Does Your Child Need A Sleep Study?

Key Takeaways:

• Sleep studies are recommended for children who snore loudly at least 3 nights per week and show symptoms like breathing pauses or daytime behavioral problems.
• Children with sleep-disordered breathing often display hyperactivity rather than sleepiness, leading to potential ADHD misdiagnosis.
• Orthodontic treatments like palatal expansion can significantly improve airflow and reduce sleep apnea symptoms in children.
• Untreated sleep disorders can impact your child's growth, immune health, focus, and academic performance.
• Impact Orthodontics offers free airway-focused consultations for children and teens under 20 in Calgary.

Is Your Child Showing These Key Sleep Study Warning Signs?

That loud snoring from your child's bedroom might be more than just an annoying nighttime habit. For many parents, distinguishing between harmless snoring and potential sleep-disordered breathing requiring medical attention can be challenging. At Impact Orthodontics, we understand this concern and want to help you identify when a sleep study might be necessary for your child.

Sleep studies are typically recommended when children exhibit loud, frequent snoring plus additional warning signs like breathing pauses, daytime behavioral issues, or unexplained academic difficulties. While occasional snoring affects about 10% of children without indicating any underlying problem, persistent symptoms warrant attention.

How Parents Can Identify Sleep-Disordered Breathing at Home

1. Nighttime Symptoms That Require Medical Attention

As a parent, you're in a unique position to observe sleep patterns that doctors might never witness directly. Pay particular attention to:

• Loud snoring occurring three or more nights per week
• Breathing pauses lasting 10-20 seconds, often ending with gasps or snorts
• Unusual sleep positions (like sleeping with neck hyperextended or sitting upright)
• Restless sleep with frequent tossing and turning
• Excessive sweating during sleep despite normal room temperature

These nighttime observations provide crucial information that helps determine whether your child needs further evaluation through a sleep study.

2. Daytime Behaviors Often Misattributed to Other Causes

Unlike adults who typically become drowsy with sleep disorders, children often exhibit paradoxical hyperactivity when sleep-deprived. This can lead to misdiagnosis of conditions like ADHD when the underlying issue is actually disrupted sleep. Watch for these daytime signs:

• Hyperactive behavior or difficulty staying focused
• Unexpected academic performance decline
• Morning headaches or complaints of feeling tired despite adequate sleep time
• Emotional volatility, irritability, or mood swings
• Difficulty waking up in the morning despite going to bed at an appropriate time

These symptoms often improve dramatically once sleep-disordered breathing is properly treated, highlighting the importance of accurate diagnosis.

3. Physical Changes That Develop Over Time

Chronic breathing difficulties during sleep can gradually alter your child's physical appearance and development. Be aware of:

• Persistent mouth breathing during waking hours
• Teeth grinding (bruxism) that may be detected by dental professionals
• Development of an elongated facial appearance
• Growth concerns or failure to meet expected growth curves
• Dental issues including overcrowding or misalignment

Remember, multiple symptom clusters appearing together are significantly more concerning than isolated findings. If your child exhibits symptoms across several categories, consultation with a healthcare provider becomes increasingly important.

What Happens During a Pediatric Sleep Study?

The Polysomnography Process Explained

A pediatric sleep study, known medically as polysomnography, is the gold standard diagnostic tool endorsed by the American Academy of Pediatrics. During this overnight procedure, your child will sleep in a comfortable, child-friendly environment while sophisticated monitoring equipment records various physiological parameters.

The study measures:

• Breathing patterns and oxygen levels
• Brain wave activity
• Eye and limb movements
• Heart rate and rhythm
• Sleep stages and quality

While the thought of sleeping with monitoring equipment might seem intimidating, most sleep centers make the experience as comfortable as possible for children, often allowing a parent to stay overnight and bringing familiar items from home like pillows or stuffed animals.

How Children's Sleep Studies Differ From Adult Testing

Pediatric sleep studies use specialized criteria that differ significantly from adult standards. Children's breathing patterns naturally vary from adults, so pediatric scoring criteria define abnormal as an Apnea-Hypopnea Index (AHI) of ≥1 event per hour—much stricter than adult standards.

Additionally, home sleep testing, which is sometimes used for adults, is considered inappropriate for pediatric populations due to insufficient validation and the complexity of childhood sleep disorders. Children require the comprehensive monitoring that only in-lab polysomnography can provide.

Medical Criteria That Qualify a Child for Sleep Testing

When Your Pediatrician Should Refer for a Sleep Study

The American Academy of Pediatrics recommends that all children be screened for snoring during routine health visits. When concerns arise, pediatricians evaluate several factors to determine if a sleep study is warranted.

1. Screening Tools Doctors Use to Evaluate Sleep Disorders

Healthcare providers rely on validated questionnaires and physical examination findings to identify children who need sleep studies. Common screening approaches include:

• The Pediatric Sleep Questionnaire (PSQ) - Shows 85% sensitivity when scores exceed 0.33
• The BEARS screening tool - Assesses Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Snoring
• The Brodsky Grading Scale - Measures tonsillar size, with Grades 3-4 (tonsils occupying >50% of the airway) strongly correlating with OSA

2. High-Risk Groups That Require Special Attention

Certain children need polysomnography even with relatively mild symptoms. These high-risk populations include those with:

• Obesity (BMI at or above the 95th percentile)
• Craniofacial abnormalities
• Down syndrome
• Neuromuscular disorders
• Sickle cell disease

For these children, even mild symptoms can indicate significant sleep-disordered breathing that requires intervention.

3. Physical Examination Findings That Raise Concern

During clinical evaluation, doctors look for physical signs that correlate with increased OSA risk, including:

• Adenoid facies (long, narrow faces with chronic mouth breathing)
• High-arched palates indicating maxillary constriction
• Retrognathia (recessed lower jaw) or micrognathia (small jaw)
• Enlarged tonsils visible during oral examination

The Connection Between Orthodontics and Sleep Breathing

How Dental Professionals Help Identify Airway Issues

Dentists and orthodontists often spot signs of sleep-disordered breathing during routine examinations. These oral health professionals look for:

• Scalloped tongue borders (indentations from teeth pressing against the tongue)
• High-arched, narrow palates that restrict nasal breathing
• Severe dental crowding, particularly with posterior crossbites
• Signs of bruxism (teeth grinding) which can accompanies sleep apnea

Treatment Options That Combine Medical and Dental Approaches

For many children with sleep-disordered breathing, a multidisciplinary approach yields the best results. Orthodontic interventions can play a crucial role, particularly:

• Rapid Maxillary Expansion (RME) - Widens the upper jaw to improve airflow in the nasal passages
• Palatal expansion - Creates more space in the mouth for proper tongue positioning
• Mandibular advancement devices - Move the lower jaw forward to keep the airway open (typically for older teens)

These orthodontic approaches often complement medical treatments like adenotonsillectomy (removal of enlarged tonsils and adenoids), which is commonly the first-line treatment for pediatric OSA.

Long-Term Health Consequences of Untreated Sleep Disorders

The impacts of untreated sleep-disordered breathing extend far beyond nighttime symptoms. Research shows that children with untreated sleep apnea may experience:

• Impaired cognitive development and academic performance
• Growth delays due to disrupted hormone production during sleep
• Compromised immune function leading to more frequent illnesses
• Cardiovascular stress that may have long-term health implications
• Behavioral and emotional regulation difficulties

Early intervention is key to preventing these consequences and helping your child thrive both physically and academically.

Evaluation and Diagnosis in Calgary, Alberta

Free Airway-Focused Consultations for Kids and Teens at Impact Orthodontics

If you're concerned about your child's sleep and breathing patterns, Impact Orthodontics offers free consultations for children and teens under 20 years old. During these evaluations, our specialists assess airway and dental health, providing guidance on appropriate next steps.

Our team works closely with sleep specialists, pediatricians, and ENT doctors to ensure comprehensive care. While we don't diagnose sleep apnea—that requires a physician-ordered sleep study—we can identify warning signs and connect you with the right medical professionals.

For Calgary families concerned about their child's sleep and breathing, the path to better health often begins with awareness of these warning signs. Whether your child needs orthodontic intervention, medical treatment, or both, early identification leads to better outcomes.

Impact Orthodontics is committed to helping Calgary families understand the connection between oral development and healthy breathing for lifelong wellness.