tired child with sleep apnea

Sleep Apnea in Children, Infants and Adolescents

Did you know that kids can suffer from sleep apnea, too?  It’s more common than you might realize, and it can have life-long health consequences if not treated early on. The good news is that orthodontic intervention can provide a permanent solution that may eliminate their need for sleep apnea treatments as adults. Before your child undergoes invasive, irreversible surgery to correct a sleep breathing problem, contact Denver Dental Sleep Care today and learn more about safe, predictable dental sleep treatment. Call (720) 317-2700 now.

Baby’s sleep apnea can be fatal; prevention and early treatment is the best thing you can do for your kids.

Sleep disorders often occur in children due to problems with their tonsils, congenital issues, or a combination of the two. Children that are sleep-deprived should be evaluated by a dentist and pediatrician to check for these types of complications. Morning crankiness or behavioral problems at school could signal a warning for OSA; long narrow faces may indicate sleep deprivation, and a bluish hue under the eyes can be a sign of allergies or oxygen deprivation.

Children who have sleep disturbances are often smaller in size because they lack vital growth hormone production during the lesser stages of REM sleep. Aside from behavioral and attention problems, sleep deprivation can also increase the risk of obesity. 

Obstructive sleep apnea has being associated with heart disease and sudden death. Overall, sleep apnea is a serious condition and a potentially life threatening disorder in children as well as adults.

Parents of children with sleep apnea are becoming more educated in the dangers of the disorder, and in learning what is best for their children’s nutrition, education and life. As a modern parent, you too should learn about your child’s facial development, and its influences in airway, sleep, pain and orthodontic conditions. This will help you make healthier choices for your children that will last for the rest of their lives.

Symptoms of Sleep Apnea in Children and Adolescents


    • Hyperactivity
    • Poor concentration, sometimes diagnosed as ADD/ADHD by mistake
    • Developmental delay
    • Hypo-nasal quality to their voice
    • Noisy breathing
    • Obesity
    • Frequent upper airway infections
    • Earaches
    • Bedwetting
    • Nocturnal mouth breathing
    • Snoring
    • Restlessness
    • Sleep Nightmares
    • Headaches
    • Chronic nose running

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Obstructive Sleep Apnea Treatments for Children and Adolescents

    • CPAP – Continuous Positive Airway Pressure Machine
    • Corrective surgery
    • Removal of tonsils
    • Weight loss
    • Avoidance of airway irritants and allergens
    • Orthodontic oral appliance

Denver Dental Sleep Care can help!

Orthodontist Dr. Paul Hamersky at Denver Dental Sleep Care is able to provide treatment for sleep apnea and sleep disorders in children and adolescents. Through the use of dental oral appliances and braces, early intervention can have lasting effects. Growing children do present a more complicated treatment challenge for the typical dental oral appliance therapy (OAT) than do non-growing adults. Many of the sleep apnea and snoring appliances currently used today can affect the growth patterns of children, sometimes in detrimental ways. Yet, if used with the knowledge and experience of a trained orthodontist, they can be very effective in the treatment of these sleep disorders. The devices can also correct many of the commonly developed orthodontic problems that usually require later treatment. This is where an orthodontist is uniquely qualified in the care of Sleep Related Breathing Disorders (SRBD) in children and adolescents.

Dento-facial orthopedics and Braces are the preferred method of early treatment and prevention of OSA (Obstructive Sleep Apnea Syndrome.) They can open the airway by 10 mm or more through developing the facial profile to an optimum situation, and maintaining or increasing the airway space.

before-after-dentofacial-orthopedicsGive your children a present for life: beautiful smiles and faces without apnea and snoring! Treatment can be started as young as 2 years old and can help your children reach their maximum growth potential by reducing possible obstacles in their breathing, swallowing and sleeping, and developing a beautiful facial profile at the same time.

Parents are the first ones to notice their baby’s problems, and as a parent you can be the first to help in the prevention and early care of potentially life threatening conditions affecting your children. Treatment should be started as soon as the problem is diagnosed by your pediatrician or doctor; without treatment, the problem is only going to get worse. Contact us for a consultation.

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Prevention of Childhood Breathing Related Sleep Disorders

1. Start at pregnancy

Sleep_Apnea__ChildrenFirst, educate yourself about craniofacial development, and discover the harmful impediments that affect children in reaching their full potential development.  Quality of sleep is arguably one of the biggest factors overall in the health and growth. Yet, many harmful habits which can be controlled since birth have very detrimental effects on breathing and the natural airway.  The airway is the keystone of the face, and stabilizes the surrounding arches including: the boney eye sockets, palate, upper and lower jaw positions, cheekbones and sinuses. The upper jaw (maxillary bone) holds 85% of the nasal airway – a compromised airway in a child changes the activating signal and alters growth and development.  Airway, allergies, tongue and lips posture, adenoids and habits are all related.

The largest increase in development occurs within the first 4 years of life, so early treatment works faster, is less expensive and traumatic, and has better results. It only takes a low pressure force of 1.7 grams to move a front tooth. The lower lip alone can exert a force of 100 to 300 grams of strength. The tongue has 16 muscles with a total force of up to 500 grams, making it the strongest muscle in the human body depending on how you group muscles. Just imagine what could happen when there is no control or equilibrium on these forces, and the damage that can be done on a child’s dental arches and overall facial shape.

2. Learn about breastfeeding advantages

Overall, recent research is finding that the incidence of sleep disorders of all types in infants and children is significantly lower in breastfed babies.  Artificially fed infants also have a greater overall incidence of upper respiratory allergies than those of who are breastfed. These allergies can block the nasal airway, resulting in mouth breathing and a childhood predisposition to respiratory disorders.

The best holding position when nursing an infant is upright, rather than reclining; healthy swallowing in a reclining position is just as difficult for the baby as it is for the adult. Nursing in a reclining position often causes milk to flow into the middle ear. This can cause inflammation and possibly other pharyngeal complications. The infant will thrust their tongue forward to expel the milk, and thereby preventing a pooling in the throat region. Continued feeding in a reclined position may develop into a longer term tongue thrust swallow, which has many damaging side effects to the teeth and jaw.

When babies are held in upright positions, they are encouraged to take the breast milk with their neck stretched and a forward stretching of the chin, which is very important for healthy natural facial development.

3. Learn about poor habits and how to control them

Sucking, tongue thrust, lips posture and mouth breathing can be controlled and treated early.

The neonatal sucking reflex is an automatic reflex that is clinically evidenced immediately after birth. The infant’s tongue undulates forward and backward in the mouth to carry food and fluids back to the throat. Any object placed into the oral cavity on which the infant sucks, other than the breast, can act as an orthodontic appliance depending on the force, intensity, direction and duration of the sucking. This allows the potential for creating malocclusion with a resultant TMJ dysfunction and airway invasion, and increases the risk of developing sleep apnea.

Granted, there are children who are passive suckers and they do not create a malocclusion, but rather than take the risk it is better to discourage the habit. There are alternative choices for “determined-to-suck” children including many “naturally” designed nipple/pacifier/exercisers.  Generally, the objective is to channel the sucking activity through the nipple to stimulate healthier growth and development. This design allows the child to close their lips and enables the normal forward and back movement of the lower jaw, as in nursing. The nipple/exerciser is designed to broadly fit the anatomy of the baby’s palate and inner arch. The nipple hole, being on top and toward the palate, distributes fluid over the palate and on top of the tongue. The tongue side of the nipple is cupped, causing the tongue to lie flatly under the nipple and not around it, as with conventional nipples. The soft design has low inclined anterior guide planes, which are designed to broadly and flatly contact important anterior elements of the upper and lower jaw during nursing.  It is also designed so that the infant can close the lips during nursing.

All this helps the baby to grow and develop the face and airway in an unrestricted way. There is plenty of evidence in recent literature that mouth-breathing has an adverse effect on the growth and development of the face and jaws. Virtually all children who are habitual mouth-breathers will have a malocclusion.


Early Orthodontic Intervention of Obstructive Sleep Apnea 

4. OSA and TMJ disorders

These disorders are related to facial and airway development; you can take preventative measures and early treatment as the best option to avoid major complications.


5. Orthodontic conditions

Teeth crowding and abnormal bites with deep/overbite are more likely to develop OSA and TMJ dysfunction due to the airway space invasion and jaw collapse. Early treatment with orthodontic dento-facial orthopedics will help to prevent OSA and develop a more appealing facial profile for your children.

Waiting to treat your children with braces until after 12 years of age only increases the risk of required teeth extractions and jaw surgery to correct the problem, compromising at the same time the upper airway space.

6. Diet

healthy-snacks-emma-without-teethSofter diet from fast food in young infants creates smaller bones and an incorrect maxilla/mandible relationship. This will allow developing teeth crowding with major orthodontic needs, TMJ dysfunction and Obstructive Sleep apnea. Hard/semi-hard and fibrous diet accompanied with normal swallowing and breathing stimulates growth factors to develop the necessary bone structures to accommodate all teeth and proper airway.   It is also a well know fact that sleep apnea and snoring are related to obesity. The best is prevention by decreasing eating hot-dogs, fries, burgers, pizza and increasing the intake of more fruits, vegetables and fiber rich foods.

Meet Dr. Paul Hamersky at one of his Denver-area locations, including offices in Lone Tree, Green Valley Ranch, and Aurora, to see your options on Oral Appliance Therapy, and learn more on sleep apnea in children.

Call 720-317-2700 today to schedule your first consultation, or contact the office through our website!

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