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A Primer on OSA &
SDB for Parents
“Why would an orthodontist ask me about my child’s
sleeping or behavior? Don’t they just straighten teeth?”
Not at all. Many of us understand that orthodontic care can make a big difference in many people’s overall health. OSA
(Obstructive Sleep Apnea) and SDB (Sleep Disordered Breathing) have largely gone unrecognized in children but can
have serious implications. This can contribute to growth problems, failure to thrive, Asthma, Type 2 Diabetes, ADD,
ADHD, autism, hypertension, stroke, and cardiovascular disease.
Causes
The most common and significant are:
Obstructive tissues (enlarged tonsils, adenoids, turbinate bones, deviated septum)
Lack of room for the tongue (narrow jaws, recessive upper or lower jaws)
What happens physiologically
With improper breathing, blood O2 levels decrease and CO2 levels increase. This triggers release of cortisol (the “fight
or flight” or “survival” stress hormone) to increase heart rate and drive muscles to force breathing. This arousal
overcomes the obstruction and the person “catches their breath”. And then it happens all over again. This is hard on the
body – like running a race all night long. You wake up exhausted.
Prolonged levels of increased cortisol has negative effects on the immune system, on normal hormone production, on
proper insulin function, gastric acid production, on learning and memory retrieval, and a host of other organs and body
functions.
What are the implications of decreased O2 in a growing and developing brain of a child? The current feeling is that even
a couple of events per hour are not healthy and it is harmful to the developing neural tissues.
Diagnosis
Clinical Examination, 3D imaging, nocturnal oximetry recordings, polysomnography
Treatment
-Reduction of obstructive tissues (surgery or naturopathic)
-Growth-oriented Orthodontics (jaw expansion, advancement of upper and/or lower jaws to create room for the tongue
and open the airway) rather than pulling teeth or using headgear (which can actually decrease the airway).
Research has shown that the best results occur when both are done!
When to assess and treat?
As soon as you become aware of the problem! From the orthodontic side, 8 or 9 years is an important age for correction,
but you can make a big difference in 3- to 6-year olds with some simple and timely care.