Pediatric Sleep and Breathing
What is Pediatric Obstructive Sleep Apnea and Sleep Disordered Breathing?
Pediatric Sleep Apnea is a condition estimated to affect 2-3% of the population. Sleep apnea occurs when a child's breathing is partly or completely blocked during sleep. Breathing can briefly stop and start again many times a night. The condition happens when the upper airway narrows or is blocked during sleep. Pediatric Obstructive Sleep apnea is a milder form of obstruction than sleep apnea. The patient may not qualify for a diagnosis of sleep apnea but may still be experiencing periods of oxygen desaturation that reduce quality of sleep.
It may be helpful to think of these diagnoses like sleep grades. Sleep apnea represents "D and F" grade sleepers while sleep disordered breathing represents "C and B" grade sleepers.
Sleep apnea can look different in children than it does in adults. While adults tend to present as being sleepy (men) and/or depressed (women), children often present with behavior issues like hyperactivity, short attention span, lack of emotional control, etc.
In many cases obstruction can be resolved with dental intervention. White Oak Pediatric Dentistry's goal is to help families identify sleep problems and improve sleep using a multi-disciplinary approach.
Diagnosis
Pediatric Obstructive Sleep Apnea is diagnosed when a pediatric patient has an AHI (Apnea Hypopnea Index) greater than 1. An apneic event is defined as a period where breathing has stopped or reduced to 10% of normal levels for at least 10 seconds. A hypopnic even occurs when a partial collapse of airway causes airflow to decrease by 30% for at least 10 seconds. A child is diagnosed with sleep apnea when AHI average is over 1 event per hour.
Pediatric sleep apnea can only be officially diagnosed with a sleep study.
Pediatric Sleep Disordered Breathing can be diagnosed using sleep study as well. While official diagnosis requires sleep study other tools can be used to give clues that patients may be experiencing sleep problems. Tools like CBCT exam, cephalometric exam, parent surveys, day and nighttime symptoms, and clinical exam findings will be discussed with you and what they may reveal about your child's sleep and breathing.
Sleep Consultation
Sleep consultations visits at White Oak Pediatric Dentistry consist of many different components including:
Surveys
You and your child will complete two surveys which can be downloaded below. On survey is called the BEARS Sleep Screening Tool. This survey helps start the sleep conversation asking questions that shed light on how well your child may or may not be sleeping. The second survey is called the Pediatric Sleep Questionnaire (PSQ). This questionnaire is a validated screening tool that helps identify sleep problems in children.
Both the questionnaires and scientific papers related tot he questionnaires are available for download below.
Clinical Exam
A detailed clinical exam will be completed evaluating your child's:
- skeletal anatomy
- head and neck pain
- soft tissue relationships
- airway patency
- speech movement
Imaging Exam
Imaging helps us evaluate things we cannot see clinically and continue to evaluate your child after the appointment has ended. Images that may be taken include:
- CBCT exam
- Lateral cephalometric exam
- Clinical photos
- 3D oral scans
Sleep Study
Depending on findings we may suggest setting up a home or hospital sleep study to collect more information regarding your child's sleep challenges.
Treatment Plan
All of the information gathered from the consultation visit will be reviewed and used to help create a treatment plan for your child. Options, expectations, pros and cons will be discussed at length to ensure we create the best plan for your child's specific needs.
