My daughter is 4years old and from day one she has had issues. It began at the hospital where her O2 sats were low but every time they would give her oxygen her sats wold raise. 2 days later releasing her. From there she was a gerd baby. That gastrul esophagus reflux disorder. And it was with every feeding I would b puked on an not a little the whole bottle. This resulted in going o here pediatrics dr every week to see if she gained weight or lost weight and changing of formulas constantly. And yes she was full term. This lasted until she was a year and a half. From there she began getting frequent ear infections which resulted in getting tubes in her ears at 2 years old. She continued to get ear infections even with tubes and theENT at that time said if she got one more she was going to have to get new tubes put in. Thankfully the ear infections disappeared and we only see them maybe once a yeAr or so. 2 years ago she was diagnosed with ADHD and we have tried many medications but cannot seem to get the "cocktail jut right" her pediatrician noticed her tonsils were huge and at every dr appt asks me if she complains of her throat hurting and always getting the same answer of no. Finally she ordered the sleep study to see if maybe there is a connection between the ADHD and her tonsils. The results of her sleep study confirmed that she was not sleeping well
Recording tech comments: mouth breathing throughout entire study. TCO2 had to be utilized. Occasional respiratory events noted. Frequent snoring, moderate to loud in volume heard. Occasional gasping witnessed. CO2 and O2 levels WNL.
Impression: the study demonstrated mild obstructive sleep apnea without hypoxemia or hyperventilation. There was REM sleep-related worsening noted in obstructive events. Sleep was fragmented with frequent arousals and awakenings. Patient was irritable, restless and uncooperative in the beginning but remained asleep are an early sleep onset. Moderate to loud snoring audible.
Recommendation: upper airway evaluation by ENT service is suggested for surgical options.
Arousal summary #of arousals. Index per hour
Leg movements. 0. 0.0
Respiratory. 39. 5
Spontaneous. 123. 14.5
Total. 166. 19.6
Respiratory disturbance index 6.5hrs. Number of respiratory events
OAHI. 6.0. Obstructive apnea. 17
CAI. 0.5. Obstructive hypo apnea. 30
RERA. 0.0. Central Apneas. 4
NREM AHI. 3.0. Mixed Apneas. 4
REM AHI. 24.2. RERAS. 0
Total-AHI. 6.5. Total #. 55
REM latency: 179 mins
The longest event was a 23 second obstructive apnea with a minimum SaO2 of --%.
The longest central apnea event was 21 seconds
The minimum SaO2 associated with obstructive apnea is 93%
The lowest SaO2 was 89% associated with a 13 second obstructive hypopnea
Duration of time with periodic breathing was 0.0 min
A % of TST with periodic breathing was 0.0%
I need help figuring out what is the best course of action to take from here and if someone could explain to me what all this information means.