Pediatric sleep-disordered breathing (SBD) is a term used to describe breathing difficulty that occurs to children during sleep. It ranges in severity from allergy-related breathing difficulty to severe Obstructive Sleep Apnea. Clinical symptoms vary based on age. It affects children mostly between the ages of 4 and 8 years old.
The most obvious symptom for pediatric SDB is loud snoring in the absence of illness. Unlike adults, snoring is considered to be a pathological finding in children. Other signs and symptoms include tooth grinding, chronic headaches, daytime mouth breathing, daytime tiredness, difficulties in concentration, bedwetting, dark circles underneath eyes, restless sleep, increased sweating while sleeping, paradoxical breathing.
Risk factors for pediatric SBD are enlarged tonsils and adenoids, preterm birth, obesity, male, small /recessed jaws, tooth crowding, crossbite, craniofacial syndromes (e.g., Down syndrome, cleft palate), medications that decrease muscle tonicity.
Pediatric SBD, when left untreated, can lead to decreased attention and memory capacity, increase risks of depression, diabetes, obesity, hypertension, hypothyroidism.
Very often, children with pediatric SBD are misdiagnosed with ADHD.
The first line of treatment for pediatric sleep apnea is the removal of tonsil and adenoids. It has a success rate of 71 - 88%.
Orthodontic expansion of the upper and the lower jaw, the advancement of the lower jaw can increase the nasal airway and airway space. Addressing and removing the cause of allergies will help improve the patency of the airway.
CPAP, the gold standard treatment for adults with SBD is contraindicated in growing children because it will limit mid-face growth resulting in upper jaw deficiency.
Early orthodontic evaluation and treatment for children age seven or younger can improve their quality of life and help them grow to their full genetic potential.
Dr. Susie Ang is an associate with Red House Dental, an advertiser and supporter of OnRichmondhill.com