Do you notice your child snoring or stop breathing while they are asleep?
Do you notice them gasping for air or mouth breathing during the day or while sleeping? Do you hear your child grinding their teeth at night?
If you have answered yes to any of these questions, your child may be suffering from sleep-disordered breathing. Sleep disordered breathing includes increased resistance to airflow or decreased volume of airflow through the upper airway (possible difficulty with breathing through the nose), snoring, and complete stopping of breathing (apnea). A recent study in Finland found that approximately 10 percent of children had some type of sleep-disordered breathing.
Without proper rest, children can develop other medical conditions. Proper rest and sleep is crucial for our children’s development. Sleep is the time for the brain to relax and recharge. It allows for memory storage and toxin removal from the brain. We are still working on learning about the association between poor sleep and health issues but there are several links to health concerns that have been worked out so far.
A recent large-scale study of more than 10,000 children found that sleep disordered breathing in children leads to a higher likelihood of behavioral and emotional problems, including hyperactivity (ADD/ADHD), anxiety, depression, conduct problems, bullying and aggressive behavior. They found that in a room full of children who had either ADHD or sleep apnea, the medical professionals observing them could not distinguish between the two groups. Both sets of children exhibited the same behavior. This study even linked cognitive difficulties with sleep disordered breathing.
Why does this happen to our children? Poor sleep can be caused by many underlying health conditions. Proper growth of our face occurs during the first few years of life and is in a downward and forward position. Without proper growth and development of the head and face, other structures in the cranial cavity do not develop correctly as well. This improper growth can lead to needing to have tonsils and adenoids removed as well as ear tubes placed. We also see issues with allergies and mouth breathing in these children. Without proper development of the lower face, the jaws do not grow and develop properly in the correct direction. This lack of jaw growth can allow your child’s teeth to become crowded and the tongue to work improperly due to lack of space. The tongue is supposed to live up in the roof of the mouth, but if the upper jaw has not grown properly, the tongue becomes crowded. Crowding of the tongue causes it to move backwards and close off their airway and causing sleep disordered breathing.
If you notice grinding or snoring, these can be the first signs of sleep disordered breathing. Grinding occurs because a child’s brain is trying to move their jaw forward to get their tongue out of the way and open their airway to allow them to breathe. If you hear your child stop breathing or gasp for air, there can be a sleep apnea event. Any apnea events in children is considered abnormal and a cause for concern.
What can we do to help our children? First, screen your child at home. Do you notice anything that seems abnormal? Are they grinding, are they mouth-breathing, are they struggling for air, are they struggling with behavior? If there is anything that seems abnormal to you, speak with their doctor and with their dentist.
Sleep tests can be completed on children to allow us to evaluate their breathing and determine if there is a sleep issue for the child. Our office can provide sleep tests for children that are completed by wearing a small ring on their finger for three nights. These tests are then read by a sleep physician to determine if a diagnosis of sleep disordered breathing or sleep apnea is appropriate for your child.
Dentists can help with the development of the jaws to add more space to the oral cavity. This gives the tongue more room to move and the lower jaw to move forward and allow for a more open airway. The larger the airway, the easier it is for the child to breath and the decreased risk for sleep disordered breathing. Treatments can also help with the eruption of the child’s permanent teeth, potentially lessening the need for orthodontic treatment of the teeth in the future.
If you have concerns, please reach out to your medical doctors or our office and we would be happy to answer any questions you have regarding your children and their sleep.
(Dr. Wallander practices at Kiel and New Holstein Family Dental, a Preferred Business Sponsor of the Tri-County News.)