You may or may not know but my family has had 2 bonus kiddos with us over the past year. And with that has come new experience and insight into sleep disordered breathing.

 

Both of our bonus kiddos have been through sleep studies and eventually tonsillectomies and adenoidectomies. This led me to realize that it's been a while since I've discussed red flags for sleep breathing disorders.

 

So let's dive in! These are things to be on the lookout for with your child:

 

Sleep disordered breathing red flag #1: Snoring

Snoring may seem innocent or even cute in little ones, but it's important to recognize that it is not normal sleep behavior. In fact, it can be a red flag for underlying sleep breathing disorders in children.

 

Snoring occurs when there is a partial blockage or narrowing of the airway during sleep. It disrupts the smooth flow of air, leading to vibrations in the throat tissues and the characteristic snoring sound. While occasional snoring can be benign, persistent or loud snoring should raise concerns.

 

When you notice your child snoring during sleep, it's crucial to take it seriously. These behaviors can be signs that your child's airway is not functioning optimally, which can impact their sleep quality and overall well-being.

 

Sleep disordered breathing red flag #2: Mouth breathing

Does your child frequently breathe through their mouth instead of their nose? While occasional mouth breathing is normal, persistent and predominant mouth breathing can be a red flag for sleep breathing disorders in children.

 

Breathing through the nose has several important functions. It helps filter and humidify the air, promotes proper development of the facial structures, and aids in optimal oxygen uptake. When a child consistently breathes through their mouth, it suggests that their nasal passages may be obstructed or that they have difficulty breathing through their nose.

 

Mouth breathing during sleep can disrupt the natural airflow and affect the quality of your child's sleep. It may lead to increased snoring, dry mouth, and even daytime fatigue. Additionally, chronic mouth breathing can impact facial development, potentially leading to a long face, high palate, and dental abnormalities.

 

Common causes of mouth breathing in children include nasal congestion due to allergies, enlarged tonsils or adenoids, or structural abnormalities in the nose or airway.

 

Sleep disordered breathing red flag #3: Open mouth posture

Have you noticed that your child's mouth tends to hang open, even when they are not speaking or eating? This observation could be an indication of an underlying structural issue related to their airway and should not be overlooked.

 

An open mouth posture, where the mouth remains partially or fully open throughout the day or during sleep, can be a red flag for potential sleep breathing disorders in children. It is important to pay attention to this habit as it may suggest an obstruction or difficulty in maintaining proper airflow.

 

When the mouth is constantly open, it can lead to inefficient breathing and contribute to sleep disturbances. The position of the jaw and tongue can affect the openness of the airway, potentially leading to snoring, disrupted sleep patterns, and decreased oxygen levels during the night.

 

Sleep disordered breathing red flag #4: Head tilted back & chin up

Have you ever noticed that your child sleeps with their head tilted back and their chin lifted upwards? This position, although seemingly innocent, can actually be a sign that your child is attempting to open their airway to improve their breathing during sleep.

 

When a child adopts the head tilted back and chin up posture during sleep, it indicates that their body is instinctively trying to increase the airflow into their lungs. This positioning aims to alleviate any obstruction or blockage in the airway and ensure an adequate oxygen supply.

 

While occasional changes in sleeping positions are normal, persistent head tilting and chin lifting during sleep should not be overlooked. It could suggest the presence of sleep breathing disorders, such as obstructive sleep apnea or other forms of airway obstruction.

 

Sleep disordered breathing red flag #5: Exhaustion despite lots of sleep

It can be puzzling and concerning when your child consistently sleeps for an adequate duration, yet wakes up exhausted, exhibits dark circles under their eyes, or displays other signs of fatigue. This paradoxical situation could be indicative of underlying sleep breathing disorders affecting the quality of their sleep.

 

Sleep disordered breathing can disrupt the normal sleep cycle and prevent your child from experiencing restorative sleep. Despite spending enough time in bed, their sleep may be fragmented and shallow due to repeated awakenings or disturbances caused by breathing difficulties. As a result, they wake up feeling tired, irritable, and lacking energy.

 

If you observe these signs of exhaustion despite your child's seemingly sufficient sleep, it is essential to recognize them as red flags for potential sleep breathing disorders. 

 

Sleep disordered breathing red flag #6: Unresolved tongue ties

Tongue ties can be a controversial topic when it comes to sleep breathing disorders in children. While the association between tongue ties and sleep issues is a subject of ongoing debate, it is worth considering their potential impact, especially when coupled with other red flags we've discussed.

 

An unrevised tongue tie refers to a condition where the frenulum, the tissue that connects the tongue to the floor of the mouth, is tight or restricts the movement of the tongue. This restriction can affect various functions, including proper resting posture of the tongue at the roof of the mouth.

 

When a child has an unrevised tongue tie and exhibits red flags such as snoring, mouth breathing, open mouth posture, or other sleep breathing disturbances, it is plausible that the tongue tie may contribute to their breathing mechanics and overall sleep quality.

 

The tongue plays a crucial role in maintaining the structural integrity of the oral cavity and ensuring proper airflow. When the tongue is unable to rest in its optimal position, it can impact the size and shape of the airway, potentially leading to breathing difficulties during sleep.

 

While the direct causative relationship between tongue ties and sleep breathing disorders is not fully established, it is advisable to consider the potential relationship between these factors. In some cases, revision of the tongue tie may be recommended to improve tongue mobility and restore correct oral posture. However, it is essential to approach this decision in collaboration with healthcare professionals who can assess your child's specific situation and determine the most appropriate course of action.

 

Whew! Now if you've noticed several of these red flags in your child, there's no need to panic.

It's important to have a conversation with your pediatrician and an ear, nose, and throat (ENT) specialist to gather more information and ensure your child receives the necessary evaluation and support. 

 

Your child's healthcare team may recommend further evaluations, such as a sleep study or imaging tests, to gather more detailed information about their sleep disordered breathing. These diagnostic tools can help identify the underlying causes and guide the development of an appropriate treatment plan.

 

Treatment options for sleep disordered breathing in children vary depending on the specific issues identified. They may include lifestyle modifications, allergy management, removal of adenoids or tonsils, orthodontic interventions, or addressing tongue tie concerns, if applicable.

 

For a more in-depth exploration of this topic, you can refer to my Instagram story highlight, where Dr. Staci Whitman provides valuable insights. While I'm not an expert, I've gained knowledge through my sleep background and personal experiences. Feel free to reach out if you have any questions or concerns!

 

While I am NOT an expert by any means, I do have some peripheral knowledge on this because of my sleep background {and now I have some experiential knowledge from our experiences this past year}, so feel free to shoot me an email if you have any questions or concerns!