Children are not supposed to snore. They are also not supposed to be mouth breathers. If they only do so when they have a cold or are really tired, that is OK, but otherwise there may be a problem. In Pediatric ENT specialist clinics, this is one of the most common reasons for consultation. To understand why snoring is a problem, you need to appreciate why snoring occurs. The actual noise of snoring is made because there is a blockage in the breathing. This blockage reduces the amount of oxygen that gets into the blood. It also triggers brain signals that affect sleep pattern and quality. In up to 20% of snoring children, there is also the problem of undiagnosed hearing loss – the combination of a tired child who cannot hear properly is a recipe for potential learning problems. The other affect that breathing problems can have, is on facial growth and dental development. There is a growing body of evidence that shows that children with airway obstruction are more likely to have problems with their teeth that may require orthodontic treatment. There is also evidence that shows with early intervention, to relieve the airway obstruction, these orthodontic issues can improve by themselves. Furthermore, in children, teeth grinding at night is now shown to relate to obstructed breathing (as opposed to ‘stresses’). For these reasons, and the learning and behavioral issues, the concept of letting children outgrown the problem is now no longer valid.
Snoring alone is hard on the heart and brain. Research suggests that snorers have low night oxygen even if they do not have a sleep disorder. Snoring has been found to be a predictor of poor school performance. A study that compared childhood snoring at 2 to 6 years of age to school performance at 13 to 14 years of age found children with lower performance in middle school were more likely to have snored during early childhood. They were also more likely to require tonsil and adenoid removal
To help with snoring, it is important to make space for breathing. . An undergrown small jaw can result in a small airway that is more easily blocked when a sleeping jaw drops. Compressed and crowded throat tissues can result in choking a sleeper hundreds of times a night. Often assessment by an ENT will be recommended to assess the tonsils and adenoids as well as early orthodontic intervention to make unobstructed nasal breathing possible.
What is Obstructive Sleep Apnoea (OSA)?
It is believed that obstructive sleep apnoea affects millions of people every year, but since it occurs at night while you sleep, people are unaware they are suffering and thus it goes undiagnosed. Signs and symptoms include unrefreshed sleep, daytime sleepiness, depression, morning headaches and going to the toilet frequently throughout the night. For many, gagging or gasping for air at times whilst sleeping or loud snoring is common.
Sleep Apnoea results from the tongue and soft palate collapsing onto the back of the throat while you sleep. This obstructs the upper airway, causing airflow to be restricted or completely stop; often for more than 10 seconds at a time. Your brain signals the body that there is a lack of oxygen and adrenalin is released and you arouse, this is where you may gasp for breath. Your airway will regain tonus and open, forcing the obstruction in your throat to clear and then your breathing will begin again. This is an obstructive apnoea; the process repeats itself over and over again through the night. In severe cases some people can lose breath for as much as 40 seconds over 60 times an hour.
The combination of low oxygen levels and consistent, disturbed, and interrupted sleep can causes the patient to feel exhausted throughout the day, but in some cases the patient does not even know how bad their sleep really is. Thus it is vital that if you have any symptoms you have a sleep study to assess your risk of sleep disordered breathing; as the ill effects of sleep apnoea can contribute to a host of very serious health concerns like cardiovascular disease, stroke and heart attack.
What are the signs and symptoms of Sleep Apnea?
- Tiredness/fatigue and irritability in the mornings and during the day
- Daytime sleepiness
- Frequently waking throughout the night to go to toilet or get a drink
- Regular Morning Headaches
- Worn teeth caused by clenching or grinding of teeth
- Poor memory
- Reflux problems
- Dark circles or bags under or around the eyes
Why is it so harmful?
Not only does OSA cause daytime sleepiness but repetitive airway collapse can lead to large pressure fluctuations in the lungs and oxygen deficiency which places stress on the heart and cardiovascular system. Consequently in people with OSA, the risk of high blood pressure, stroke and sudden cardiovascular death during sleep is increased as is diabetes. It is imperative that once diagnosed with OSA you are adequately treated.
If you or a loved one snores, the problem can be more than just a social embarrassment. Historically those who were afflicted with the condition were left to live out their restless lives without a treatment solution. There are many non-surgical alternatives to traditional snoring and sleep apnoea therapies.
For those who suffer with mild to moderate sleep apnoea, treatment may be a dental device such as a mandibular advancement device/splint. This device is worn while you sleep and works to open your airway by bringing the lower jaw, tongue and associated soft tissue forward stopping it from collapsing during sleep. This appliance maintains the patency of your airway and thus greatly reduces or eliminates the snoring and apnoeic events.