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Pediatric Sleep Disordered Breathing

Does your child snore?

Does he sleeps, does he breathe via his mouth??

Do you ever notice pauses in your child’s breathing while she’s asleep?

Does your child exhibit loss of focus and learning difficulties at school?

Is your Child not eating well or showing delayed growth and development?

If you have answered yes to any of these questions, your child may be suffering from sleep disordered breathing.

Pediatric sleep-disordered breathing (SDB) is a general term for breathing difficulties during sleep. SDB can range from frequent loud snoring to difficulty breathing to repeated complete stay of breathing for a unnumbered seconds, a infirmity called Obstructive Sleep Apnea (OSA), wherein part, or all, of the airway is blocked hourly during sleep.
When a child’s breathing is fragmented during sleep, the body thinks the child is chokingThereforeheart rate increasesblood pressure rises, brain is aroused, and sleep is fractured. Oxygen situations in the blood can also drop.
Children are particularly vulnerable to Sleep Disordered Breathing because their bodies and mentality are still growingChildren with SDB may not produce enough growth hormone, responding in abnormally slow growth and development. SDB may also invoke the body to have increased resistance to insulin and day time fatigue, which can lead to eased physical exercise.
In both children and grown-upslapse of breathing can wake a person up and piece their sleep. These interruptions disrupt the normal sleep cyclesleading to sleep privation. There are strong associations between springtime sleep illnesseslack of good serene sleep and problems with how a child develops mentally and physically and also how the child behaves, concentrates and learns at academy or preschool.

  • What Are the Symptoms of Pediatric SDB?

    Possible symptoms and consequences of rude pediatric SDB may include:

    • Snoring-loud snoring that’s present on supreme nights.
    • High Pitched”squeaks”when sleeping
    • Posturing or listing head back while sleeping
    • Plethoric sweating at night, restless sleep
    • Sleep walking
    • Hyperactive Demeanor
    • Perverseness or Aggression
    • ADD ( attention inadequateness Conditions)
    • Difficulty concentrating in academy
    • Bedwetting
    • Knowledge difficulties
    • Slow growth
    • Downsized appetite
    • Cardiovascular and lung difficulties
    • Fattiness
  • What Causes Pediatric SDB?

    A common cause of SDB in Children is a physical narrowing of airway due to excess or enlarged tissue around the neck or back of the throat

    • Enlarged Tonsils and Adenoids, Blockage of nasal airway like deviated nasal septum
    • Children with Dental Malocclusion, Small dental arch, Underdeveloped Jaw bone, enlarged tongue , Changes in facial proportions have a higher risk of developing SDB as adults.
    • Obesity with increased fat deposits around the neck may cause blockage of the airway
    • Children with neuromuscular deficits such as cerebral palsy, Downs syndrome
  • How is Sleep Disordered Breathing Diagnosed in children?

    If any of the above symptoms are reported in your child, at Snoring and Sleep Apnea centre, we will have your child evaluated by our Dental and ENT specialists. Our Dentists with Sleep Medicine training will check for growth and development issues that may affect breathing. Our ENT specialists will check for nasal and throat obstructions such as a deviated nasal septum, Enlarged nasal turbinates, adenoids and tonsils.

    After a thorough clinical and radiographic examination, our specialists will make a diagnosis of SDB based on history and physical examination. In other cases, like children suspected of having severe OSA additional testing such as a sleep test may be recommended.

    The sleep study or polysomnography (PSG), is an objective test for SDB. Wires are attached to the head and body to monitor brain waves, muscle tension, eye movement, breathing, and the level of oxygen in the blood. The test is not painful and for children, is generally performed in our sleep laboratory

  • What Are the Treatment Options?

    Enlarged tonsils and adenoids are a common cause for SDB in children. Our ENT team will evaluate with an endoscope to check for the same. Surgical removal of hypertrophic tonsils and adenoids is generally considered the first line treatment for pediatric SDB if the symptoms are significant, and the tonsils and adenoids are persistently enlarged.

    Many children with OSA show both short- and long-term improvement in their sleep and behaviour after Tonsillectomy and Adenoidectomy

    Not every child with snoring needs to undergo T&A. If the SDB symptoms are mild or intermittent, academic performance and behavior is not an issue and if the tonsils are small, or the child is near puberty (because tonsils and adenoids often shrink at puberty), it may be recommended that a child with SDB be watched conservatively and treated surgically only if symptoms worsen.

    Our dentists with sleep medicine training will design dental appliances like Rapid Maxillary Expansion ( RME ) appliances to improve craniofacial abnormalities that affect airway and help with proper growth or expansion of jaw bone. Orthodontic treatment, jaw surgery, myofunctional therapy to improve the tonicity of the muscles or the use of continuous positive airway pressure (CPAP) may be required simultaneously to improve the airway.

    By treating children with SDB with early diagnosis and management, we can help prevent lifelong complications that can negatively affect a child’s sleep, overall health and well being.

    At Snoring and Sleep Apnea Centre, a team approach and actively involving the child and parent in treatment decisions ensures the best possible treatment outcomes for the child.

  • At what Age should Children be treated for Sleep Disordered Breathing?

    Most Children start showing signs of SDB as early as the age of two years. However, even infants can have a form of SDB such as Sleep Apnea.

    Children of any age should be examined if they show signs of routine sleeplessness, loud snoring, gasping or choking during sleep, night sweats, or extreme tossing and turning. If older children experience these symptoms in conjunction with poor school performance, behavioral issues, or moodiness, SDB may be the reason.

Some common forms of Sleep disordered Breathing in kids include:

  • Loud Breathing Sounds/Snoring: If no airway resistance or blockages are noted, snoring may be harmless; sometimes, if the snoring comes and goes, it could be a sign of congestion from allergies. However, in some children, even very mild snoring may be a symptom of Sleep disordered breathing, just like behavioral issues, bed wetting and fatigue.
  • Upper airway resistance syndrome (UARS): A narrowing of the upper airway so breathing is more difficult; just shy of a blockage, UARS is often a precursor to obstructive sleep apnea. Pediatric UARS is more common than pediatric OSA, and is sometimes caused by minor disruptions in growth and development. Children may have an oral cavity that’s too small to accommodate their tongues, for example, which can lead to mouth breathing and difficulty getting enough oxygen during sleep.
    Often, such issues can be treated by expanding the oral cavity through the use of orthodontic or dental appliances. Myofunctional therapy to tone the tissue of the airway and to improve, placement of the tongue during sleep may also be helpful.

Obstructive Sleep Apnea in a child

Obstructive sleep apnea (OSA) is a sleep related breathing malady. OSA occurs when the muscles relax after you fall asleep. As a result soft hankie in the tail of the throat collapses and blocks the airway. This leads to partial reductions in breathing. These are called “hypopneas.” It also can lead to complete pauses in breathing. These are called “apneas.” In children these obstructions tend to happen during the stage of splitting eye movement (REM) sleep.
Yea brief apneas can prompt a child to have low stations of oxygen in the blood. This is called “hypoxemia.” It can happen fast in a child with OSA. Because children have minor lungs, they’ve smaller oxygen in reserveChildren tend to take frequentshallow breaths rather than slowdeep breaths. This also can prompt a child with OSA to have too substantial carbon dioxide in the blood. This is called “hypercapnia.”
Unlike grown-upsChildren with OSA hourly don’t wake up in response to pauses in breathing. They’ve a progressives “arousal threshold” than grown-ups. As a result, their sleep pattern tends to be fairly normal and towering daylight somnolence isn’t as common in youthful children as in grown-ups with OSA.
Last children with OSA have a history of snoring. It tends to be loud and may include conspicuous pauses in breathing and gasps for breath. Sometimes the snoring involves a continualpartial block without any conspicuous pauses or arousals. The child‘s body may move in response to the pauses in breathing.
Adolescent children have a really flexible burlesque coop. As a result the breathing problems can produce unusual movements of a child‘s bin and belly. The burlesque coop may appear to move inward as the child inhales. This is called“paradoxical movement.”Parents hourly notice that the child seems to be working hard to breathe. For healthy children over three times of age, this type of breathing isn’t normal.
In extreme cases a child with raw OSA may develop a” conduct case“over time. The ongoing breathing problems effectuate the sternum, or”breastbone,”to sink near. This produces a depression in the case wall.
Children with OSA may sleep in unusual positions. They may sleep sitting up or with the neck barred. They also may sweat a lot during sleep and may have headaches in the morning. Bedwetting or sleep demons also may comedown.
Children with OSA tend to breathe ordinarily when they’re awake. But it’s common for them to breathe through the mouth. They may have frequent infections of the upper respiratory tract. Some children with OSA have connate large tonsils that they’ve a hard time swallowing. This is called“dysphagia.”
Symptoms of OSA tend to appear in the first multiple eras of life. But OSA hourly remains undiagnosed until multifold eras thereafter. In early springtime OSA can decelerate a child‘s growth rateFollowing treatment for OSA children tend to show incoming in both height and weightNatural OSA also can lead to high blood pressure.
Cognitive and behavioral problems are common in children with OSA.

These problems may include Aggressive bearing

  • Aggressive behavior
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Mood changes, anxiety/depression
  • Delays in development
  • Poor school performance
  • Excessive daytime sleepiness