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April 16th, 2017

Sal Taiym DDS

Sleep Apnea. Is my child at risk?

Sleep ApneaDuring the first initial visit, parents expect Dr. Kamali and I to inform them whether their child has cavities, and whether their child is at a higher risk to develop cavities. What parents are quite surprised about is when we start asking questions about how well their child sleeps? Is your child hyperactive or has he/she been diagnosed with ADHD? Is your child able to stay focused at school? These are just a few questions I would like to know if I suspect your child may suffer from some sort of Sleep Disordered Breathing (SDB), more commonly referred to as Sleep Apnea.


Sleep Apnea can definitely occur in children. A common misconception around Sleep Apnea is it only occurs in obese children or adults. That assumption is false. Sleep Apnea can occur in non-obese children and I see it frequently in our office.

In addition to the above questions I ask, here are a few more:

1) Does your child snore at night?
   If your child is not sick with a cold or flu and his allergies are controlled, it is not normal to snore at night.
   If you observe your child snoring at night you should be concerned about airway obstruction during sleep.

2) Is your child a mouth breather?
   Mouth breathing is not normal. I tell the parents of my patients, the mouth is for eating and the nose is for breathing.

3) Does your child suffer from severe allergies?
   Children that suffer from severe allergies can become nasally obstructed and eventually become mouth breathers.
   Nasal passages can be chronically inflamed and cause structural changes that include, but are not limited to constriction of the upper jaw and a deviated septum.

4) Does your child grind at night?
   Grinding can occur frequently in children. Some mild grinding can be benign and idiopathic in nature. Grinding can also be an underlying symptom of something much more sinister.
   Children who frequently grind might have some form of sleep disordered breathing.


Why should you care if your child has a good night sleep or suffers from Sleep Apnea. Sleep Apnea has been linked to heart disease, neurocognitive/behavioral deficits, ADHD, and the development of moderate to severe orthodontic problems. Of main concern for us in the short term, and why parents seek our help is for orthodontic issues. Many parents ask about braces to correct crowded teeth and misaligned jaws, but if the primary cause is not addressed, such as Sleep Apnea or some other causes such as oral habits, good orthodontic treatment results can be very difficult to achieve.

The main difference between children that suffer from Sleep Apnea and adults that suffer from Sleep Apnea is, children can be cured if detected early. Early detection and treatment can change a child’s life for the better. The great thing about being a parent and a dentist is I can see it from both perspectives. As a parent, I can understand trying to provide the best for my kids. Detection and treatment for children who suffer from Sleep Apnea can be a life changing event. Better rest at night, more focus at school, decreasing the risk for cardiovascular problems in the future and an overall healthier and smarter child. What parent would not want that for their child?

Below is the Epworth Sleepiness Scale for children. Feel free to answer the questions below.



Epworth Sleepiness Scale—Children

How likely is your child to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your child's usual way of life in recent times. Even if your child has not done some of these things recently, think about how they would have affected your child. Use the following scale to choose the most appropriate number for each situation.


0=would never doze or sleep

1=slight chance of dozing or sleeping

2=moderate chance of dozing or sleeping

3=high chance of dozing or sleeping.


Please answer 0, 1, 2 or 3 for each question


1. Sitting and reading

2. Watching television

3. Sitting inactive in a public place (for example, a movie theater or classroom)

4. As a passenger in a car for an hour without a break

5. Lying down to rest in the afternoon when circumstances Permit

6. Sitting and talking to someone

7. Sitting quietly after lunch

8. Doing homework or taking a test

Results:

0-9                    Normal Sleepiness

10-16                Mild Sleepiness

17 and above    Moderate to Severe Sleepiness



Sources:

Dr. Steven Olmos. TMJ and Sleep Centre International

Owens JA, Dalzell V. Use of the ‘BEARS’ sleep screening tool in a pediatric residents’ continuity clinic: a pilot study. Sleep Medicine 6 (2005) 63–69


Starting April 16th, 2017 through April 30th, 2017, I will be taking questions regarding my latest blog "Sleep Apnea. Is my child at risk?". Please post your questions below.



AAPD   ABPD