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Published on: December 6, 2016
Sleep respiratory problems in children: Diagnosis and contribution of the orthodontist
Mathilde Galievsky1, Astrid Lambert2
14, rue Corneille, 78140 Vélizy-Villacoublay, France.
Insights
Obstructive sleep apnea/hypopnea syndrome (OSAS) in children is often undiagnosed due to varied symptoms. Early detection by orthodontists and sleep specialists is crucial for managing this condition and its significant health impacts.
Area of Science:
- Pediatric Sleep Medicine
- Orthodontics
- Respiratory Medicine
Background:
- Obstructive sleep apnea/hypopnea syndrome (OSAS) is underdiagnosed in children, presenting with diverse clinical signs.
- Diagnosis relies on recognizing nocturnal/diurnal symptoms and analyzing sleep recordings for abnormal respiratory events.
- An Apnea/Hypopnea Index (AHI) quantifies severity, with thresholds differing for children (1.5AHI/h) and adults (5AHI/h).
Purpose of the Study:
- To highlight the importance of early OSAS detection in children.
- To emphasize the role of orthodontists in identifying at-risk children.
- To underscore the potential for orthodontic treatment in managing OSAS by improving upper airway volume.
Main Methods:
- Clinical observation for identifying children at risk of OSAS.
- Initiating dialogue about sleep issues with young patients.
- Referral to sleep specialists for definitive diagnosis and management.
- Utilizing sleep recordings to calculate the Apnea/Hypopnea Index (AHI).
Main Results:
- OSAS can lead to learning difficulties, mood problems, growth abnormalities, and neurodevelopmental delays.
- The syndrome may also impact children's metabolism.
- Orthodontic intervention can potentially prevent or treat OSAS by enhancing upper airway dimensions.
Conclusions:
- Early detection of pediatric OSAS is vital, with orthodontists playing a key role.
- Multidisciplinary management, led by sleep specialists, is essential for OSAS patients.
- Orthodontic treatment offers a potential avenue for improving upper airway function in children with OSAS.
Abstract:
Obstructive sleep apnea/hypopnea syndrome (OSAS) is still not widely diagnosed in children as its clinical signs are extremely variable. The diagnosis is based on recognition of the nocturnal and diurnal clinical symptoms of the syndrome, but above all on analysis of a sleep recording revealing abnormal respiratory phenomena. This recording makes it possible to determine an Apnea/Hypopnea Index (AHI) for each hour of sleep. The abnormality threshold is 1.5AHI/h for children and 5AHI/h for adults. The higher the index, the more severe the OSAS. The consequences of this syndrome are far from negligible, leading possibly to learning difficulties, mood problems, growth abnormalities and delayed neurocognitive development; it may even have an impact on metabolism. The orthodontist, as a health specialist frequently in contact with young patients, needs to be able to detect OSAS by launching a dialogue on the question of sleep so as to refer the patient to a specialist who can confirm the diagnosis. Through observation of the patient, it is possible to identify children at risk. Potential OSAS can then be prevented or cured by increasing the volume of the upper airways thanks to orthodontic treatment. Management of patients suffering from OSAS is multidisciplinary, under the direction of the sleep specialist.
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