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My grandson is 12 years old, he has been diagnosed with food allergies, asthma, eczema, reflux, obstructive sleep apnea and Awakenings. He seems to be getting worst. Every night for the past 2 months he has had some sort of episode, from wakeing up suddenly screaming (all night), to boughts of what appears to be severe reflux that occurs every couple of minutes. Sometimes he awakens and goes into what looks like a seizure. He has been tested for seizures but is said to not be having them. Most nights when he has his C-pap on, at some point he rips it off due to having an awakening or mostly reflux. When he has these seizure look-a-likes, his lips turn white and around his mouth turns blue and he is gasping for air and spitting. Usually after a seizure he is incoherent and cannot be understood, he then sleeps. Also at some point he releases a large burp during the seizure, sometimes he has wet himself. The seizures are lasting longer.

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replied May 14th, 2010
Allergies Answer A12083
Hi, welcome to the ehealth forum and I am glad to help you.
You seem concerned with obstructive sleep apnea, night awakenings, reflux, allergies, asthma, eczema and he now has worsening of symptoms over the last 2 months. The seizures that you suspected have been ruled out in consultation with your doctor.
All the symptoms that you have enumerated seem to be the consequence of obstructive sleep apnea including the awakenings and bedwetting in the backdrop of mildly delayed mental development.OSA is characterized by brief, repeated episodes of airflow obstruction at the nose and mouth that occur during sleep. These periods of complete airflow cessation (apnea) or partial airflow obstruction (hypopnea) result in both frequent, transient reductions in oxygen (hypoxia) and increases in carbon dioxide levels (hypercapnia) that are associated with partial awakenings or arousals throughout the night.
Children with OSA may have secondary enuresis, most likely as a result of the disruption of the normal nocturnal pattern of antidiuretic hormone secretion. That could be the reason child is wetting the bed.
The most common risk factor for childhood OSA is adenotonsillar hypertrophy. Children with seasonal and environmental allergies, asthma, and/or frequent sinus infections may also be at increased risk for OSA due to increased resistance in the upper and lower airways. Gastroesophageal reflux may also result in posterior pharyngeal irritation, edema, and obstruction.
In most cases, adenotonsillectomy is the first line of treatment in chidren. Positional therapy i.e. not to sleep in supine position and aggressive treatment of conditions such as asthma, seasonal allergies, and gastroesophageal reflux can help in decreasing the symptoms of OSA. CPAP and BIPAP can be used in resistant cases that splint the airway open. BIPAP is better than CPAP.
You must consult an ENT doctor for consultation and discuss regarding the need for surgical intervention.
Hope this helps. Take care.
Note: This post is not to emphasise final diagnosis as the same cannot be made online and is aimed just to provide medical information and no treatment suggested above be taken without face to face consultation with health care professional.

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