Sleep Apnoea – Kids

Three things are required for correct growth of the face and jaws:

  • Lip Seal
  • Nasal breathing
  • No abnormal tongue habits

Nasal breathing (along with lip seal) creates negative pressure in the nose. That stimulates the upper jaw to grow to its genetic potential. (Don’t worry; that’s all the technical stuff out of the way.) This means that if your child is a mouth breather, he or she could end up with a funny looking face if the bones aren’t growing the way nature intended.

What causes mouth breathing?

Mouth breathing is usually caused by some sort of nasal obstruction. Typically, an allergy (food or environmental) causes the adenoids to swell and block the nasal passages. Everyone is designed to be a nose breather, but if the nose is blocked, the emergency escape route” that keeps you alive is your ability to breathe through your mouth. This is supposed to be a short-term fix until the nose becomes unblocked, but two things can go wrong:

  • The nose might never become unblocked
  • Mouth breathing might become a habit

So is distorted facial growth the worst thing that can happen?

No. The distorted facial growth apparent in your child makes us suspicious (and concerned) that he or she may have obstructive sleep apnoea Sleep apnoea is a serious condition that can result from an obstructed airway. If present, it means your child is not getting enough oxygen while they sleep for their brain to grow normally. Studies have shown sleep apnoea can reduce a child’s IQ by 10-16 points and is often misdiagnosed as ADD or ADHD. It needs to be taken very seriously.

What else should I be looking for?

Other things that can indicate an airway obstruction and put your child at risk of sleep apnoea include snoring, teeth grinding, frequent sore throats (tonsillitis), thumb sucking or hand sucking, acid reflux, bad breath, bed wetting, sleep walking, waking up and going to the bathroom in the middle of the night, restless sleep (tossing and turning), calling our or waking for any reason regularly in the middle of the night, frequent ear infections, being underweight or below average height.

What should I do?

For the next two weeks observe, observe all your kids (and other people’s kids too if you have the time) and record if they are breathing through their mouth, or their nose, and if they are snoring (or making any other noise while sleeping). Snoring, wheezing, whistling, or indeed any breathing noise you hear your child making is an indication that the air is only getting into the lungs (end eventually the brain) with considerable effort. If that’s occurring it shouldn’t be a mystery why some kids are tired in the morning. They spend half the night just trying to survive. Try to check twice a night and write down what you observe. Also observe them while they’re watching television (or concentrating) and determine if their lips are sealed or apart. Record this also.

If a pattern of mouth breathing is suspected, referral to an ENT specialist will be recommended. Generally we use Dr Gregory Lvoff at St George Private Hospital (9553 7543). He will assess whether the mouth breathing is the result of an obstruction or just habit. Alternative we may recommend referral to a paediatric sleep physician, or sometimes return you to your family doctor for assessment and referral if they have a special interest in this area.