Sleep Apnea as it Affects Kids

February 26, 2018 by: Martha Cortes, DDS Article Tags:

Whether you are new parents or your kids are headed back to school, autumn is the perfect time to screen your kids for a possible sleep apnea, as October is Sleep Apnea Awareness Month. It is also a time when seasonal allergens have a tendency to kick in, which are amplified by sleep apnea. Below are some common questions parents have about sleep apnea as it relates to their kids.

What is sleep apnea? Apnea means “without breath.” Sleep apnea is the loss of breath while sleeping. The disorder can be mild, medium, or severe depending on how many breaths are lost per minute.

Can kids have sleep apnea? Yes. Sleep apnea can begin as early as infancy, and develop at any age thereafter regardless of gender or ethnicity. Note: If the mother has sleep apnea, then there is a 40% likelihood her child will have sleep apnea too.

What are the causes of sleep apnea? Causes for the sleep-breathing disorder include: genetic inheritance; unhealthy gestation; craniofacial deficiencies, such as a small jaw, creating inability for the mouth to close; a small airway, making it difficult to breathe; large tonsils, adenoids, or tongue, making it difficult to swallow; and bad habits, such as breathing through the mouth or sucking the thumb.

My newborn has a hard time latching onto my breast when trying to nurse. Could this be linked to sleep apnea? Infants who have a hard time nursing may be suffering from an underdeveloped jaw, a tied or disproportionally large tongue, or large tonsils and adenoids. Any of these characteristics are signs that the airway may be obstructed, which in turn affects the breath, and therefore may cause sleep apnea. A small jaw will limit the neuromuscular movement required to nurse. No wonder these babies are fussy – they are exhausted and hungry!

My newborn keeps spitting out my breast milk and the bottle formula. He always seems hungry, and is so fussy! Recently I went to the doctor’s office, and they think it’s GERD; they are recommending GERD medication. Any thoughts? Make sure your child is not tongue-tied. A simple way to check is to place your finger under his tongue. If that area feels like a tight guitar string when you place light tension on it, then he is more likely to be tongue-tied. This may be why infants regurgitate their milk, or formula – they do not have full range of motion with their tongue.

For evaluation, you can bring your child to an ear, nose, and throat doctor (ENT) or to an oral surgeon who performs frenectomies by clipping with scissors. You also have the option to bring your child to a laser-certified dentist, or oral surgeon who performs a laser-assisted frenectomy. To ensure a successful outcome from all the above procedures with respect to babies, the mother will have to manually massage under the tongue so that it maintains the increased range of tongue movement. For children, as well as adults, orofacial myofunctional exercises can be taught by myofunctional therapists. You can also view more on YouTube.

My kid suffers from constant sinus infections – is this linked to sleep apnea? Sinus infections can affect the quality of sleep your child achieves for the simple fact that their respiratory system is compromised. In addition to obstructed breathing, a runny or stuffy nose does not allow nitric oxide production, which is only achieved through nasal breathing. Nitric oxide plays a key role in overall health in that it boosts the immune system and fights bacteria. The other disadvantage to constantly having the mouth open is the developmental influence it has on the facial anatomy. Kids who always have their mouth slightly open develop long face syndrome, or a skeletal open bite. This creates an inability for the upper and lower jaw to come together, perpetuating the cycle of mouth breathing, and therefore respiratory issues. This may create a road to sleep apnea.

Is it a bad thing if my kid snores? If your kid snores more than four times per week, it’s worth taking him to a sleep doctor, or ENT to see what’s causing the issue. Snoring is a prime characteristic of sleep apnea, as it usually involves excess soft tissue of the throat, which in turn blocks adequate airflow.

Will sleep apnea influence the way my kid looks? Sleep apnea greatly affects the developmental influence of pre-teens (twelve years and younger) because they are still growing and therefore susceptible to influencing factors including limited amounts of oxygen to their brains. Research from the University of Pennsylvania shows the effects on rabbits’ development of limited breathing while sleeping. The research shows the frontal cortex is the first brain region to be limited in oxygen. A compromised frontal cortex lacks executive disorder and sensory integration.

Babies and children who breathe through their mouths instead of their noses often have small jaws and narrow faces. Fortunately, parents can screen for a possible sleep disorder by looking for some key characteristics, which will help determine if the child may need to see a sleep doctor for further evaluation and analysis.

Characteristics of sleep apnea

•    Habitual snoring
•    Deep-set lines under the eyes
•    Sclera visibility above or below the iris
•    A small or set-back jaw
•    Unleveled eyes
•    Narrow nostrils
•    High vaulted pallet
•    Large or scalloped tongue
•    Large tonsils or adenoids
•    Forward head posture

What health risks are involved with sleep apnea? Infants, children, and adolescents who have sleep apnea may be at high risk for a number of short- and long-term health complications, including (but not limited to): cardiovascular disease, such as diabetes and hypertension; acid reflux; anemia; lung disease; seizures; autism; depression; anxiety; and, due to acidosis, a potential for a higher risk of cancer.

What types of doctor(s) treat sleep apnea? Sleep doctors who have an advanced level of education in the realm of sleep disorders will be able treat sleep apnea. There are seven types of doctors that can receive board-level certification in sleep medicine, including: primary care doctors, sleep specialists, technologists, dentists, otolaryngologists (ENTs), neurologists, and psychiatrists. One or multiple specialists (depending on the root cause of the sleep apnea) will review your child’s symptoms with increased precision because of their voluntary level of advanced education. Specialists often work together to offer the highest level of healthcare for their patients.

Martha Cortes

Martha Cortes, DDS

Martha Cortes, DDS, is a general practitioner who is a certified laser biological, restorative dentist who focuses on sleep-disordered breathing and well-being.  Her methods include non-surgical, facial-airway-enhancement remodeling techniques effectively designed to treat mid-facial deficiency, temporomandibular joint dysfunction (TMJ), sleep apnea, and children and adults who suffer from chronic pain.