Affective respiratory attacks in children help. Affective-respiratory attack: signs of breath holding in children. What are affective-respiratory attacks

Affective-respiratory attacks (ARA) are sudden stops in breathing that occur at the height of inspiration when the child hits, gets scared or cries. At the same time, the baby may turn pale or even turn blue, which, of course, greatly frightens his parents, who do not know what is happening to him and how they can help him.

In this article we will dwell on this problem in detail, considering at the same time the reasons for the appearance of this paroxysm and the methods of its treatment.

What is ARP

Affective-respiratory attacks, from the point of view of doctors, are the earliest manifestation of fainting or hysterical attacks.

To better understand what exactly is happening to your baby, it’s worth first deciphering the name of the concept we are considering. The word “affect” denotes a very strong uncontrollable emotion, and everything related to the concept of “respiratory” is associated with the respiratory organs. This means that ARP is a violation of the breathing process, somehow combined with the emotional sphere of the child. And, as researchers have proven, they are more susceptible to excitable, spoiled and capricious children.

The first affective-respiratory attacks begin, as a rule, after the baby is six months old and last until about 4-6 years.

By the way, I would like to draw the attention of parents that holding their breath in children occurs involuntarily and not on purpose, although from the outside it looks as if the baby is pretending. The described paroxysm is rather a manifestation of a pathological reflex that is triggered during crying, at the moment when the baby exhales most of the air from the lungs at once.

What does it look like to hold your breath in a crying baby?

Affective-respiratory paroxysm most often occurs when the child is crying a lot. So to speak, at the peak of his indignation at the current situation.

During such a noisy display of emotions, the child may suddenly suddenly become quiet and, opening his mouth, not utter a sound. In this case, breathing may stop for 30-45 seconds, the baby’s face becomes pale or blue, depending on the circumstances, and at this time the parents themselves are ready to lose consciousness.

By the way, it is how the child looks when he cries that determines what type of seizure you observe. They are conventionally divided into the so-called “pale” and “blue”.

Types of breath-holding seizures

“Pale” affective-respiratory attacks in a child occur as a painful reaction at the time of a fall, bruise, or injection, while the baby sometimes does not even have time to cry. At this time, the child may not have a palpable pulse, and this type of attack is similar to fainting in adults. By the way, often this condition later develops into fainting.

And “blue” attacks are the “highest point” of the expression of anger, rage and discontent. In children, paroxysms develop in most cases of this type. If it is impossible to get what is required or achieve what is desired, the child begins to scream and cry. As he inhales, his intermittent but deep breathing stops, and a slight blueness appears on his face.

Most often, the condition normalizes on its own, but sometimes the baby may experience tonic muscle tension or, conversely, a decrease in their tone. Outwardly, this manifests itself in the fact that the child suddenly tenses up and arches or goes limp, which, by the way, also does not last long and goes away on its own.

Are seizures dangerous for a child?

Concerned parents should be immediately warned that the described paroxysms do not pose any serious danger to the health and life of a crying baby.

You should call an ambulance only if the child’s breathing has stopped for more than a minute. And you should consult a doctor in case of frequent (more than once a week) attacks, as well as in cases when they change: they begin differently, end differently, or if unusual symptoms are detected at the time of the paroxysm.

If you observe affective-respiratory attacks in a child, the main thing is not to be nervous, try to help him restore his breathing by lightly patting his cheeks, blowing in his face, sprinkling some water on him or tickling his body. This is usually successful, and the baby begins to breathe normally. After an attack, hug the baby, reassure her and continue to do your job without showing concern.

A child has seizures: causes

If holding your breath during an attack lasts more than 60 seconds, the child may lose consciousness and go limp. Such an attack in medicine is classified as atonic non-epileptic. This condition is caused by a lack of oxygen in the brain and, by the way, occurs as a protective reaction to hypoxia (after all, in an unconscious state, the brain requires much less oxygen).

Next, the paroxysm turns into a tonic non-epileptic attack. At this moment, the child’s body becomes stiff, stretches or bends in an arc. If hypoxia does not stop, clonic convulsions may develop - twitching of the baby's arms, legs and entire body.

Holding your breath causes an accumulation of carbon dioxide in the body (the so-called hypercapnia state), which is replaced by a reflex release of spasm of the laryngeal muscles, from which the child inhales and regains consciousness.

Convulsive affective-respiratory attacks, the causes of which we have examined, usually end in deep sleep lasting 1-2 hours.

Do I need to see a doctor?

As a rule, these attacks do not have any serious consequences, but, nevertheless, if convulsive twitching occurs at the moment when the child starts crying, it is worth seeking advice from an experienced neurologist, since some diseases of the peripheral nervous system.

Rolling motions that are accompanied by seizures can be difficult to diagnose because they can easily be confused with epileptic seizures. And, by the way, in a small percentage of children, this condition during ARP later develops into epileptic attacks.

Affective-respiratory convulsions and their difference from epileptic seizures

In order to be sure that your child's seizures are not a sign of developing epilepsy, you should have a good understanding of the differences between them.

ARVs tend to become more frequent if the child is tired, and with epilepsy, an attack can develop in any condition.
Epileptic seizures are the same. And affective-respiratory paroxysm occurs in different ways, depending on the severity of the situations that provoke it or the pain sensation.
ARP occurs in children no older than 5-6 years, while epilepsy is a non-age disease.
ARP is well affected by sedatives and nootropic drugs, but epileptic seizures cannot be stopped with sedative drugs.
In addition, when examining a child with ARP, EEG results do not show the presence of epiactivity.

And yet we repeat: if twitching occurs during an attack of breath holding, parents should show the baby to the doctor.

What is the difference between ARP in cardiovascular pathology?

As it turned out, the parents of 25% of children with ARP also had similar attacks. And yet, in modern medicine it is believed that the main reason for this phenomenon is the presence of constant stressful situations in the family or overprotection of the child, which lead the baby to the described version of childhood hysteria.

Although it should be taken into account that in a small proportion of patients, affective-respiratory paroxysm is one of the manifestations of concomitant cardiovascular pathology. True, it also has distinctive features:

the attack passes with less excitement;
the blueness of the face is more pronounced;
the child begins to sweat;
complexion recovers more slowly after an attack.

However, such children, even without attacks, simply begin to sweat and turn pale during physical exertion or crying, and, as a rule, they feel unwell in transport or a stuffy room. They are also characterized by rapid fatigue and lethargy. If the listed signs are present, it is best to have the child examined by a cardiologist.

What to do if your child is having breath-holding spells

Due to the fact that affective-respiratory syndrome is more likely to be a neurotic manifestation, it is best to get rid of it by regulating the child’s psychological state.

Parents should first of all pay attention to how they build their relationship with their child. Are they too protective of him, afraid of any situations that could disturb the peace of their child? Or maybe there is no mutual understanding between the adults in the family? Then it is best to consult a psychologist.

In addition, the orderliness and rationality of their regime is of great importance for such children. According to E. O. Komarovsky, considering affective-respiratory attacks, they are always easier to prevent than to treat.

Parents should be aware of the child’s condition. After all, everyone knows that a child is more likely to cry if he is hungry or tired, as well as in a situation where he cannot cope with any task. Try to mitigate or bypass all the causes of breath holding and convulsions: for example, if your baby gets irritated while rushing to get ready for a nursery or kindergarten, you better get up earlier to do it leisurely and measuredly.
Be aware of how children perceive prohibitions. Try to use the word “cannot” as little as possible. But this in no way means that from now on everything is allowed for the baby! Just change the vector of its action. The baby will be more willing to comply with the suggestion: “Let’s go there!” than the requirement to stop immediately.
Explain to your child what is happening to him. Say, “I know you’re angry because you didn’t get that toy.” And then make it clear that, despite his grief, there are limits to the expression of feelings: “You’re upset, but you shouldn’t yell in the store.”
Explain the consequences of such actions: “If you yourself do not know how to stop in time, we will have to send you to your room.”

Clear boundaries of what is permitted, as well as a calm environment in the family, will help the child quickly cope with the feeling of panic and confusion that caused the rolling up.

Drug treatment of ARP

If your child experiences frequent and severe attacks of breath holding, they can be stopped with medication, but this is done only as prescribed by a doctor.

Like other diseases of the human nervous system, ARP is treated using neuroprotectors, sedatives, and B vitamins. Preference is usually given to the drugs Pantogam, Pantocalcin, Glycine, Phenibut, as well as glutamic acid . The course of treatment lasts approximately 2 months.

It is better to replace sedatives for children with infusions of sedative herbs or ready-made extracts of motherwort, peony roots, etc. By the way, doses are calculated depending on the age of the baby (one drop per year of life). For example, if a child is 4 years old, then he should take 4 drops of the medicine three times a day (course - from two weeks to a month). Baths with pine extract and sea salt also have a good effect.

If a child’s seizures are difficult to stop, and they are accompanied by convulsions, the causes of which we discussed above, then the tranquilizers Atarax, Teraligen and Grandaxin are used in the treatment process.

A few final words

Remember that any therapy in the case of affective-respiratory syndrome can only be prescribed by a neurologist, who will individually select the dose of the drug. Self-medication, as you probably understand, can be dangerous to your baby's health.

If you are faced with the problem of holding your breath in children, do not panic, since the child always comes out of this state on his own, without consequences, and gradually “outgrows” the described paroxysms.

Like all human diseases, ARP is easier to prevent than to treat, so once again I would like to remind you of the need for parents to have a flexible attitude towards the emotions of their child. Try to avoid situations that cause tantrums, and at the moment when the child is already on edge, postpone educational activities until a calmer time.

Remember: the child is not able to cope with this type of hysteria on his own, he cannot stop, and this, by the way, frightens him very much. Help him break this vicious circle.

Talk to him, don’t shout, show maximum patience and love, distract him, switch his attention to something pleasant, but do not give in to the baby’s obvious attempts to control you with attacks. If you grasp this line, then you most likely will not need drug treatment! Good luck and health!

Problems of maintaining and strengthening the health of children should be considered from the moment of birth. Prevention is the best way to avoid many diseases in later life.

Affective-respiratory attacks in children, only at first glance, are an ordinary problem, to which the less attention you pay, the faster it goes away. You shouldn't think like that. In fact, it is important to know that nervous disorders only get worse over time. Dangerous consequences can manifest themselves in the form of poor performance at school, mental and physical development delays. Somatic disorders may also occur, for example, increased aggregation of erythrocytes, decreased activity of the alveoli in the lung tissue, hypoxia of brain structures, etc.

Affective-respiratory attacks should be prevented whenever possible. With development, first aid should be provided promptly and fully to the baby. The video at the end of this page shows the opinion of an authoritative specialist. He gives convincing explanations of the reasons for the sudden stop of breathing in a child against the background of neurological damage. And the article discusses the etiology, pathogenesis and clinical symptoms of hysterical seizures, methods of their prevention. It tells what parents should do if they see that their child is developing an affective-respiratory attack or convulsions. Before apnea occurs, it is important to try to calm the baby.

What it is? ARP development mechanism

Understanding what breath-holding spells or an affective-respiratory attack is in a child helps to cope with this common problem. The situation is as follows. In common parlance, this condition is called “rolling up.” Roughly speaking, the baby, against the background of strong nervous overexcitation, loses control over his autonomic nervous system. A full-blown hysterical attack develops with all the accompanying symptoms. Affective-respiratory attacks are especially dangerous in infants or newborns, since in the first weeks and months of life there is no clear control over the work of all structures of the central and autonomic nervous system.

Hysteria begins with exposure to a trigger. Negative emotions such as fear, indignation, frustration, irritation, nervousness, pain, etc. can act as an irritant. At the moment when the baby experiences strong negative emotions, he experiences the effect of a primary convulsive reaction. Moreover, it mainly affects the intercostal muscles and the diaphragm. There is a feeling that he cannot breathe air. This causes severe fear, which, against the background of hypercapnia, forms the preconditions for respiratory arrest.

The development of an attack of affective breath-holding can be preceded by aggression or hysteria: the child begins to stomp his feet, scream, demand something, try to hit a parent or others, etc. This is the so-called primary hysterical reaction, which subsequently triggers the mechanism of blocking the respiratory muscles. It is worth understanding that children really cannot inhale and exhale air for completely physiological reasons. And they need help.

Paroxysms can occur in different situations. This distinguishes affective-respiratory syndrome in children from true epilepsy, which always has similar clinical manifestations.

What else is important for parents to know?

The most important thing that modern guardians of a child prone to affective-respiratory breath-holding and convulsive syndrome should know are options and ways to prevent such paroxysms.

Let's start by understanding the definition of APR as a manifestation of insufficient development of the child's autonomic nervous system. By its pathological nature, an affective-respiratory attack in children is a cessation of respiratory movements of the chest due to the lack of innervation (paralysis) of the intercostal muscles and diaphragm. Overexcitation of the nervous system can also turn off the child’s consciousness. This is necessary to quickly restore the reserve of the central nervous system. The lack of oxygen supply to the brain structures makes the baby temporarily forget about the emotional background that led him to such a state. Thus, affective-respiratory syndrome can be considered as a protective reaction of brain structures.

After an attack, the child experiences severe drowsiness and relaxation of the muscular frame of the body. It's best to let him sleep. After awakening, there will be no trace left of the hysterical paroxysm.

According to clinical manifestations, affective-respiratory attacks are divided into white and blue. In the first case, there is a short-term loss of consciousness and severe pallor of the skin. With blue ARP, there is cessation of breathing lasting up to 1 minute, loss of muscle tone and blue discoloration of the nasolabial triangle.

Causes of affective-respiratory attack in children

Many pediatricians still recognize only one cause of affective-respiratory attack in children, and this is typical hysteria. However, in reality everything is much more complicated. There are multiple or complex causes of an affective-respiratory attack, and among them there is indeed an excessive or hysterical reaction of the autonomic and central nervous system to the influence of a negative traumatic factor. But this is far from the only factor that provokes ARP.

So, pathogenetic influence factors include:

weakness of the autonomic nervous system, such children will suffer from vegetative-vascular dystonia in the future;
consequences of severe birth trauma (cerebral hypoxia, low assessment of the condition of the non-born on the Apgar scale);
violation of the daily routine and regular lack of sleep (often found in children attending kindergarten and parents going to bed late);
insufficient amounts of B vitamins and some important amino acids in the diet;
the presence of serious chronic somatic pathologies;
increased convulsive readiness;
increased muscle tone;
disruption of the development of cerebral blood vessels of the neck;
thyroid diseases;
adenoiditis, tonsillitis and other chronic pathologies of the upper respiratory tract that complicate the process of physiological breathing.

To prevent attacks with breath holding, it is important to exclude, if possible, all possible causes of this pathological condition. It is important for parents to remember that affective respiratory syndrome can cause sudden death. And in the future, this condition can lead to serious neurological disorders, including epilepsy.

Classification of attacks depending on clinical manifestations

The modern classification of attacks of affective-respiratory arrest with convulsive syndrome implies subdividing them into 4 distinct types.

Depending on the clinical manifestations of pathological spasm of the respiratory muscles, the following types of attacks are distinguished:

blue ARP begins with hysteria, followed by a sharp deep breath and then asphyxia (lack of breathing) sets in, hyperemia of the skin quickly gives way to cyanosis, the child loses muscle tone and becomes limp, and may lose consciousness;
white ARP is more complicated, with obligatory loss of consciousness and the rapid onset of characteristic pallor of the skin of the face, neck and chest;
a simple type of ARP occurs without hypercapnia and hypoxia, the breath holding is short-term and does not exceed 20 seconds;
a complicated type of ARP occurs with severe hypoxia of the brain (if there is no breathing for more than 60 seconds), accompanied by involuntary urination and convulsions in the lower and upper extremities.

In all 4 types, respiratory activity is completely restored on its own. Emergency medical care may be required only in the case of a complicated version of the development of ARP. But frequent attacks always lead to disruption of social adaptation. They can provoke a delay in the mental and mental development of the child. Therefore, it is important to carry out psychocorrection in a timely manner and do everything necessary to prevent affective-respiratory attacks in children.

Symptoms and clinical picture

It is important to understand that the clinical picture of ARP may resemble an epileptic attack. Therefore, it is important to conduct a full examination to exclude epilepsy. Symptoms may include the following:

the increase in hysterical reaction to external negative influence occurs within 2-4 minutes;
with a gradual deepening of hysteria, the child experiences overexcitation of the cerebral cortex;
control over the muscles is lost - at this moment you can see stopping breathing and loss of tone of the whole body;
the baby seems to go limp, stops breathing and slowly slides to the floor;
the skin of the face, neck and chest begins to change color - at first they turn sharply red, then, depending on the type of attack, they turn white or blue;
a short-term loss of consciousness may occur;
After a few seconds, the child comes to his senses, abruptly stops crying and begins to breathe fully.

In the complicated type, the clinical picture is supplemented by clonic convulsions. From the outside they look like slight twitching of the arms and legs of an unconscious baby. The picture is very difficult for the parents of the injured child to perceive. Usually in such situations, parents begin to panic. And this only makes things worse. Why? Let's tell you further.

Diagnosis and differences from epilepsy

It is important to understand that affective-respiratory convulsions are only superficially similar to the manifestation of epilepsy. However, to exclude such a condition, it is not enough to know the main differences. Diagnosis necessarily includes an EEG (electroencephalogram of the brain). This examination shows the absence of a focus of excitation in the cortex and brain structures in ARP and its presence in epilepsy. Therefore, this examination is definitely worthwhile. At least to calm myself down. And treat the baby more correctly.

It is also important to exclude hysteria. It is based on an attack of aggression, but it does not provoke respiratory arrest and loss of consciousness. If a child has a hysterical attack, you should maintain your own calm and not show your child that this behavior greatly upsets you. Under no circumstances should a child be allowed to achieve his goals with such hysterical attacks. Otherwise, such a style of behavior will be fixed at a reflex level. You will receive regular affective-respiratory attacks at the slightest reason for the child’s negative perception of reality.

The distinctive features of epileptic seizures and affective-respiratory attacks are as follows:

Various circumstances lead to ARP, and epilepsy manifests itself without external causes;
ARP always develops differently, but epileptic seizures are always the same;
In children under 4 years of age, epileptic seizures account for no more than 2% of the total number of such disorders;
in children over 5 years of age, attacks of affective-respiratory disorder are diagnosed only in 1% of the total number of cases;
with ARP, valerian, motherwort and nootropic treatment help;
in case of a true epileptic seizure, it is useless to give sedatives;
There are significant pathological changes in the EEG only in epilepsy.

If the baby has an attack, then it is necessary to show him to the doctor within the next 1.5 hours. These manifestations can be the result of very dangerous diseases. Only in a medical institution can an ECG of the heart and an ultrasound of internal organs be done to exclude heart defects, pulmonary vein embolism and other dangerous conditions; spirography, an X-ray of the lungs, and examination of the trachea for the presence of foreign bodies may also be required.

You may also need to consult a pulmonologist, neurologist and allergist. After collecting all the necessary information, the doctor will be able to make an accurate diagnosis and prescribe adequate treatment.

Providing first aid to a child with ARP

You need to know what to do when such symptoms appear, and what you should avoid categorically. Providing first aid to a child when symptoms of ARP appear should begin with clearing the airways. You can take the baby out into the fresh air. You need to unfasten the top buttons and remove the pressure on your neck.

It is important not to get confused or panic. Try to maintain your composure and smile. This will help the baby recover faster. Try patting him on the cheeks or lightly tickling him. If you have ammonia on hand, give it a sniff. Just don't bring it too close to the baby's face.

In case of loss of consciousness, it is important to create conditions to prevent tongue retraction. To do this, place the child on a flat surface and turn his head to the side. And here you should call an ambulance.

Treatment of affective-respiratory attacks in children

Therapy begins with behavior correction and psychological work with parents. Such conditions most often occur in children raised in families where parents do not follow the rules of communication with them.

Treatment of affective-respiratory attacks begins with a consultation with a neurologist. A specialist can give a referral to a psychologist to correct the mental state of both the baby and his parents. Drug therapy may then be prescribed. But, as a rule, it does not give any special results. It is much more important to take the following steps:

normalize the child’s daily routine:
develop a special diet containing all vitamins, minerals and amino acids;
exclude, if possible, traumatic factors;
teach your child to listen to his parents and compromise with them.

Effective treatment for respiratory attacks in children may include visiting a chiropractor. Acupuncture and reflexology, massage and therapeutic exercises will help restore the functioning of the autonomic central nervous system.

If the nervous system is hyperexcitable, it makes sense to carry out a course of treatment with nootropic drugs and sedatives. But this can only be done on the recommendation of a doctor and strict adherence to the recommended dosage.

See why affective-respiratory attacks develop in children - the video presents the opinion of a specialist in child neurology:

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What's happened affective-respiratory attacks? Let's look at this below in this article; it will be especially useful to read for parents who have small children...

Do you need to ask any mother what is most important and valuable in life, and she will immediately answer that it is the health of the child. After all, sometimes parents can encounter childhood diseases that they have never heard of before! And at such moments the mother feels especially helpless, when in such a peculiar state of panic it seems to her that she cannot help her baby.

Our children are the flowers of life. And undoubtedly, every parent is ready to give their child the maximum of what they themselves have, so that this very life is not overshadowed by illnesses and other negative emotions. But sometimes it happens that children still get sick. And this is especially scary when the disease reaches a newborn or infant, who cannot tell for himself what hurts him. And you don’t want anyone to experience this feeling of powerlessness that overtakes a parent at this moment!

But forewarned is forearmed! Affective respiratory attacks (ARA) are sudden stops in breathing that occur at the height of inspiration when the child hits, gets scared or cries. At the same time, the baby may turn pale or even turn blue, which, of course, greatly frightens his parents, who do not know what is happening to him and how they can help him.

Affective-respiratory attacks, rolling up in tears, attacks of breath holding, attacks of apnea are episodic occurrences of apnea in children provoked by strong emotions. Sometimes accompanied by loss of consciousness and convulsions. In response to pain, most often when falling, anger, fear, fright, the child begins to cry, followed by cessation of breathing upon inhalation. Such strong negative emotions are called “affect”.

Next comes apnea, when the child cannot exhale and does not breathe; at the same time, the muscles of his larynx are in spasm. Sometimes, in response to the emotion, the child does not even have time to cry, and a spasm of the larynx occurs immediately. The color of the skin often becomes bright red or cyanotic (blue). Apnea can be short from a few seconds to 5-7 minutes, but on average lasts 30-60 seconds. Although it seems to parents or others around that the child is not breathing for 10-20 minutes.

If the period of apnea is prolonged, then loss of consciousness may follow; “going limp” is an atonic non-epileptic attack. The attack is superficially similar to an atonic attack in epilepsy, but ARP occurs due to acute oxygen deficiency in the brain. In response, inhibition occurs as a protective reaction of the brain. It is known that during the period of loss of consciousness the brain consumes less oxygen than when conscious. Further, this anoxic attack turns into a tonic non-epileptic attack.

The child experiences tension in the whole body, stretching or arching. If the process of hypoxia is not interrupted, then the phase of clonic convulsions (twitching of the limbs and the entire body of the child) follows. In response to the resulting breath holding, carbon dioxide accumulates in the body. This biochemical state is called hypercapnia.

Causes a reflex release of spasm of the laryngeal muscles, and the child takes a breath, and then begins to breathe. The patient then regains consciousness. After such a prolonged attack with tonic or clonic convulsions, deep sleep often occurs for 1-2 hours. Most often, rolling up in crying is interrupted after apnea or after the subsequent short “limp” for 5-10 seconds. Next, the spasm of the larynx is reflexively relieved, followed by a sharp inhalation or exhalation, often with crying. Afterwards, breathing returns on its own.

Seizures with tonic or clonic convulsions rarely occur. Doctors assure that such attacks are an age-related condition and do not pose any danger to the general health of the baby. You only need to dial the emergency number if the child’s breathing has stopped for more than 1 minute. It is worth making an appointment with a neurologist if attacks occur more than once every 5–7 days. And also if, at the beginning, development or end of ARP, unusual symptoms appear that are not typical for this attack.

During an affective-respiratory attack, parents can help the child overcome suffocation. That is: lightly pat the baby on the cheeks, blow on the face, sprinkle with cool water, and walk over the body with “tickling” hand movements. After the baby begins to breathe and comes to his senses, you need to hug him and say some soothing words in a quiet voice. You should never show your child your fear!

Sometimes an affective-respiratory attack is accompanied by convulsions. Why is this happening?

If the baby's breathing is interrupted for more than 60 seconds during an attack, he loses consciousness. In medical practice, this condition is known as atonic non-epileptic seizure. It occurs as a result of oxygen starvation of the brain due to respiratory arrest and performs a protective function. When a person faints, the brain consumes much less oxygen than usual. The atonic state is further transformed into a tonic state. All the muscles of the body are very tense: the child is stretched or arched. If the brain experiences sufficiently severe hypoxia, seizures begin.

Outwardly, this is manifested by twitching of the limbs and the whole body as a whole. At the same time, due to the lack of breathing, carbon dioxide accumulates in the body, due to which the spasmodic laryngeal muscles reflexively relax - the child is able to take a breath and wake up. After convulsive ARP, the baby falls asleep soundly and sleeps for at least 1.5–2 hours.

And although doctors claim that such attacks do not pose a danger to human life, this does not make it any easier for parents who have seen their child’s body cramping. To make sure that everything is fine with the baby, you need to consult a competent specialist - a neurologist. The fact is that sometimes such convulsive attacks are based on diseases of the nervous system. In isolated cases, children who have experienced such attacks may develop attacks of epileptic etiology in the future.

in newborns may result from:

birth trauma;
violations of the anatomy of the nose (displacement of the nasal septum, congenital changes);
obesity;
tonsil hypertrophy;
swelling of the nasopharynx (with inflammation or allergies).

This disease occurs in children at any age, but most often it manifests itself from two to eight months. If your child is constantly tired or, on the contrary, behaves restlessly, breathes intermittently and frequently, sleeps lightly, snores, or his chest suddenly stops heaving when breathing, consult a doctor immediately! This may be a manifestation of a case of sleep apnea. And if apnea is a symptom of a disease, and a rather rare one, then affective-respiratory attacks are not uncommon and are often diagnosed in 25% of children when very strong emotions are displayed.

During an affective-respiratory attack, a baby bursting into intense crying may suddenly turn blue and stop breathing. Such an attack does not last long, however, this is the main symptom of an affective-respiratory attack.

Affective-respiratory attacks occur reflexively, but if they become more frequent, it is necessary to consult a neurologist and psychologist, because ARP in newborns manifests itself in connection with strong negative emotions that cause spasm of the laryngeal muscles. And only doctors will help you find the causes and cope with the consequences of these emotions.

Children may also be predisposed to developing ARP due to calcium deficiency, which can cause spasms in the larynx, or if the child suffers from increased nervous excitability. Doctors have proven a direct connection between such attacks and heredity. So, if your moms and dads ever told you that you were suffocating in your sleep or you were diagnosed with ARP, remember that your child is at risk and therefore be more attentive to any manifestations of delay, especially night breathing.

Affective respiratory attacks (ARA) or breath holding syndrome can occur from once a year to several times a day. Most often, attacks are noted that occur monthly or weekly in the second year of a child’s life. This syndrome occurs during intense, tearful crying. At some point, the child simply stops breathing, frozen with an open mouth and blue lips. Then he simply slides to the floor, limp. Usually such an attack does not take more than 30-60 seconds, but when a parent observes this in their child, these seconds turn into an eternity!

How should parents behave during ARP?

In the course of ongoing scientific research, scientists have found that the parents of 25–27% of children suffering from ARP have had similar attacks in the past. But this does not at all indicate that attacks are inherited. Most likely, it is more appropriate in this case to talk about the traditions of upbringing in a family where two generations - parents and children - at one time suffered from the same problem. As a rule, doctors agree that the main factor causing the beginnings of childhood hysteria in the form of ARP can be considered conflicts between parents, stressful situations for the child in the family, and excessive parental care.

An affective-respiratory attack is mainly a neurotic disorder, so parents should pay priority attention to unobtrusive correction of the child’s psychological worldview.

When you somehow witness ARP in your child, it is advisable to immediately think about how you build a relationship with your child. Perhaps you are overprotective of him, sometimes trying to protect him from minor life adversities, or are you pampering him too much when parents do not deny their child anything? Here you may need to contact a psychologist if there is no mutual understanding between the spouses in your family.

The correct daily routine, which is based on a balanced, correct physical and mental load, is of great importance for the development of a strong child’s psyche. It will not be amiss if you closely monitor your baby during the day - this way you can predict and prevent the development of ARP. For example, a hungry and tired child will be more capricious than one who was fed and put to bed on time. This also applies to everything else: getting ready for kindergarten, going to visit or to the store - everything should cause the baby the least discomfort.

You definitely need to talk to the little man about his feelings. Indeed, in some cases, hysterics appear and continue to occur with enviable regularity only because the child cannot cope with his feelings and stop in time. But you just help the capricious person understand that all his emotions - anger, frustration, resentment - are completely natural, and they can be dealt with one way or another. Be sure to teach your child the art of compromise, because this can later help him out more than once in the future.

In case of particularly severe attacks of breath holding, the doctor may prescribe a course of treatment for the baby using neuroprotectors and sedatives (Pantogam, Glycine, Pantocalcin) lasting 1.5–2 months.

If the mother can prevent the child from approaching that dangerous edge beyond which whims and hysterics begin, it is quite possible to do without drug treatment.

ARP treatment.

When treating affective-respiratory attacks, it is necessary to take into account that they represent the first manifestation of childhood hysteria and usually occur on a neuropathic basis. Therefore, such treatment should be carried out in two directions.

Firstly, family psychotherapy is needed, which will be aimed at correcting upbringing, eliminating pandering overprotection, and the subsequent normalization of family relationships. It is also advisable to place the child in preschool institutions, where, as a rule, these attacks do not recur. If the manifestation of affective-respiratory attacks became a reaction to placement in a nursery or kindergarten, on the contrary, it is advisable to temporarily take the child from the children's group and re-assign him there only after appropriate preparation.

Secondly, it is necessary to directly treat neuropathy using a number of drugs that strengthen the nervous system and sedatives. Here, the most beneficial is the use of calcium (calcium gluconate, calcium lactate, 0.25-0.5 g per dose), valerian in the form of tincture, as many drops per dose as the child is old, or valerian infusion 3-5 g, multivitamins. In more severe cases, lipocerebrin, phosphrene, glutamic acid, and aminalon are used 2-3 times a day. When frequent (daily, several times a day) seizures are observed (which may indicate increased excitability of the brain), it is necessary to use small doses of antiepileptic drugs (phenobarbital, hexamidine at night).

The use of such drugs is also recommended if paroxysmal activity is detected on EEG studies. It has been characteristically noted that some children with affective-respiratory attacks subsequently experience epileptic paroxysms. During such an attack of affective-respiratory convulsions, assistance to the child is usually not required. And if only a prolonged paroxysm is observed, then action should be taken (spraying with water, patting the cheeks). To promote reflex restoration of breathing.

The older the child becomes, the more important psychotherapy is in the treatment of various paroxysms of neurotic origin. Other types of family psychotherapy are also included - group and collective, as well as individual, aimed at correcting asteroidal personality traits.

If a sick child has somatic asthenia, then it is necessary to carry out restorative therapy, followed by sanitation of foci of chronic infection. Sedative therapy is recommended, and in addition to calcium preparations, valerian, bromides, it is often necessary to use tranquilizers - trioxazine, elenium, seduxen (in age-appropriate dosages). Water procedures, such as pine baths and rubdowns, are also useful. In cases of the most hysterical attack, no help is required for the sick child.

At the beginning of an attack, you can sometimes stop it if you try to switch the patient to a variety of activities, this could be reading books, playing games, or walking. If this cannot be done, then it is better not to focus the attention of others on the seizure, you can also leave the child alone, and very often and it is likely that then the attack will pass faster.

There is no need to be afraid, but there is no need to experiment aimlessly. But still, it’s up to you, future or current parents, to try everything stated above one way or another!

Many parents have encountered incomprehensible behavior of their little child. When a child falls or cries heavily, he suddenly begins to turn blue, breathing stops, and he loses consciousness for a few seconds. Affective-respiratory attacks in children are not a rare phenomenon; they often occur in children under 5-6 years of age; they occur unexpectedly and are very frightening for parents who do not know what to do in these cases. Let's try to find out why this is all happening and how to deal with it.

ARP - what is it?

Doctors are unanimous in their opinion that affective-respiratory attacks (ARA) are the primary manifestations of hysterics and fainting.

The very name of this phenomenon explains what exactly is happening in the body of the little man at this time. The word “affect” refers to an uncontrollable emotion of great strength that occurs under the influence of certain factors. The word “respiratory” indicates the localization of the causes - the respiratory organs. So, putting these concepts together, we can determine that ARP is a respiratory problem associated with the emotional behavior of the child..

Studies have shown that very spoiled children are susceptible to this syndrome. The more relatives indulge their whims, the more often attacks occur.

As a rule, the first cases of ARP begin at six months of age, when the child already understands everything quite well. This usually continues until school age.

There is one important point that parents should know. From the outside it may look like pretense, but the child’s attack occurs involuntarily, against his will.

When crying, the baby exhales all the air from the lungs, forgetting to breathe it back in. At an early age, breathing reflexes have not yet been developed, so this happens. Later, when the child begins to understand that seizures can achieve what he wants, he begins to simulate and cause them on purpose.

Clinical picture

Affective-respiratory syndrome occurs at the time of strong crying or when sharp pain occurs during a fall or impact, for example, with the head on a table. When hit, the child may pass out without having time to make a sound. He turns pale, rolls his eyes and does not breathe.

When crying, things happen a little differently. When a child does not agree with the current situation and begins to cry a lot, his emotional state is at the extreme boiling point. To get what he wants, the child raises a loud, continuous cry. To do this, he needs to release the air from his lungs, which suddenly ends and the scream stops. The baby turns blue and passes out.

The whole process takes a matter of seconds, but at this moment it seems to parents that their child has not been breathing for an eternity, and they themselves are on the verge of hysterics.

Types of ARP and their symptoms

Depending on the complexion during the attack, this condition is divided into two types - “pale” and “blue”.

Pale attack

This is the nervous system's reaction to sudden pain. In this case, all the signs of fainting are present:

pale skin;
breathing is depressed or absent;
the pulse is weak, threadlike or not palpable at all;
consciousness is absent;
Involuntary urination may occur.

With age, a child with such a reaction often faints.

Blue attack

This is the peak of anger, rage and disagreement with what is happening. The following picture occurs:

After the screaming crying, suddenly there is a lull.
The child's face turns blue from lack of air.
The child freezes with his mouth open.
Breathing may be delayed for up to a minute.

Usually children come out of such states on their own. But with a protracted form, muscle tension is possible with arching of the body. Or, conversely, the body becomes limp and relaxes. Such manifestations also pass on their own without consequences for the child’s body. Parents who have experienced these moments and suffered fear for their child suffer more.

Consequences of seizures for a child

Affective respiratory attacks do not threaten the life and health of the child. If they are constantly the same and do not repeat very often, parents do not need to worry. You need to be patient and wait. With age, the child will outgrow this and everything will return to normal.

You can fight mild attacks on your own. To do this, just pat the child on the cheeks, tickle his armpits, blow on him and splash water on his face. There is no need to panic and show your fear to your baby.

But if the breath is held for more than a minute, you need to call an ambulance; medication may be required.

If attacks become more frequent or their symptoms change, you need to make an appointment with a doctor. It is quite possible that affective-respiratory paroxysms are a manifestation of some serious pathologies of the nervous system. Therefore, consultation and examination by a neurologist is never superfluous.

Causes of seizures during an attack

If you hold your breath for a long time (more than a minute), the child loses consciousness and goes limp. Doctors call this type of attack non-epileptic atonic. The condition is caused by oxygen deficiency. This is how the brain protects itself from hypoxia, because in a switched off state it needs less oxygen than in a working state.

When the attack becomes tonic, the baby’s body becomes rigid and stiff. He stretches and arches. If breathing has not resumed at this time, convulsions appear in the form of tremors of the arms and legs.

ARP usually goes away with age. But there are cases when they turn into epilepsy.

When respiratory activity stops, carbon dioxide accumulates in the body, after which a reflex occurs that relieves spasm in the larynx. The baby takes a breath and comes to his senses. An affective-respiratory attack of this kind usually leads to deep sleep for several hours.

Differences between ARP and epilepsy

Affective-respiratory seizures differ from epileptic seizures. Parents whose child suffers from these paroxysms need to know the differences so as not to miss the moment when complications begin. Here's how to describe them:

An epilepsy attack can occur suddenly, without any reason. ARP occurs when there is pain or nervous crying.
Epileptic seizures always have the same picture; they cannot be weaker or more severe. With ARP, seizures differ in time and severity.
ARP is a childhood condition that ends after 6 years. Epilepsy has no age restrictions.
With ARP from medications, sedatives and nootropics have a good effect. Epilepsy cannot be stopped with these medications.

If the baby begins to have convulsions while holding his breath, he must be shown to a doctor. Neglect can lead to epilepsy.

ARP and cardiac pathology

According to statistics, in 25% of cases of affective-respiratory paroxysms in children, their parents also suffered from this symptom in childhood. Therefore, we can assume that heredity plays an important role in the causes of this phenomenon.

But doctors attribute most cases to the internal situation in the family. If parents constantly argue in front of their child, he gets stressed, and this has a bad effect on him. The same thing happens when a baby is spoiled too much. He believes that everything is allowed to him and the slightest restriction makes him hysterical.

There is also an opinion that ARP is associated with cardiac pathology. 5% of children who suffer from seizures have heart or vascular disease. But their seizure has a slightly different picture:

The attack is less emotional.
The baby's face turns blue more pronounced.
During and after an attack, the child sweats profusely.
When the baby comes to his senses, the blueness on his face remains for some time.

Such children feel bad even without an attack, they are lethargic and get tired quickly. If there are such symptoms, he needs to be shown to a cardiologist.

Approaches to parenting if your baby has ARP

Affective-respiratory syndrome in children occurs due to nervousness. Therefore, in order for the baby to feel better, you need to pay attention to his psychological state. We must approach raising a child with full responsibility:

You shouldn't pamper him too much; he should know that there are things in the house that shouldn't be touched.
But you also can’t be too strict with your baby. We must remember that he is still small, and his psyche is just developing. Constant bans have a bad effect on him.
It is best if the baby has his own corner or room where he can do everything, but only within its boundaries.
The relationship between parents is also important. You can’t sort things out in front of children. The loud screams of adult babies frighten them, and they begin to cry. Fear can also lead to an attack with respiratory arrest.

A properly structured daily routine plays an important role. A well-rested and timely fed baby is less capricious and balanced than a tired and hungry one.

How to prevent ARP

Here are some tips that you can follow to, if not completely prevent an attack, then at least smooth it out:

You should always feel the mood of your child. Notice what irritates him most and try not to create such situations. For example, if he doesn’t like quick preparations, you can start them a little earlier and collect them more slowly.
The categorical word “impossible” can be replaced with a proposal for some interesting action, bypassing the prohibited item. For example, if a child wants to walk through a puddle, he must be gently convinced that it is better to walk along the path and bridge. And explain to him why this is better.
You need to constantly communicate with the child and explain why his behavior is bad, what he is doing wrong. It is necessary to explain that his condition is understood, but one cannot behave this way.
The child also needs to be told what consequences his bad actions will lead to. He must understand that if his parents do something he doesn’t like, namely punish him, then he will be to blame for this.
There is no need to set tasks for your child that he is not able to complete. This will lead to unnecessary irritation. If a child is already good at something, let him develop these skills. At the same time, it will not be amiss to praise him.

With the right approach, parents and their baby build a trusting relationship. The child obeys adults and is not capricious.

Treatment of ARP

Drug treatment for seizures is extremely rare. The decision for this is made by the doctor; under no circumstances should you drug the child yourself.

Sedatives, vitamins and neuroprotectors are used for treatment. For about 2 months, the child is given Phenibut, Pantogam, Glycine or other similar medications. For sedatives, it is better to use herbal teas and baths. In rare cases, tranquilizers are prescribed - Grandaxin, Atarax and others.

If your baby easily tolerates attacks and recovers from them on his own, there is no need to panic and resort to medications. Most likely, over time, everything will work out for the baby without this.

Traditional methods

You can fight children's tantrums using traditional medicine:

An infusion of valerian roots relieves excitability well. For this, 2 tsp. infuse in 100 ml of water. Give 1 tbsp 3 times a day. l.
Tea made from raspberry leaves, chamomile, mint, linden flowers, and hawthorn has a beneficial effect. You can brew the whole collection or separately.
A glass of warm milk before bed has a calming effect. The child quickly falls asleep and feels cheerful in the morning.

The games that the baby plays play an important role. Modeling with clay or plasticine and drawing are very relaxing.

In many ways, the parents themselves are to blame for the fact that their child throws tantrums. Often they spoil their child so much that they themselves suffer from it. Children very quickly understand that in this way they can achieve what they want, and after three years they are already in full swing manipulating adults. If this is left unattended and not stopped, it will affect the character in the future.

Children are the flowers of life. And every parent is ready to give their child the maximum of what they themselves have, so that this very life is not overshadowed by illnesses and other negative emotions. But it happens that children still get sick. This is especially scary when the disease reaches a newborn or infant, who cannot tell for himself what hurts him. And you don’t want anyone to experience this feeling of powerlessness that overtakes a parent at this moment! But forewarned is forearmed! And today we will figure out what affective-respiratory attacks in children are and what to do if this happens to your child.

What are ARPs?

Affective respiratory attacks (ARS) are episodic occurrences of apnea in children, which are accompanied by loss of consciousness and sometimes convulsions. According to ICD-10, this condition is classified in article R06 “Abnormal breathing”. However, understanding this definition, it is still worth explaining what apnea is.

Causes and help for apnea

Apnea is the actual cessation of breathing movements for more than twenty seconds. When it occurs, newborns experience pale skin, decreased muscle tone, lethargy and bradycardia. However, if such symptoms occur, then the child urgently needs resuscitation care!

There are also cases called “false apnea,” when a person stops breathing due to severe irritation of the skin, for example, when the body is suddenly immersed in cold water. In this case there is no threat to life. But there is a separate subtype of this disease called “sleep apnea” and it is especially dangerous for newborns. This phenomenon is characterized by a child stopping breathing during sleep for more than 10-20 seconds. Sometimes holding your breath can account for up to 60% of the total sleep time, and when you come out of this state, in the morning, a person feels sleepy and tired. His performance and intelligence decreases. Such manifestations of sleep apnea in children can cause irreversible consequences - slow development, and in severe cases, death.

Therefore, having recognized respiratory arrest syndrome in an infant, parents should immediately be wary and understand what is causing the difficulties.

Sleep apnea in newborns may result from:

birth trauma;
violations of the anatomy of the nose (displacement of the nasal septum, congenital changes, etc.);
obesity;
tonsil hypertrophy;
swelling of the nasopharynx (with inflammation or allergies).

If you notice your child holding his breath for more than 10 seconds, act urgently! First of all, call an ambulance and while it is on its way, get down to business.

First of all, make the child wake up. Then massage his hands, feet and earlobes, this will help restore normal blood flow and saturate the brain with oxygen faster. Next, tilt the child's head back and open his mouth, making sure that there are no foreign objects in the respiratory tract. If the baby is still not breathing, gently cup the baby's mouth and nose with your lips and exhale five or six smoothly. Be careful, because a baby's lungs are very small and if you exhale sharply, you can damage them. In parallel with exhalations, you need to massage the heart.

And most importantly, don't panic. In this situation, the health and life of your child depends on your actions.

Symptoms of affective-respiratory attacks

And if apnea is a symptom of a disease, and a rather rare one, then affective-respiratory attacks are not uncommon and are often diagnosed in 25% of children when very strong emotions are displayed. During an affective-respiratory attack, a baby bursting into intense crying may suddenly turn blue and stop breathing. Such an attack does not last long, however, this is the main symptom of an affective-respiratory attack.

Also, children may be predisposed to developing ARP due to calcium deficiency, which can cause spasms in the larynx, or if the child suffers from increased nervous excitability. Doctors have proven a direct connection between such attacks and heredity. So, if your moms and dads have ever told you that you suffocated in your sleep or were diagnosed with ARP, remember that your child is at risk and therefore be more attentive to any manifestations of delay, especially night breathing.

ARP or breath holding syndrome can occur from once a year to several times a day. Most often, attacks are noted that occur monthly or weekly in the second year of a child’s life. This syndrome occurs during intense, tearful crying. At some point, the child simply stops breathing, frozen with an open mouth and blue lips. Then he simply slides to the floor, limp. Usually such an attack does not take more than 30-60 seconds, but when a parent observes this in their child, these seconds turn into an eternity!

There are “pale” and “blue” attacks of sudden breath holding syndrome. During pale attacks, the child turns sharply white, his pulse slows down, and he loses consciousness. Such attacks can be triggered by a sudden reaction to pain (a fall or an injection).

With blue attacks, a bluish coloration of the skin appears. Such attacks occur most often from anger and negative emotions, when the child exhales too sharply and as a result, a spasm of the larynx occurs, which sharply cuts off the supply of oxygen. Most often, in such a situation, loss of consciousness occurs; the child may become limp or, on the contrary, arch over.

Despite the fact that breath holding syndrome disappears after 3 years, consultation with an experienced neurologist is necessary. Such a doctor should immediately determine whether the symptoms described above are symptoms of another disease, such as heart failure or epilepsy. A qualified psychologist will help clarify the reasons why the child experiences the greatest stress, which can also provoke ARP.

Treatment of breath holding syndrome in children

No special drug treatment is prescribed for ARP. The attacks go away on their own by the age of 3-4 years. But you can help your child survive an attack and avoid having one in the future.

So what should you do if your child has ARP?

Don't panic and hug your child. Your closeness will calm the baby.
Help your child regain his breathing. Massage your earlobes, pat your cheeks, wipe your face with a damp cloth.
Don't hesitate. An attack at the beginning is easier to stop.
Only you know your child best. Perhaps in order for him to calm down and come to his senses, you just need to leave him alone.
In order not to instill in your child unreasonable fears, try not to focus attention on what happened and distract the baby.

Remember, affective-respiratory attacks are not as dangerous as they seem at first glance. Unlike apnea. Here you need to be very careful and, with the help of a qualified neurologist, immediately determine the nature of breath holding, especially at night. And if the doctor diagnoses you with “apnea” or “sleep apnea,” then the child will be prescribed treatment.

In cases where a child has already had a case of sleep apnea, a thorough examination in a hospital is necessary. You can also install special breathing sensors that parents can install in their newborn’s crib. They alert parents if the baby's breathing stops.

Severe sleep apnea can be treated with a positive pressure breathing mask and medications.

If you are experiencing ARP or sleep apnea in your child, remember that the first thing you need to do is control yourself as a parent. Maintain a sound mind so as not to provoke the development of neuroses in yourself and not to irritate your baby with your worries. The child feels everything.

Remember, pauses of less than ten seconds are allowed in the breathing of a child under one year old and this is completely normal. Don’t stress yourself out over trifles and pay attention to preventing these attacks. Then you won't have to treat them.

Prevention of affective-respiratory attacks in children

Trying to protect their child and themselves from the repetition of ARP, many parents choose to model their behavior by indulging in any whim of their child, as long as he does not get nervous. This is fundamentally wrong and in this way you only make it worse for your child, since strangers are unlikely to be loyal to his whims. And a child accustomed to permissiveness will expect the same attitude from others and will not receive it. Such situations, on the contrary, provoke anger and nervous stress in the child and can cause breathing problems.

To avoid the occurrence or recurrence of such disorders, create a calm and friendly environment at home in which the child will not be provoked into hysterical reactions.

Try not to shout or swear, both at the child and in front of him. Remember, children are not born hysterical. This behavior is the result of parental upbringing. After all, it is we, trying to protect our child from the cruelty of the outside world, who in the first months of life indulge all his desires, without building any model of behavior or prohibitions. And when a child grows up and they begin to “teach him wisdom,” he does not understand why yesterday it was possible, but now it is impossible. This provokes attacks.

Overprotection gives our children nothing but an incorrect understanding of the outside world. Love your children and let them experience this life under your strict guidance, even if they need to hit a couple of bumps to do this. And in the future they will only say “thank you” to you.