Sleep Like a (Cranky, Fussy, Restless, Irritable) Baby

Sleep disordered breathing (SDB) of which obstructive sleep apnea (OSA) is a part, is hurting not only adults, but also our children.   Today’s post will follow up on a post I did earlier – “Breathing- Not Everyone is Doing it Right” and look more deeply into childhood sleep apnea.  (Brace yourselves, I went a little list-happy.)   

Great OSA diagram via
diagnosingsleepapnea.com

Why is this so important?  Breathing correctly both at night and during the day are vital to health and well-being.  Children with sleep apnea may suffer from/have:

1. Poor school performance
2. Hyperactivity
3. Inattentiveness/inability to focus
4. Irritability
5. Easy frustration/difficulty moderating impulses and emotions

See the attached video- Finding Conner Deegan  (I had posted it on the Breathing blog above but it was so important I felt it worth posting again.) 

Often these children are misdiagnosed with Attention Deficit Disorder and are given drugs to wake them up when what they really need is to breathe properly all night long.  

Do you suspect your child might have a breathing problem at night?  Some signs for you to look for:

Hyperextended neck, mouth breathing
and flaccid lips, probably snoring, too. :(
from sleepapneadisorder.info

• Snoring
• Restless sleeper- changes positions frequently
• Hyper-extending the neck during sleep
• Nocturnal enuresis-bed wetting
• Sleep walking
• Loud gasping respiration, snorts, pauses in breathing
• Paradoxical chest movements - 
• Frequent colds, runny nose or tonsil infections
• Recurring ear infections
• Mouth breathing (both during sleep and/or daytime)
• Behavioral disturbances
•  Hyponasal voice (like they alwayshave a cold) /muffled voice
• Allergic shiners (bags under theeyes)
• Tongue thrust
• Abnormal swallowing habits
• Speech problems
• Weak flaccid lips
• Asthma
• Low energy levels

Here's a video of a two year old with many of these signs and symptoms. 

The American Academy of Pediatrics (AAP) recommends children and adolescents be screened for snoring during their regular physicals, and for those that snore, to be tested for sleep apnea.  While children may snore, they may not be as loud as an adult because they are not as big as an adult, so don’t use snoring loudness to determine if your child has OSA.  Children’s airways are often too narrow due to swollen tonsils and adenoids. 

Here’s another list of signs your dental hygienist and dentist can also be on the lookout for:

• Grinding teeth
• Scalloped tongue
• Narrow palate
• Large tongue
• Wear on the front teeth
• Pitting/erosion of the molars
• Mouth breathing
• Narrow airway
• Crossbite
• Enlarged tonsils--  “kissing tonsils”
• Tongue resting forward and down
• Bad Breath
• Poor palate development
• Crooked teeth
• Tonsil stones
• Dry cough

(Sometimes a check list is best!)

It is so important to screen for sleep apnea- upwards of 10% of children have it!  Sleep apnea lays the ground work for a host of other health problems in adulthood.    Lack of oxygen contributes to high blood pressure, obesity, heart attacks, strokes and dementia to name a scary few.  It is vital to screen children for sleep apnea to improve their health now and for the future. 

There is treatment for those children with sleep apnea.  Most can be cured, depending on the cause of the problem.  If the problem is enlarged tonsils and adenoids then an adenotonsillectomy is the first line treatment per the AAP.  Allergy treatment, weight loss, paper tape, and a CPAP (Continuous positive pressure) machine may also help and are other options to surgery. [Check out the paper tape information and try it!]

Be aware of the sleep apnea signs before they affect your child’s health.  Breathing correctly in not optional.  Please share this post and especially the Conner Deegan video with all your friends, family and even teachers.   Let's help spread the word to have happy healthy children we need to breath correctly- day and night. 
Next week we’ll review adult sleep apnea.   It’s just as deadly!

Part II next week,

 Keep smiling!  
Barbara

P.S.  Another good reference:  www.mysnoreworld.com/snoring-101/sleep-apnea-sleep-disordered-breathing-cause-more-than-hypoxemia