My concentration has improved for the most part, although my b/p still is not as

" normal " as it once was. In reading so much information about OSA and how

harmful it can be if left untreated, it's wise for anyone who suspects that a

child OR adult has it, follow through with appropriate dx and treatment. As I

said, I'm a very unlikely candidate for OSA, and I do NOT snore. When my family

doc, who is also a close personal friend of mine, was treating my high b/p, it

seemed unbelievable that even with combination meds, it just would NOT come

down. I was reading an ADHD article where OSA was mentioned, casually.....did

some searching and basically dx'd myself. There's NO WAY it would have been

uncovered, especially with my only marker being the rise in b/p.

~K

Re: [ ] Re: Gray matter matters/Oxygen/brain

damage?

I have a son who has apraxia, he snores at night once in a while and makes a

snoring noise and takes a deep breath in while he does it. He has been

diagnoised with asthma also. I have an ENT appointment for him in December. He

has a hard time going to sleep at night. He used to wake up several times during

the night until he was put on a steroid neb. He is on a preventaive neb once a

day. He doesn't like to eat food. His speech lady thinks that maybe his

adnoids and tonsils need to be removed. But Can all of this be related?

HE does not have ADHD- he can concentrate on things for along time. He does

however have problems remembering colors, numbers, alphabet etc. Oh MY GOSH -

it's like everything just clicked inside of me. Who tests him for OSA?? What

doctor do I go to for that???

Thanks,

Vicki mother of son 5 apraxia, sensory...

[Guest guest]

LOL ........very true. But the " awakenings " they measure I " believe " <I

never really did any work with sleep studies> are measured through the EMG, so

they are actually measuring when your brain is awake (definitely not being clear

here....)

I have a great pulminologist, and he of course recommended having Jordan treated

immediately. He talked of the very high incidence of children that snore, who

wind up with LD's in the early school years, and who later present with lower IQ

scores than their peers.

~K

[ ] Re: Gray matter matters/Oxygen/brain damage?

" I actually had to have two tests (these are NOT pleasant, trust

me)........Every epic of your sleep is recorded. After the

pulmonologist reads the study, they then determine whether apnea is

present, or

not. In my case it was SEVERE (go figure). I never realized I woke

up 24 times

an hour. "

Hey Karyn -any chance you woke up 24 times in an hour because you

were hooked up to tests that were NOT pleasant?

(just kidding!)

I believe they found around 30-40% of those with speech

impairments/stuttering had OSA -I'm more curious how many with

speech impairments have OSA or other problems while they sleep.

(PS according to an experiment with USPS -the chicken comes first)

http://www.improb.com/airchives/paperair/volume9/v9i4/chicken_egg.html

=====

[Guest guest]

Wow.....talk about a WORLD of difference~

I arrived and was promptly wisked off to a " room " ....looked more like a birthing

suite, lol.......I was told to change into " night clothing " and then was

IMMEDIATELY hooked up to all those wires, etc. Lights OUT, no TV....ok ok, I'm

not a pediatric patient, and I've surely been exposed to hospitals and their

" routines " many times, but it was very abrupt. And I don't care how tired you

are, it's no walk in the park with wires from head to toe, EKG and EMG leads,

bands around your chest and waist, and a nasal cannula to measure O2 output, and

then told " go to sleep. " I literally had to FORCE myself to sleep, reminding

myself that this was the only way this would end for me, was to get the test

DONE AND OVERWITH. I was initially told it would be a " split study. " Half the

night without CPAP, and then they would wake me up and give me the CPAP, if the

first part of the study indicated apnea. Unfortunately that wasn't the case. I

was disappointed that I had to wait 4 weeks to even get a result, and then had

to wait yet another two weeks to get the second study scheduled. Then another

three weeks for that second study to be read, and finally the CPAP prescribed.

This center in the article you sent seems to say they read the results

immediately. If you have something like OSA, and you're really feeling it (it

got to the point where I would just fall asleep sitting up, so I knew this was

BAD), you don't want to have to wait MONTHS for the process. They sound very

child/parent friendly, but dealing with children with something like this is

very different. No WAY a child would have been comfortable in the environment I

was in. In fact, my husband went for the study and couldn't sleep at all.

After 3 attempts, they still don't have a reading they can " use. " <thinking I

should send him to THIS hospital, lol>

So here I am, 3 months with CPAP, and I do feel markedly better. I don't fall

asleep anymore (which is so odd, because I was always such a high energy

person..... but my understanding with apnea is that the effects become

cumulative. Months and years without restorative sleep really can take it's

toll, and Lord knows Im not getting any younger.....) My ADHD symptoms which

had gotton HORRIBLE, are markedly better without any meds. (I was taken off of

Adderall because of the dangerously high b/p). My b/p has come down to a very

reasonable level and I'm taking minimal medication for that <using clonidine,

which is also helpful for ADD/ADHD, so it works>

The mask is definitely difficult to wear, and there are many mornings I wake up

and find it on the floor <attestation to the fact that you wake up and don't

know it>. But for the most part, it's working. Seems so odd that with all the

technology, the therapy for this still seems so archaic.

Children often can't tell us what's bothering them, and often they don't even

KNOW. A child with apnea may present some symptoms such as excessive daytime

tiredness, learning problems, hyperactivity...but unless a study is done,

there's really no way to know FOR SURE. Surely worth investigating if as moms

and dads we have doubts. The longterm effects of childhood OSA unfortunately

are long lasting and irreversible.

~K

[Guest guest]

W

This makes sense to me because he doesn't drink milk, allergic, he's not a great

eater and he LOVES banannas, probably doesn't get enough B12 because he's not

into veggies *that's where you'd find b12, right?

Thanks,

I am going to have the ENT run tests for nutrition, I do give him a vitamin too

but you can never be too sure..

Vicki W.