San Diego Health Connection Newsletter

Dr Newsletter San Diego December 2015
San Diego Health Connection newsletter
Sleep breathing disorders in children, particularly pediatric obstructive sleep apnea (OSA), often goes undiagnosed. OSA can occur in children at all ages, including infants. However, children may instead be treated for ADHD, since hyperactivity can actually be a symptom of OSA. Untreated OSA can lead to more severe health problems, including diabetes, cardiovascular disease and hypertension.

In most cases, OSA is caused by a poorly positioned jaw or tongue that leads to a blocked airway. Sleep apnea, essentially, is the absence of breathing when asleep. The blocked airway causes slow suocation, and the sleeper is briey but abruptly woken up throughout the night in order to open the airway and breathe. Bruxism, or teeth grinding, is also a symptom of sleep apnea—it’s an unconscious movement to open the airway while sleeping. Children who suer from this interrupted and poor sleep suer from excessive sleepiness during the day, hyperactivity or irritability, migraines and even depression or cognitive impairments.

Luckily, pediatric OSA can be cured because in children, it’s possible to manipulate the development of their airways so they aren’t blocked or obstructed as they grow up. The American Academy of Pediatrics recommends all children get screened for snoring, and those who do snore should undergo further evaluation to test for OSA and other sleep disorders. Dentists are often able to provide a preliminary screening for OSA and can refer patients to a sleep specialist for further screening and treatment.

Signs to Watch
Look for the following common OSA symptoms in your child:
• Snoring
• Restlessness during sleep (are the sheets strewn all over the bed when the child wakes up?)
• Gasping or choking when waking up
• Diculty waking up
• Trouble concentrating, easily agitated
• Nightmares or night terrors
• Teeth grinding (bruxism)
• Frequent headaches
• Dark circles under eyes
• Excessive daytime sleepiness

Talk about these symptoms with your child’s pediatrician and ask to be referred to a sleep specialist. You can also use the “BEARS” sleep screening algorithm, which is a series of questions available on the TMJ & Sleep Therapy Centre website:

The BEARS screening tool provides information to help doctors assess whether a child likely has a sleep disorder.

Adult therapies for OSA, including CPAP machines or oral appliances, are not appropriate for children. Pediatric OSA is usually treated with dynamic orthopedic therapies, with the goal of increasing airway volume and encouraging or correcting skeletal development.

If it is diagnosed early, pediatric OSA can be completely cured in as little as three months; however, the time needed for
treatment varies with each child.

When a child is diagnosed with OSA, the entire airway should be evaluated to determine where it is obstructed.

Depending on the location and severity of the obstruction, treatment may include expanding the upper or lower jaw or correcting their alignment, tongue and lip exercises and lifestyle changes.

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