Help – my child snores!Loud snoring, or a regular pattern of snoring over most nights can be caused by multiple conditions. Allergies, enlarged tonsils, obesity, low tongue posture, and respiratory infections can affect sinuses and air passages, causing loud snoring. Treating these conditions can increase the airway and reduce the symptoms of snoring. Unfortunately, loud snoring can also be a sign of a serious medical condition called sleep apnea. About 3%-5% of children have Obstructive Sleep Apnea Syndrome (OSAS). Sleep apnea is a serious medical condition characterized by gaps in a sleeper’s normal breathing rhythm and can affect persons of all ages. The gaps – during which a person doesn’t breathe at all – can last a few seconds or as much as a minute. This irregular breathing pattern and the resulting lack of oxygen triggers the brain to wake up. This pattern of premature waking produces low-quality sleep and can lead to other chronic health issues. Loss of one hour of sleep in a developing child is equivalent to the loss of two years of cognitive maturation and development. Since brain development continues through age 21, the long term of effects can be very serious.
What are the impacts on children with sleep apnea?Children who experience sleep apnea at night may be more tired during the day, experience headaches, and may have trouble focusing on tasks. They may exhibit behavior problems, breathe through their mouths during the day, and experience difficulty learning. In addition, they may experience growth delays and cardiovascular problems associated with sleep apnea. Many factors can combine to cause or aggravate sleep apnea in children. In addition to obesity, asthma and allergies, deformities in the face and jaw can contribute to breathing problems during sleep. A small jaw can have an oversized impact on your child’s breathing at night! A narrow upper jaw is highly correlated with a deviated nasal septum, which can cause more nasal resistance. The size of a child’s tonsils can also impact his or her ability to breathe while sleeping. Large tonsils can easily block a young child’s airway. When they swell, they can further reduce the air passage, and lead to snoring. More than 250,000 children in the US have tonsillectomies each year to treat sleep apnea.
Teeth GrindingOne phenomenon that’s associated with sleep apnea is called bruxism – teeth grinding. About 8%-10% of adults regularly grind their teeth when they sleep. Among adults, bruxism is also commonly associated with stress, smoking, alcohol use, high caffeine intake and fatigue. Children frequently grind their teeth at night. Fortunately, teeth grinding isn’t necessarily a habit your child will take with him into adulthood. Unfortunately, bruxism is more than a side effect of sleep apnea. It’s a natural response to an obstructed airway. Sleep studies have shown that the grinding motion pushes the sleeper’s jaw forward. This serves to re-open a closed airway. While grinding may permit better breathing, this comes at a significant cost: abnormal wear on the enamel and tooth surfaces, cracking, tooth breakage, receding gums and chipping of the teeth. In addition, bruxism can cause headaches, earaches and chronic jaw pain.
Here is a brief health history of a child suffering from upper airway resistance syndrome and more seriously, OSAS:
- Asthma or allergies
- Chronic or habitual mouth breathing
- Tonsils and/or adenoids removed or evaluated in the past
- Not breastfed or not being able to breastfeed as an infant
- Late bedwetting
- Poor school performance
- Inability to pay attention or organize task
- Behavioral problems
- ADHD diagnosis
- Daytime fatigue
- Restless sleeper
- Wakes in the middle of the night
- Difficulty falling asleep
- History of speech therapy