If you want to know how important sleep is to a child, ask a parent who has had to deal with a sleep-deprived child! Let’s not sugar-coat it; kids can act like little monsters if they don’t get enough sleep. They can get cranky and melt down over the smallest of things. Perhaps, the question we should be asking ourselves is what’s preventing our children from getting a good night’s rest. For instance, have you noticed that your child snores during sleep? Does he sleep with his mouth open? Does he generally experience restless sleep, with a lot of tossing and turning? These symptoms might point to a sleep disorder; even though sometimes mild, it is more common than most of us realise.
What is obstructive sleep apnea in kids?Paediatric Obstructive sleep apnea (OSA) is a condition in which there are brief pauses in a child’s breathing during sleep due to the upper airway getting partially or entirely blocked. Such obstruction of breathing results in a reduced intake of air and oxygen, which is essential for the regeneration and development of a child’s body during sleep. Sleep apnea interrupts sleep, affects sleep quality, and makes kids miss restful, restorative sleep. Untreated obstructive sleep apnea can lead to children’s learning, behaviour, and growth problems. Studies show that obstructive sleep apnea affects 1 to 5 percent of children, and many of these kids are between the ages of 2 and 8.
Symptoms of sleep apnea in kidsWhat is truly worrying is that sleep disorders in kids often go unnoticed. Not many parents of young children know about it, let alone look out for it. And to make matters worse, we often mistake sleep apnea as an “adult” problem. Paediatric OSA manifests itself in several symptoms. You may have noticed that your child sleeps with his mouth open or heard him snore softly during sleep. And then there are the daytime symptoms. Children affected by Paediatric OSA may be sleepy during the day. They may not be able to focus as well as their peers and thus learn at a slower pace. Take the case of mummy Melody Yazdani and her son, Kian. In a Facebook post that went viral a few years back, she shares how her son’s behavioural issues and tantrums puzzled even his teachers and doctors. The boy almost got misdiagnosed with ADHD until Kian’s dentist noticed that he was a teeth grinder. “Lightning struck” when Melody found an article linking ADHD to sleep-disordered breathing and mouth breathing. She suspected that most of her son’s symptoms resulted from an undiagnosed sleep disorder. A sleep study soon revealed that Kian had sleep apnea. Mummy Melody realised that her son’s mouth breathing habit was a red flag she shouldn’t have ignored. “CHILDREN SHOULD NOT BREATHE THROUGH THEIR MOUTHS. Not while awake, not while asleep. Never,” she warns. Mouth breathing is one of the leading causes of sleep disorders in children. The natural position of the tongue is supposed to be at the roof of the mouth. When sleeping at night, a mouth-breathing tendency causes the tongue to not be in contact with the roof of the mouth, making it an obstruction to the airway.
Now, let’s re-examine the link between sleep apnea and ADHDFor children with sleep apnea, oxygen levels in the body drop when breathing stops during sleep. At night, this lowered oxygen saturation negatively impacts the quality of sleep and the brain’s ability to get enough rest. Because children with sleep apnea don’t get enough good-quality sleep, they often feel tired during the day. This deficiency leads to behaviour and development problems, as well as issues at school.
“When oxygen levels are low to the brain and other organs, the body becomes very anxious because of this air deficiency. Air deficiency usually can manifest as symptoms similar to ones displayed in kids with attention deficit hyperactivity disorder (ADHD),” explains Dr Yue Weng Cheu (Clinical Director of DP Dental)Studies have suggested that as many as 25% of children diagnosed with ADHD may have symptoms of obstructive sleep apnea and that much of their learning difficulty and behaviour problems can be the consequence of chronic fragmented sleep. To summarise, here are the signs you should look for when it comes to sleep apnea in kids:
- Coughing or choking while asleep
- Teeth Grinding
- Mouth breathing
- Restless sleep – lots of tossing and turning
- Excessive sleepiness during the day
- Difficulty concentrating in school
- Behavioural problems that often mimic attention deficit hyperactivity disorder (ADHD), such as hyperactivity, rebelliousness, irritability
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The dentist’s role in treating sleep apnea in kidsThe good news is that children’s sleep apnea is treatable. If your little one isn’t getting enough good quality sleep, a dentist trained in sleep medicine can help screen your child for sleep disorders and offer an effective solution. In fact, in its Policy Statement on the Role of Dentistry in the Treatment of Sleep-Related Breathing Disorders, the American Dental Association (ADA) encourages dentists to screen adults and children for sleep-related breathing disorders (SRBD):
Dentists are encouraged to screen patients for SRBD as part of a comprehensive medical and dental history to recognise symptoms such as daytime sleepiness, choking, snoring or witnessed apneas and evaluate risk factors such as obesity, retrognathia, or hypertension. In children, screening through history and clinical examination may identify signs and symptoms of low growth and development or other risk factors that may lead to airway issues. If the risk for SRBD is determined, intervention through medical/dental referral or evidenced-based treatment may be appropriate to help treat the SRBD or develop an optimal physiologic airway and breathing pattern.