Over the years I have had probably a dozen students who frequently dozed off at school. These student's disabilities ranged from Apert Syndrome to Mitochondrial Disease to Down Sydrome to Cerebral Palsy. Only one of my students has even been formally diagnosed with and treated for sleep apnea and that student often refused to wear the CPAP device that was prescribed to treat the apnea . (A CPAP is a Continous Positive Airway Pressure device that basically blows air into the nose or mouth in order to maintain enough pressure to keep the airway open during sleep, there are other variations such as a BiPAP.)
Rarely are students with special needs evaluated for sleep apnea (although it is becoming common practice to rule out sleep apnea before diagnosing ADD/ADHD). This is inspite of 45% of children with Down Syndrome having obstructive sleep apnea and apnea being more common in individuals with sickle cell anemia, muscular dystrophy, mitochondrial disease and other neuromuscular diseases, cerebral palsy, and craniofacial abnormalities. (Here is a list of risks from the Mayo Clinic.)
Can you imagine how hard it is to learn, perform and most of all BEHAVE if you are exhausted all the time? In fact some Down Syndrome specialists think that sometimes what looks like early symptoms of Alzheimer's in Down Syndrome is really sleep deprivation from sleep apnea!
As far as treatment, in children and adults with special needs a CPAP or BiPAP may be used (if the individual is likely to be compliant), but other treatments may also be options, including orthodontic treatment and surgical intervention.
Teachers and classroom nurses of students with disabilities are on the front lines. If students are sleepy in class, if parents complain of frequent night waking, difficult sleep patterns or snoring, it might serve the student well to suggest a visit to the primary care physician to discuss the possibility of obstructive sleep apnea.
Here are some links for more information:
- American Sleep Apnea Association
- Children and Sleep Apnea and Overview
- Obstructive Sleep Apnea and Down Syndrome
- Sleep Apnea and Down Syndrome
Great post! I never thought about the connection with sleep apnea but it makes sense. Many times my students complained of not sleeping well but it usually was a result of being on the phone, or watching TV. I wonder how many of them have sleep problems.
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