Snoring In Children
Some of the signs and symptoms of sleep apnoea in children include:
- Pausing in breathing or gasping or choking during sleep
- Waking up with a dry mouth or headache
- Bed wetting
- Teeth grinding during sleep
- Waking episodes at night as the child finds it hard to breathe
- Excessive sweating while sleeping
- Restless sleep
- Night terrors
- Being tired or waking up not refreshed in the morning
- Behavioural and mood issues
- Learning and concentration difficulties
- Fussy eating
It is important to know that snoring can be a symptom of sleep apnoea but not all children who snore will have sleep apnoea.
About Sleep Apnoea
Obstructive sleep apnoea occurs when a child has short periods of time when they stop breathing while they are sleeping as a result of the airway being blocked. The reasons for the blocked airway are a small airway, weak muscles of the airway, small upper and lower jaw and enlarged adenoids and tonsils. Quite often children display a combination of the above problems. As the airway size is reduced, the airway is more likely to collapse during sleep causing the child to stop breathing.
Upper airway resistance syndrome is a similar condition and children with this condition have identical symptoms and health risks. In upper airway resistance syndrome, instead of the airway collapsing there is increased work of breathing to maintain airflow through the narrowed airway. The symptoms and approach to treatment for upper airway resistance syndrome is similar to sleep apnoea.
Symptoms of sleep apnoea
In addition to the symptoms mentioned above, other symptoms include tiredness, sleepiness and memory impairment. Some children may exhibit behavioural problems such as being hyperactive, aggressive and have trouble focusing and learning. Sleep apnoea has been linked to bed wetting and Attention Deficit Hyperactivity Disorder (ADHD).
After a while a lack of sleep can cause personality changes, poor school performance and contribute to having a low mood and becoming depressed.
Causes of sleep apnoea
Sleep apnoea can occur as result of a variety of reasons but one of the most common is a smaller airway. This can arise through a combination of enlarged tonsils and adenoids, weak muscles of the airway and in many children a relatively smaller jaw and airway structures. Being overweight and obese can also contribute to sleep apnoea as fat round the neck can affected the airway during sleep.
Approaches to managing sleep apnoea
After the assessment, if the child’s adenoids and tonsils need removal by an ENT specialist this is the first step. If these are considered enlarged and need removal, then the removal will normally result in the improvement of symptoms and sleep quality.
However recent studies (using sleep studies) have now shown that up to 80% of children do not have complete resolution of sleep apnoea after this procedure. Some children may improve initially but see a recurrence of the problem later in childhood. Other studies have linked impact of poor or obstructed nose breathing on the proper development of the jaw and face. Studies have shown that treating the obstruction and modifying function improves outcomes. This has led to the incorporation of myofunctional therapy in our dental practice in Point Cook.
The upper jaw forms the floor of nose and expansion or widening the upper jaw has been shown in clinical studies to assist some children. This treatment is not for every child and in selected cases early functional orthodontic intervention may be of benefit.
Continuous Positive Airway Pressure (CPAP) has been the standard for managing sleep apnoea. As in adults, compliance is an issue for children. When considered from a dental point of view, a mask worn for prolonged periods over the face during sleep does impact the development of the upper jaw and thus affecting facial development.
How we can assist
Dr Nomita Gonsalvez has undertaken further training and gained postgraduate qualifications in dental sleep medicine. She can assist in identifying children at risk of sleep apnoea and other sleep disturbed breathing. She can assist with referral to an Ear, Nose and Throat specialist and work with your general practitioner and other allied healthcare providers. All our dentists in Point Cook have also undergone training to identify airway issues and can also refer you to an Ear Nose and Throat specialist.
Both Dr Gonsalvez and our dental Hygienist Lydia Wang have undertaken further training in Myofunctional therapy. They can assist in education and training in this area.
Please contact us for more information or book a consultation with Dr Nomita Gonsalvez