Sleep apnea is far too common in children. Almost all premature babies are born with breathing disorders with many having obstructive sleep apnea because they have not gone through the normal embryological developmental that occurs with a normal gestation period. Many full term children also develop sleep apnea. Unfortunately a large number of both these groups of infants are never properly diagnosed with the problem of sleep apnea. For a child, even one apneic event in the entire night produces an OSA diagnosis.
So what can happen to an infant with sleep apnea? Sleep apnea, by definition occurs when breathing is stopped for over 10 seconds. Many kids have numerous events per night and oxygen desaturation associated with these events can produce irreversible brain damage. Work by Ron Harper, PhD Neurobiologist at UCLA, describes areas of the brain damaged with even one night of desaturation. He further describes long term effects that seem to be irreversible. Do I have your attention? Interestingly, orthodontists in the early 1900’s were aware of these issues but the term obstructive sleep apnea and many other terms now used in this discussion were not yet used. Over 100 years ago orthodontists were actively treating children in the primary dentition to help alleviate or cure these issues.
My good friend, Dr. Phil Cooper of Savannah, GA authored a book entitled Why African American Children Can’t Read. His premise is that this historically disadvantaged group often suffers from OSA with resulting brain damage. They arrive in school with brain damage that often prevents them from learning to read and certainly adversely affects their academic performance. My belief is that children of any race with a similar medical history would be affected in the same way. To a great degree these problems stem from a lifestyle that people of all races living in industrialized countries have adopted.
What could be more important than preventing or at least reducing the damage and long term effects of sleep apnea in children of all ages? Sleep apnea in many kids sets them back in the race of life so that they never will prosper and be contributing members of society. What might the long term public health consequences of this problem be? It doesn’t require a college degree to know this is NOT a good thing for our young kids.
Snoring, gasping, restless sleep, hyperextension of the neck, a torn up bed in the morning, hyperactivity, reduced attention span, interrupting conversations, being fidgety, bed-wetting beyond the normal age, dark circles around the eyes, poor performance in school, and ADHD (with or without a formal diagnosis) are all common signs and symptoms of Pediatric Sleep Apnea.
If your child exhibits any of these symptoms it would be a good idea to see someone well versed in diagnosing and treating these issues. Pediatric sleep specialists are actually a rare breed and not universally available in many areas of the country. Some pediatricians are aware of these issues whereas others will view snoring, etc. as normal and something that a child will “grow out of”. More and more pediatric dentists, general dentists, and some orthodontists are becoming well versed in Pediatric Sleep Apnea. Dentists are not qualified to diagnose sleep apnea, but may be able to help with treatment. You have everything to lose if you ignore this problem in your child and do not get a diagnosis and appropriate treatment.
The most recent figures I have seen claim about 15% of our kids qualify for an ADHD diagnosis. These kids are routinely disruptive in school and hyperactive because they have not slept. Teachers are, not surprisingly, wanting something to be done to address this just to make a child not be disruptive. Medications are routinely given to such kids with this diagnosis. Dr. Stephen Sheldon is a world-renowned Pediatric Sleep Specialist (now retired) from Lurie Children’s Hospital in Chicago. In his lectures he often says, “I do not believe there is such a thing as ADHD. I believe it is always a sleep/breathing disorder.” If you have a child with these behaviors you are probably at your wits end. Parents rightfully become frustrated when their children exhibit these behaviors. Get help for your child’s sake, and for your own sanity.
Brain damage affecting both motor function and cognitive abilities are obvious short and long term problems. Experts on these issues cite the increased incidence of heart and circulatory issues in adulthood, poor academic performance, frustration of the child resulting in inappropriate behaviors including increased antisocial behavior. Kids who don’t perform well in school generally are starting life 3 laps behind in a 4 lap race.
The late Dr. Christian Guilleminault wrote a number of articles about this in the refereed literature. His articles on premature birth almost always causing sleep/breathing disorders are a must read for those interested. Adoption of mouth breathing dramatically increases risk. Interestingly these issues were described in the 1800’s by Charles Dickens and George Catlin, renowned western artist and author of Shut Your Mouth and Save Your Life.
