Posted by Dr. Bill Williams on January 2, 2017 · 2 Comments
You’re in the den watching the late news, your child is in bed and you hear snoring that seems louder and more interrupted than usual. What does it mean? Should you be concerned with snoring?
Well that depends on whether it’s upper airway restriction and mostly just noise or worse, i.e. sleep apnea.
Here’s the problem. Small diameter tubes can get less air through them than large tubes. That is the key to air flow and breathing well. Also, air flow and easy breathing relate directly to oxygen getting to the lungs and then to the brain. The actual airway size is not diagnostic for whether your child has obstructive sleep apnea (OSA) in every case. But, OSA is more likely to occur in patients with smaller airways. A smaller sized airway doesn’t have to even result in OSA for it to be a problem. What matters is when that airway is partially or totally blocked during the night by the tongue, enlarged tonsils or adenoids, small nares or swollen sides of the mouth and throat. When this happens it is a serious medical problem.
Children who struggle to breathe have far less energy than those with a normal airway. Studies have shown that many, many problem stem from oxygen deprivation at night while sleeping: high blood pressure, mental fogginess, ADD, heart disease and much more. Neurological changes become permanent after a while so need to be addressed as soon as they are found. A disruption in the normal four stages of sleep makes a child grumpy, irritable, and even unruly. Sleep problems can then turn into muscle and growth problems. Normal sleep is essential for brain health.
A change of a few millimeters in airway opening can dramatically affect air flow. We know that arrested growth of anatomic structures in the head and neck cause a blocked airway due to scar tissue, genetic disorders, obesity, enlarged tonsils, adenoids, allergies and such. As dentists we want to see open airways for normal growth. Physicians must play an important role in helping keep the airway open and normal during the growth years or permanent damage is done. The diagnosis of whether it’s snoring or sleep apnea must come from a proper sleep study.
An early intervention to enlarge the airway diameter and openness in childhood will often result in the patient not developing OSA as an adult. We see this from the use of expansion appliances that make the palate wider, move the front teeth forward and by allowing the lower jaw to come forward and not be “trapped” back in a choked position against the throat. When the tongue has enough room and is held naturally in a forward position, the airway can work naturally and not be blocked all night long. From this you can see that orthodontics and orthopedic development of the jaws is far more critical than just making the teeth look pretty and straight.
When looking for a dentist or orthodontist for your child always ask if they know about the treatment of sleep apnea in adults and children and how to prevent OSA as well as treat it accurately.
Hi Dr. Williams
This is very sensitising post and I hope more people will be able to read about it and realise the gravity of “non-so-normal” snoring. Unfortunately most people will ignore early signs of these unknown conditions like OSA. Research shows that change is lifestyle is continually increasing the number of people who fall victims to such conditions. The best decision for a parent to make is to be wary of even the tiniest indications of sleeping problems in their kids so that they can find a solution asap before the child reaches adulthood.
Thanks for your comment Robert. We are very happy to have Dr. Williams on our PedSafe Expert Team and glad you liked his post. We’ve passed your comments on to him. Stop by the site again.