Snoring Child with Central Apnea: Uncovering a Hidden Neurological Cause

초록

Introduction: Pediatric sleep apnea is a sleep-related breathing disorder characterized by partial or total obstruction of the upper airway, usually due to an obstructive cause such as enlarged tonsils in children. However, children can rarely present with central sleep apnea (CSA), which in some cases can be associated with various neurological conditions. Materials and methods: A 7-year-old boy has presented with frequent snoring and morning headaches. Physical examination and PNS X-ray revealed no significant abnormalities in the paranasal sinuses, such as sinusitis, and no enlargement of tonsil and adenoid. Type 1 Polysomnography showed periodic breathing with central apnea and snoring, with minimal obstructive events. Further neurologic evaluation was performed to differentiate the cause of the central apnea, there is no abnormal finding on neurologic tests revealed any central nervous system problems. Results: A subsequent brain MRI revealed a cerebellar tonsillar hernia extending below the foramen magnum, consistent with a Chiari 1 malformation. Conclusions: This case highlights the importance of considering a central cause in pediatric patients presenting with snoring and abnormal central sleep apnea on sleep study findings. Early neuroimaging and appropriate management, when indicated, can result in clinical improvement and help prevent long-term complications.