What Your Child’s Sleeping Habits May Be Telling You

It’s easy to misinterpret certain types of sleep behavior in children as simple signs of deep sleep or dreaming. A little snoring or minor limb movement on occasion are certainly nothing to worry about, but when your child begins to snore chronically, breathe irregularly, or thrash physically during sleep, it may be time to consider whether or not he or she might have some form of sleep disordered breathing.

Obstructive Sleep Apnea (OSA) is one of the most common forms of sleep disordered breathing in adults, but children can also suffer from it – especially when there are other contributing factors present like excessive weight, chronic allergies, or specific jaw and bite alignment issues. Unfortunately all of these conditions can be intricately interrelated, sometimes making it difficult for a parent and a medical provider to successfully treat the OSA completely without addressing multiple factors at once.

What makes OSA so serious for both children and adults is that in its most severe form, it can be fatal. Thankfully, those cases are still extremely rare. However, medical research is now demonstrating that OSA and other types of sleep disorders in children and adults can manifest daytime symptoms that mimic mild to moderate forms of ADD and ADHD. Mistreating these cases with ADHD medication (typically stimulants) is dangerous on two levels: Your child could potentially be taking medication he or she does not need; and he or she could still have an underlying sleep disorder that remains unaddressed and potentially even exacerbated by the medication. 1

This month, I’ve added a new resource to The Airway Series that expands and explains these important issues in discovering and treating breathing and airway development issues in children. It is my hope that eventually all children will be screened for the underlying conditions that can lead to OSA, and that preventive measures like functional orthodontic treatment, healthy eating, and plenty of exercise are pursued before the pathological conditions related to OSA ever have a chance to develop.

As always, I encourage you to share this material as much as possible with your friends and family, and to bring any questions you may have about your own children with you to your next regularly scheduled appointment.

Martha (Signature)

Is Snoring Normal?

We all know people who snore. Many of us may even snore ourselves. Most people consider snoring to be an unfortunate role of the genetic dice – disruptive to the sleep of those within earshot, but mostly benign to the snorer. Unfortunately, that is simply not true. Snoring in children and adults is almost always a symptom of a potentially bigger problem. It is a warning signal that something in the airway is not right.

Many years ago, I noticed that my own husband was snoring very heavily at night, and that it seemed to be affecting his ability to breath correctly during sleep. The pauses between the end of one breath or snore and the next were extremely long, and when he did resume breathing again it often began with a choke or a gasp. As it turns out, my husband wasn’t simply snoring, he was suffering from obstructive sleep apnea (OSA).

OSA is a potentially fatal condition where the throat closes completely during sleep and all oxygen intake is cut off for seconds or minutes at a time. Anyone can have OSA, including children. My personal experience with my husband began my journey into dental sleep medicine more than 15 years ago, and I am happy to report that his condition is now successfully being controlled with the combination of a CPAP machine and a dental sleep appliance.

Snoring doesn’t always mean that a person is suffering from OSA. It can be a temporary condition – allergies, sinus infections, severe colds and flus can all include snoring as a side-effect of congestion and inflammation. Snoring can also develop as the result of a chronic condition – obesity and chronic systemic inflammatory conditions can both lead to changes in the throat tissues that make it impossible for the body to hold the airway completely open during sleep. Sometimes the issue is purely developmental – the three-dimensional relationship between the soft palate, tongue, and bite may be unbalanced. None of these snoring examples are normal or healthy for the body, however, and none of them should be ignored.

Snoring on its own may not always be a permanent or serious condition, but in combination with other symptoms, the likelihood of OSA increases dramatically. Waking up coughing, snorting, or gasping for air are all potential symptoms of OSA. Frequent dreams of drowning or choking are also common in people with OSA. And almost everyone suffering from OSA experiences a chronic level tiredness during the day. Many individuals turn to chemical sleep aids to help, but alcohol, sleep medication, and other central nervous system depressants are extremely dangerous for people with OSA.

Our bodies are amazing communicators, and when we don’t listen to early warning signals, they tend to keep screaming louder until we do. Snoring is no exception. Not every snore is an indication of a permanent or severe disorder. But chronic snoring that increases in loudness and severity, is accompanied by regular daytime sleepiness and/or other chronic conditions may be an indication that OSA is present and should be taken very seriously. Left untreated, it will only get worse.

This month, in our new Airway Series, I’m explaining even more about snoring, how it relates to other health conditions, and why you should take it seriously in yourself and the people you love. I hope that you will share What’s Snoring Got To Do With It? with anyone you know who snores chronically and encourage them to have a sleep screening. You could help save their life.

Martha (Signature)

Breathing is Living

More than food or water, our ability to breathe is essential to our survival. An otherwise healthy individual under average conditions can survive for up to five days without food or water. It’s not healthy or recommended in any way, but if a person has no other choice, and a food or water source can be restored within that time period, most people can recover with limited long-term damage. But without oxygen, brain cells will begin to die after 4 or 5 minutes, and after 15 minutes most individuals can no longer be resuscitated at all.

Breathing is a life or death issue, which is why it is so important to be informed about the different ways the airway can be constricted and what can be done about it so that permanent damage or death does not occur. It’s pretty easy to tell if you are having trouble breathing when you are awake, but during sleep many people stop breathing over and over again all through the night. Sometimes this is because of a neurological issue where the brain actually tells the body to stop breathing, but more often the condition is related to the structure of the airway itself. When some people sleep, the tissues in the airway can relax so much that they actually collapse together, effectively closing the throat. The longer the throat remains closed, the lower the blood oxygen goes. And in a matter of minutes, the situation can become very dangerous.

What I’m describing is a condition called obstructive sleep apnea (OSA). Why would a dentist be talking about what seems to be a medical condition? Because the structure of the airway can be greatly affected in a positive or negative manner by the position of the teeth and the lower jaw. Many people with mild to moderate OSA can benefit greatly from the use of a dental appliance that gently repositions the lower jaw to hold the airway open during sleep.

Even children can have OSA, or they can have other breathing problems related to allergies or chronic illness that will cause them to breathe primarily through the mouth. Children who are mouth-breathers tend to develop narrow arches in the mouth, which can complicate sleep apnea issues as they get older. Early intervention with functional orthodontic appliances that encourage proper arch development and tooth position can help significantly reduce the risk factors for OSA as an adult.

I have been treating and screening patients with OSA for more than 15 years, and I am still surprised at how little most people know about the signs, symptoms, and risks of OSA. Snoring, for example, is an early form of apnea in and of itself, but far too many people ignore even severe snoring, believing it to be benign. It is most certainly not benign.

This month, in an effort to help everyone be more informed about what OSA is and how it can be treated, I am launching a new educational series specifically dedicated to OSA, airway structure, and early development. This series is designed to help you determine if you, your spouse, or your child might need a sleep screening, what kinds of treatments for OSA are available, and how to reduce your overall risk factors for OSA. I hope that you will take a look and share this important information with your friends and your family. We all need to breathe well; there is simply no more important ingredient for life than breath.

Martha (Signature)