By: Rochelle Zozula, PhD, DABSM and Paula Fabbie, RDH, BS, COM on April 18th, 2017
Oral Airway Dysfunction and Sleep Disorders in Children
Sleep is essential for the normal growth, development and mood regulation in children and adolescents. Unresolved sleep issues may present as “sleepy” or “overtired” children in the daycare setting or classroom, and these children may actually be manifesting underlying inattention or hyperactivity.
Sleep Disordered Breathing in Children
One major underlying cause for sleep disruption in children and adolescents is sleep-disordered breathing (SDB). The prevalence for obstructive sleep apnea (OSA) in children is estimated to be between 1-3%, with a peak age of 2-5 years. OSA is a common condition in childhood that can result in growth failure, learning, attention and behavioral problems.
Limitations of the T&A in Children
While tonsillectomy and adenoidectomy (T&A) can dramatically improve SDB in most children, and result in improved daytime behavior, SDB can return in these children in their teenage years. Some pediatric patients may also have co-morbid craniofacial abnormalities, and T&A may not correct their SDB. These patients may also have orofacial myofunctional disorders, which involve inappropriate muscle function and affect the tongue, lips, jaw and face. Incorrect tongue positioning may also contribute to improper orofacial development and misalignment of the teeth.
Oral Myofuntional Therapy (OMT)
Oral myofunctional therapy (OMT) and proper tongue positioning within the oral cavity is reported to improve mandibular growth, nasal breathing, and facial contours. OMT consists of isotonic and isometric exercises that target the oral and oropharyngeal structures.
Screening and OMT therapy can aid proper oropharyngeal development and functional breathing patterns. OMT has been shown to reduce AHI by approximately 50% in adults and 62% in children with these disorders. This lends support for the role of OMT for the treatment of SDB, and as adjuvant therapy for those patients undergoing ENT procedures, using PAP therapy, or using orthodontic appliances for treatment of OSA.
In addition, as a result of SDB, some children continue to have multilevel dysfunction that needs to be addressed. If you see pediatric patients in your sleep center, please consider OMT as supportive therapy for these complex cases!
To learn more about OMT therapy click here to sign up for an event: Biobehavioral Aspects of Oral Airway Dysfunction and Sleep Disorders in Children: Adopting a Multidisciplinary Approach to Treatment
Rochelle Zozula, PhD, DABSM and Paula Fabbie, RDH, BS, COM
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