Paediatric Sleep Disordered Breathing, Adult Sleep Apnea and Craniofacial Growth – What is the link? By: Dr. Nishita Ondhia
What is (Sleep Disordered Breathing) SDB? SDB refers to a broad spectrum of sleep-related conditions including increased resistance to airflow via the upper airway, heavy snoring, marked reduction in airflow (hypopnea) and complete cessation of breathing (apnea).
At this time, our healthcare system is seeing a marked rise cases and severity of sleep apnea, a disorder characterized by pauses in breathing while one sleeps. The disorder is mostly being diagnosed in adults, however, there are similar signs and symptoms in children which warrant screening and attention.
Interestingly, it is not an adult onset disease, it is only being recognized in adulthood. The signs and symptoms have been present all along.
Common Signs and Symptoms include mouth breathing, snoring, grinding teeth, restless sleep with or without episodes of apnea, nasal obstruction, difficulty with morning arousal, daytime fatigue, dark circles under the eyes, ADHD and bedwetting. The severity of these may vary from mild to severe.
The key to paediatric SDB is the following:
- recognize risk factors early
- create for long term stability – address the structure and function of the airway by maximizing growth potential, improving muscle tone and response and modifying the orofacial growth via growth guidance
The Ultimate Goal of Paediatric SDB:
- 100% nasal breathing
- Promote positive orofacial growth
Ideal Treatment Outcomes:
- lips together, tongue on the roof of the mouth
- proper swallowing
- 100% nasal breathing to promote positive orofacial growth
- Ideal orthodontic alignment
Left untreated, continuation of SDB in children leads to a worsening of the craniofaical growth pattern year by year, ultimately leading to adult sleep apnea. For children with severe symptoms, this is a strong indication to start treatment as early as possible.
-Dr. Nishita Ondhia