Overview

Sleep Apnea is a common problem in children, and it’s caused by a combination of elements that result in a narrowed and restricted airway. Chronic mouth breathing leads to under-development of the maxilla (upper jaw) and mandible (lower jaw), which leads to airway crowding. Allergies, nasal conditions like turbinate hypertrophy, and enlarged tonsils and adenoids can exacerbate the problem.

Symptoms

Symptoms of pediatric Sleep Apnea may differ from those in adults. Kids with Sleep Apnea may have difficulty getting to sleep or staying asleep. Bedwetting may be a problem. Snoring and mouth-breathing during sleep are common. During the day, kids with SA may have behavioral or attention problems. Growth milestones may be delayed. School performance can suffer.

Health Consequences

As in adults, Sleep Apnea in kids exists on a spectrum. Untreated, pediatric Sleep Apnea contributes to cognitive dysfunction & ADHD symptoms. Inflammatory diseases of the upper airway (sinus infections, ear infections, tonsillitis) are common. As kids with untreated Sleep Apnea grow into adults, associated cardiovascular and metabolic diseases of adulthood begin to be part of the picture.

“The Nose Rules”

An exciting emerging narrative in medicine has to do with the health benefits of habitual nasal breathing! This is another way of saying that we are learning more and more about how mouth-breathing is bad for us!

Mouth breathing tends to excite the sympathetic nervous system, which would be expected to contribute to symptoms of insomnia and anxiety. The open-mouth breathing posture predisposes to both obstructive sleep apnea and central sleep apnea. Mouth-breathing promotes periodontal disease and tooth decay. Mouth-breathing during exercise fatigues us faster. Mouth-breathing increases our vulnerability to viral infections. Mouth-breathing during childhood development contributes to cranio-facial under-development & dental malocclusion. The list goes on and on…

At Rebis, rest assured that we know The Nose Rules! All of us are passionate about helping every patient reap the benefits of healthy, effortless breathing through the nose, day and night!

Rebis Treatment Approach

• Home Sleep Apnea Testing is available for children 3 and older

• In-lab polysomnographic testing is available for children 5 and older

• Early ENT evaluation and adenotonsillectomy when indicated

• Nasal breathing rehabilitation and optimization

• Expansive Orthodontic strategies: myofunctional guides, fixed and removable palatal expanders

• Myofunctional therapy +/- tongue tie release

• Age‑specific CPAP when necessary

• Allergy management to open nasal airflow

Benefits of Treatment

Like in adults, the potential benefits of treating pediatric Sleep Apnea can be mapped to each of the Five Reasons to Treat. For kids, the notion of RISK is less immediate than it is for adults, but the structure of the conversation is the same. For each Reason to Treat, there is a potential benefit to be gained from optimization of breathing!