Unhealthy and disturbed sleep is a prevalent issue affecting people of all ages, including children. Pediatric sleep-disordered breathing (SDB) is a condition that encompasses various breathing abnormalities during sleep, ranging from primary snoring to obstructive sleep apnea (OSA) and central sleep apnea. Risk factors for pediatric SDB include obesity, adenotonsillar hypertrophy, craniofacial abnormalities, neuromuscular disorders, and a family history of SDB. It can affect infants and children of all ages, and its prevalence is not influenced by age or gender.
Children with SDB exhibit different symptoms compared to adults with sleep disturbances. The severity of SDB determines the range of symptoms, which can include restless sleep, snoring, mouth breathing, difficulty paying attention, behavioral problems, and daytime sleepiness. To screen and diagnose pediatric SDB, questionnaires and polysomnography (PSG) are commonly used. Screening questionnaires provide valuable insights into the child’s symptoms and their impact on daily life. PSG is the gold standard for diagnosing SDB and monitors various parameters during sleep.
Clinical evaluation and medical history play a crucial role in identifying potential risk factors and underlying conditions contributing to SDB. Assessing the shape and size of the upper and lower arches, tonsil size, tongue posture, dental development, and other factors can help identify underlying causes. Pediatric SDB can have significant impacts on a child’s health, including growth and development, cognitive development, behavior, and various long-term effects such as cardiovascular complications, metabolic disturbances, and neurocognitive deficits.
Managing pediatric SDB requires an integrated and multidisciplinary approach involving dentists, pediatricians, sleep specialists, ENTs, myofunctional therapists, and other healthcare professionals. Early screening, accurate diagnosis, and tailored treatment plans are crucial in preventing complications and optimizing healthy development and quality of life in affected children.
A case study of a 6-year-old girl with SDB highlights the importance of early detection and appropriate management. The patient exhibited various symptoms such as tiredness, behavioral problems, snoring, and restless sleep. Physical examination revealed enlarged tonsils, constricted arches, and other oral abnormalities. Diagnostic investigations, including PSG and imaging studies, confirmed the diagnosis of obstructive sleep apnea. Treatment options included tonsillectomy, adenoidectomy, myofunctional therapy, and arch expansion using orthodontic appliances. The patient showed improvement in symptoms and airway volume throughout the treatment.
In conclusion, pediatric sleep-disordered breathing is a significant concern that requires a comprehensive and multidisciplinary approach for effective management. Early recognition, accurate diagnosis, and tailored treatment plans are essential in improving outcomes and promoting healthy development in affected children. Healthcare professionals, including dentists, play a crucial role in screening and treating pediatric SDB to ensure the overall health and well-being of children.