Your Child's Health

Night time is the right time.

That saying "if you don't snooze you lose" could very well apply to a large part of the pediatric population who suffer from unrecognized sleep disorders.

Poor concentration at school, irritability, and excessive daytime sleepiness can be caused by obstructed nasal passages and throat. Often a parent knows a child snores or even gasps occasionally while sleeping but rarely brings it to the attention of the physician during a regular office call. Unless the physician or health care provider has an awareness of the frequency that sleep disorders can occur in children, the problem never gets solved. Only the symptoms get treated.

If a child wakes up frequently at night and then goes to the bathroom ask if he or she was awakened first and then decided to go to the bathroom. Parents assume that if the child gets up to relieve themselves at night that a full bladder is what woke them. Instead the child already was awake and then proceeded to the bathroom.

Here is a checklist to help you identify a potential risk for low oxygen to the brain at night with an accompanying sleep disorder.

loud snoring
gasping for air, long pauses between breaths
short wide neck
obesity which increases abdominal pressure upwards when laying down
daytime sleepiness even when a regular bedtime schedule is followed
history of enlarged tonsils and adenoids often with allergies and frequent ear infections
large, thick tongue in relation to the back of the mouth usually noticed by the dentist
frequent night time awakenings for no reason
falling asleep in class, irritability, need for short "catnaps" during the day or after school

A simple test can be performed at home, usually for free by a home health care agency that supplies respiratory therapy equipment. An order must come from the doctor first. A small oxygen sensor called a pulse oximeter is taped to one finger overnight and the concentration of oxygen is constantly monitored. If the oxygen saturation drops significantly from 99% to below 90%,especially while laying on the back, you can be sure there is a problem.

Usually it takes a team approach to determine the best treatment. Often an ear, nose, and throat specialist called an otolaryngologist can look at the structure of the mouth, throat, and tongue. The dentist and primary care specialist also need to be involved. The teachers and parents can monitor any changes in behavior and school performance.

What's most important is to have an awareness that sleep disturbances and upper airway obstructions can cause serious health and behavior problems if not observed early enough. Osteopathic physicians have unique training over and above traditional medicine to recognize how the structure of the body can affect the function of the body.