By Dr. F. Jay Ohmes DDS, FAGD, LVIF, FIAPA
Is your child having trouble sleeping?
We all know that restful sleep is necessary to heal and repair the body. But recent health reports suggest that many children in the U.S. are chronically sleep deprived. For instance, in a National Sleep Foundation (NSF) poll, researchers found that more than two out of three children ages 10 and under have experienced some type of sleep problem.
There’s a price to pay for sleep problems in children. In a revealing study at Northwestern University Medical Center, scientists followed the sleep patterns of 520 kids between 2 and 5 years old. The study showed that less sleep at night means more behavioral problems during the day.
Other studies have linked poor sleep in children with bad grades in classes such as math, reading, and writing. In addition, some studies show that sleep disturbed children have more depressive symptoms and anxiety disorders.
As with adults, there are all sorts of reasons why children don’t sleep well. Some of those reasons are more serious than others. But if you’ve got a problem sleeper (or two) in your house, there are always ways to help everyone, including the parents, get a good night’s sleep and feel alert the next day.
Are There Different Types of Sleep Problems in Children?
Sleep problems are classified into two major categories. The first is dyssomnias.
In children, dyssomnias may include:
Sleep-onset difficulties (Insomnia)
Limit-setting sleep disorder
Inadequate sleep hygiene
Insufficient sleep syndrome
Snoring and obstructive sleep apnea (OSA)
The second class of sleep disorders is parasomnias. Examples of common parasomnias include:
Rhythmic movement disorders such as head banging or rocking
What Does It Mean if a Child Snores Loudly?
Slightly more than one out of every 10 children snore habitually. Snoring can be caused by different problems. For example, chronic nasal congestion, enlarged adenoids, or huge tonsils that block the airway can all cause snoring. Dental arch underdevelopment can also cause a narrowing of the nasal and obstruction of the upper airway due to the abnormal posturing of the tongue more posterior than normal.
With snoring, the muscles supporting the opening of the upper airway in the back of the child’s throat relax during sleep. Extra tissue in the palate and uvula—the fleshy piece the hangs from the roof of the mouth—vibrates with each breath. These vibrations actually cause the sound we call “snoring”. In some children, there is a tendency for the airway to close at any point along this area. Narrowing of the airway causes turbulence and the noises of snoring.
Although considered abnormal in children, snoring by itself can be harmless but it can also result in poor quality of sleep and changes in the child’s sleep-wake cycle. Because of restless sleep and frequent awakenings, there is diminished daytime alertness. That can lead to dramatic alterations in mood and energy. A few children who snore may have a more serious problem called obstructive sleep apnea or OSA.
What Is Obstructive Sleep Apnea?
Obstructive sleep apnea is a common problem in children today. According to the American Academy of Pediatrics, symptoms of sleep apnea in children include:
Nighttime snoring and occasional pauses.
Gasping or choking
Children with snoring and OSA often have large tonsils and/or adenoid. Many have underdeveloped dental arches causing inadequate room for the tongue and narrowing of the nasal airway including septal deviation. Many are obese and/or have an allergic disease. Sleep apnea is associated with the following consequences:
Abnormal growth and development
Behavioral and learning problems
Hyperactivity or ADHD
Treatment for children who either simply snore or who have OSA may include”
Managing allergic rhinitis
Removal of the adenoids and tonsils
Palatal expansion or dental archform development
Sometimes, nasal continuous positive airway pressure (CPAP) is used for children with obstructive sleep apnea. CPAP involves using a machine that delivers a stream of compressed air through a nasal mask to the child’s airway to keep it open during sleep.
How Much Sleep Do Children Need?
Sleep experts suggest that elementary-aged children should get 10-11 hours of sleep each night. Preschool-aged children should sleep about 11 to 13 hours a night.
How Can I Help my Child’s Sleep Problems?
If your child is sleep walking, wetting the bed, or experiencing other sleep disturbances such as night terrors, talk with his doctor. Sometimes, emotional stress is the culprit. In most cases of emotional stress, the problem can be easily resolved with a few behavioral interventions.
In addition, watch your child as he sleeps to determine a pattern in his sleeping and possible snoring or sleep apnea. If your child suffers from allergies or asthma, make sure he is taking medication properly.
What Is a Sleep Study?
An overnight sleep study, or polysomnography, may be recommended for your child, especially if he has excessive daytime sleepiness, problems with staying asleep, or OSA. The sleep study will help determine if your child has a diagnosable problem such as pure snoring, obstructive sleep apnea, restless leg syndrome, or another sleep problem. These disorders may require specific therapy that your child’s doctor will prescribe or your child might be sent to a specialist who may be able to help.
The Dentist’s Role
At Better Sleep StL, we have been trained in the screening and assessment of both pediatric and adult sleep apnea. Proper early dental development is extremely important in establishing an adequate upper airway and many children who suffer from chronic allergies, tongue ties or oral habits fail to develop sufficient airway volume and begin to suffer from the effects of OSA at an early age.
If your child snores or breaths loudly while sleeping, mouth breaths, has crowding of their front teeth, or exhibits any of the aforementioned consequences of sleep apnea, give our office a call today. We offer complimentary consultations, work with several sleep specialists in the St. Louis area and accept most major medical insurances.
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DR. F. JAY OHMES
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