Perhaps the most surprising aspect of the research has been the extent to which this condition is present among our children, and the wide variety of ways in which it can manifest in different kids. Things such as ADD / ADHD, daytime sleepiness, restless leg syndrome, bed wetting, aggressive behavior, difficulties in school, and low IQ are common. In my experience, most parents are unaware that so many of their children's health issues are interconnected, so I have put together the following list of symptoms which parents can look for to see if perhaps their child is suffering from a breathing disorder. Keep in mind as you read the list that every child is unique, and these issues need not all be present in order to indicate a serious problem.
- Sleep Disruptions / Restless Sleep - Breathing disorders are so closely tied to sleep that the clinical term for this condition is actually Sleep Disordered Breathing, or SDB. When a child has difficulty breathing properly (through their nose), the first sign may be a child's difficulty sleeping deeply for a full 9-10 hours through the night.
- Snoring / Mouth Breathing - Snoring and / or mouth breathing are neither cute nor funny, but rather a clear WARNING SIGN that something deeper may be going on that can have serious health implications. Human beings are designed to breathe through the nose, and we now know that nasal breathing offers a number of important health benefits, including a boost to the immune system, and better oxygen absorption in blood. Moreover, children who mouth breathe are far more susceptible to dental cavities and swollen tonsils and adenoids--a condition which further restricts their airway. Many children experience great difficulty breathing exclusively through their nose, especially at night. Remember, normal breathing is nasal, relatively shallow, and SILENT.
- Crowded or Crooked Teeth - Having crowded or crooked teeth is often referred to as a malocclusion (bad bite). Malocclusions are NOT NORMAL. There are always reasons why teeth aren't where they belong. One primary reason is that the upper and lower jaws are underdeveloped, are too narrow, and not set forward enough in the face. No matter what your dentist or orthodontist may tell you, in 99.9% of cases, there is no such thing as "too many teeth" or "teeth that are too big to fit in your child's mouth" or "a mouth that is too small to hold all the teeth". Never allow a dentist to remove permanent teeth in order to create space to straighten the rest. Many prominent doctors now consider such treatment malpractice because of the way it disfigures the face and can constrict an airway. So if your child's teeth are crooked, this may point to any number of other things such as mouth breathing, weak tongue, and underdeveloped jaws.
- Underdeveloped Jaws - In our modern Western culture, the tendency is for limited natural breastfeeding supplemented by plenty of bottle-feeding and non-nutritive sucking (pacifiers). Then when "solid" foods are introduced, the diet is extremely soft and requires little actual chewing. These factors all combine to create under-stimulated and weak orofacial muscles, which in turn fail to stimulate proper growth and development of the upper and lower jaws. When the jaws fail to develop and move forward they can literally choke off precious space needed for a full and open airway. Underdeveloped jaws can also lead to crowded and crooked teeth. These things are all interconnected in important ways. Fortunately, properly trained dentists have effective ways to help facilitate proper jaw growth, which can open up the airway.
- Bed Wetting - Most very young children have an occasional bed wetting accident. But if your child is wetting the bed 2 or more times a week beyond the age of 5 it is considered a problem in need of treatment. And while some do grow out of it, many children continue to experience this problem into their early teens. The issue for parents, however, is that up until now, there haven't been any effective treatments available. Now there are highly effective treatment options available from specially trained dentists for children of all ages.
- ADD / ADHD Symptoms - One large research study published in 2012 looked at 11,000 kids over several years, and found a 50% increase in behaviors linked to ADD / ADHD in kids with SDB. Remember that these diagnoses are fundamentally a list of behaviors based on observations. Once diagnosed, most children are prescribed psychotropic drugs (stimulants) in order to help them regulate their behavior. The research has shown, however, that a child with Sleep Disordered Breathing (SDB) is virtually indistinguishable in his or her behavior from other ADD / ADHD kids without SDB. So when we get their breathing and sleep under control, the behaviors quickly change and kids become much more manageable.
- Lower IQ / Difficulties In School - If your child is struggling to keep up in school, or has difficulty focusing and completing assignments, they may have a sleep or breathing disorder. We have seen many kids who were previously failing out of their elementary school classes make complete turnarounds after addressing their SDB, exchanging D's and F's for A's and B's, much to the amazement of teachers and parents.
- Thumb or Finger Sucking Habits - Thumb or finger sucking habits can affect the proper formation of teeth and gums, often creating an "anterior open bite", meaning a gap between the upper and lower front teeth when the back teeth are touching. This condition can also affect the way the upper palate forms, creating a high arch which can greatly diminish the air flow through the nasal passages.
- Dark Circles Under the Eyes - Known as Venous Pooling, purple-tinged areas below the eyes is another sign of a sleep and breathing disorder. This one is easy to spot.
- Chronic Allergies and / or Headaches - When a child doesn't breath properly through their nose, their tonsils and adenoids can swell and their immune systems can be compromised. If their jaws remain too far back in the head, the eustachian tubes can be pinched or reduced in size to the point of not being able to drain fluid from the inner ear. This too can cause frequent infections, ear aches, and operations to place tubes in their ears. Some SDB patients complain of frequent headaches and chronic pain (mostly in older children, teens, and adults).
- Teeth Grinding - Known as bruxism, there are two ways for parents to check to see if their children are grinding their teeth at night. The first is to look at the shape of the teeth. If they are flat on top or without "normal" looking cusps and crevices, then they are likely grinding at night. The other way to check is to listen to the child sleep. Often you can hear them grinding away. If you suspect your children are bruxing, you can be pretty sure they have a breathing disorder.
- Defiance and Aggression - Anti-social and aggressive behaviors are quite common in kids with SDB. We have seen amazing turnarounds in attitude and behavior once the sleep and breathing disorder(s) are addressed. Some children are just chronically tired because of a long-term lack of sleep. Without sufficient sleep, they are simply incapable of coping with the stresses caused by otherwise normal peer-to-peer interactions, and take their frustrations out on others. With parents, they often exhibit rude or disobedient behavior, and seem incapable of following through on the simplest task.
One study showed that as many as 9 out of 10 kids suffer from at least one of the above symptoms related to Sleep Disordered Breathing. Now that highly effective solutions are available, parents should not delay in seeking treatment. Most of these issues can be resolved by assisting the jaws to properly grow and develop and by strengthening the key orofacial muscles that hold everything in place. There are more and more specially trained dentists available around the country who know how to help.
