Dentistry for Children and Families

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Snoring Children, Orthodontics, and Sleep Apnea

Does your child snore? Does your child show other signs of disturbed sleep: long pauses in breathing, much tossing and turning in the bed, chronic mouth breathing during sleep, night sweats (owing to increased effort to breathe)? All these, and especially the snoring, are possible signs of sleep apnea, which is commoner among children than is generally recognized. It's estimated than 1 to 4 percent of children suffer from sleep apnea, many of them being between 2 and 8 years old.

Oral appliances for treatment of pediatric OSA are helpful in some cases, especially in adolescents whose facial bone growth is largely complete. One device that rapidly expands the transversal diameter of the hard palate over a six-month to one-year period has been used successfully in children as young as 6.


While there is a possibility that affected children will "grow out of" their sleep disorders, the evidence is steadily growing that untreated pediatric sleep disorders including sleep apnea can wreak a heavy toll while they persist. Studies have suggested that as many as 25 percent of children diagnosed with attention-deficit hyperactivity disorder may actually have symptoms of obstructive sleep apnea and that much of their learning difficulty and behavior problems can be the consequence of chronic fragmented sleep. Bed-wetting, sleep-walking, retarded growth, other hormonal and metabolic problems, even failure to thrive can be related to sleep apnea. Some researchers have charted a specific impact of sleep disordered breathing on "executive functions" of the brain: cognitive flexibility, self-monitoring, planning, organization, and self-regulation.

Several recent studies show a strong association between pediatric sleep disorders and childhood obesity. Judith Owens, M.D., director of sleep medicine at the National Children&'s Medical Center in Washington, DC, who is a member of the ASAA board of directors, believes that adequate healthy sleep is as important as proper diet and sufficient exercise in preventing childhood obesity.

In addition to orthodontic treatment, weight management, including nutritional, exercise, and behavioral elements, should be strongly encouraged for all children with OSA who are overweight or obese. An adequate nightly duration of sleep is an important component of weight management.