Airway Obstruction – Kids & TeensWilliamsville, NY
Sleep disordered breathing in children is an epidemic that’s not getting enough attention.Pediatric sleep-disordered breathing (SDB) is a general term for breathing difficulties during sleep.
Children with sleep disordered breathing (SDB) often exhibit different symptoms from adults. The indications that a child may suffer from SDB include mouth breathing, snoring, daytime sleepiness, crowded or crooked teeth, behavioral issues, chronic allergies, difficulties in school, and bedwetting. Studies have suggested that as many as 50% of children diagnosed with ADD/ADHD may actually suffer from obstructive sleep apnea, and that much of their learning difficulties and behavioral problems may be a consequence of chronic fragmented sleep.
Pediatric SDB can range from frequent loud snoring to obstructive sleep apnea (OSA), a condition where part, or all, of the airway is blocked repeatedly during sleep.When a child’s breathing is disrupted during sleep, the body thinks the child is choking. The heart rate increases, blood pressure rises, the brain is aroused, and sleep is disrupted. Oxygen levels in the blood can also drop. Recent studies indicate that mild sleep disordered breathing or snoring may cause many of the same problems as adult obstructive sleep apena. Children exhibiting even one of these symptoms should be evaluated for this life changing treatment by Dr. McCarthy.
Don’t Wait! Early Treatment is Critical
When children are young, their bodies are able to adjust and mold easily, particularly in their mouth and their bone structure. Crowded teeth may force the tongue forward against their teeth, narrowing their dental arch and constricting the airway.
Dr. McCarthy is proud to provide the help for kids as young as three years old. Palatal expansion for children is a non-invasive, non-surgical treatment protocol that uses a series of removable, flexible FDA approved mouthguards. The mouthpiece allows children to breathe, allows their jaw to align properly, prompts their airway to open, and helps provide room for crowded teeth at the same time. It can work extremely fast and it is very simple for younger patients to use regularly. This is a way to possibly avoid surgery and orthodontic treatment in the future.
What Are the Symptoms of Pediatric Sleep Disordered Breathing?
Potential symptoms and consequences of untreated pediatric SDB may include:
- Snoring—The most obvious sign of sleep disordered breathing is loud snoring that is heard while the child is sleeping. The snoring can be interrupted by complete blockage of breathing, with gasping and snorting noises associated with waking up from sleep. Loud snoring can also become a significant social problem if a child shares a room or at sleepovers and sleep away camp.
- Learning and Behavioral Problems—A child with sleep disordered breathing may become easily irritated, sleepy during the day, and may have difficulty concentrating in school. He or she may also display busy or hyperactive behavior. School and athletic performance can be hindered by an overtired child. Children with SDB may become irritable and disruptive, they may not pay attention, both at home and at school. SDB can also be a contributing factor to attention deficit disorders in some children. In fact, many children are misdiagnosed as having behavior and learning disabilities when in reality they are simply exhausted from not receiving quality sleep.
- Bedwetting—Sleep disordered breathing can cause increased urine production at night, which may lead to bedwetting (also called enuresis). This can obviously lead to social behavior difficulties.
- Slow growth—Children with SDB may not produce enough growth hormone, resulting in abnormally slow growth and development. Poor posture may develop as a result of difficulty breathing and tongue tie causing strain to the cervical spine, head and shoulders
- Cardiovascular difficulties- Obstructive sleep apnea can be linked with an increased risk of high blood pressure, or other heart and lung problems, even at an early age.
- Obesity—Sleep Disordered Breathing may cause the body to have increased resistance to insulin, and daytime fatigue can lead to decreased physical activity. These factors can contribute to obesity. Obesity is an epidemic in our society. A tired child will not be able to maintain an active lifestyle which will lead to increased health problems associated with obesity in the future. Fatty deposits in the neck and throat may further compromise an already narrow airway.
- Allergies/ asthma/ breathing disorders- if a child is unable to breathe through the nose, the body automatically begins to breathe through the mouth. Because of this, the environmental pathogens such as dust, dander, pollens, and smoke among with other triggers can not effectively be stopped through the natural filtration of the nose. These allergens are brought directly into the lungs and respiratory system which will trigger an inflammatory response.
- Enlarged tonsils/ adenoids and ear infections-A common physical cause of airway narrowing contributing to SDB is enlarged tonsils and adenoids. Most of our children are bottle fed without the benefit of long term breast feeding. When a child is bottle fed, the skeletal structure of the face and mouth do not develop the way nature intended. The mouth, nose, sinus and eustachian tubes do not develop in size. Mid face deficiencies lead to a smaller airway. If a child is not able to properly breathe through the nose, then mouth breathing ensues. The tonsils and adenoids become inflamed, only enhancing the problem of an already compromised small airway. Children who suffer from frequent tonsil and ear infections most likely have an under developed mid face and airway.
- Dark circles under the Eyes and Crowded Teeth- Children who can not breathe properly through their noses may automatically breathe through their mouth. You may notice that your child has darker circles under their eyes. This is a medical sign called venous pooling. This is a sign that the blood and lymphatics are not draining properly, leading to congestion and inflammation in the mid face. If your child has crowded teeth, it is not because their teeth are too big, there is simply not enough room in the arch to fit those teeth. The solution is not to pull teeth to make room, the solution is to grow their arches. When done early and interceptively, growing the childs skeletal arches can allow room for all of the teeth to erupt naturally into place. Not only will this possibly eliminate the need for costly orthodontic work, it can save your child’s life by allowing them to breathe and develop to their full potential.
- Speech Problems- with tethered oral tissues such as a tongue tie and improperly shaped oral structures, children and adults may notice difficulty in speech and swallowing which will not resolve despite speech therapy unless the structural problems are addressed and corrected.
- Clenching and Grinding- as the body searches for oxygen during sleep disordered breathing, the jaws may gnash together in an effort to reposition the mouth into a different angle in an effort to open the compromised airway. This leads to worn, broken and chipped dentition. Along with the obvious dental problems, TMJ pain and discomfort will evolve as well.
- Chronic Headaches- Headaches and tension are a direct result of not receiving proper oxygenation and restorative sleep.
- Digestive Issues- Heartburn, digestive problems and acid reflux are common indicators of a person with difficulty sleeping and poor tongue posturing. These problems often resolve when the underlying pathology of sleep disordered breathing are addressed.
How Do We Diagnose Sleep Disordered Breathing in Children
If you notice any of the symptoms mentioned above, have your child checked by an airway centric dentist like Doctor McCarthy. Working together with specialists like an ENT, we may be able to grow the airway sufficiently with palate expansion and eliminate the need for tonsil removal and possibly the need for orthodontic treatment in the future. Sometimes physicians will make a diagnosis of SDB based on history and physical examination. In other cases, like children suspected of having severe OSA due to craniofacial syndromes, morbid obesity, neuromuscular disorders, or for children less than three-years-old, additional testing such as a sleep test may be recommended. Sleep tests occasionally produce inaccurate results, especially in children. Borderline or normal sleep test results may still result in a diagnosis of SDB based on parental observations and clinical evaluation.