Sleep Tips for Back to School

Summer is over, and for your kids, this means they have to stop staying up all night and have to get to sleep so they can wake up for school in the morning. Unfortunately, this can be a hard thing for kids to do. If your kids are having trouble getting to bed or to sleep on time, you have to step in. Here are a few tips:

• Turn off cell phones, computers, and the TV about an hour before bedtime. This is for you as well as your kids. Laptop use in bed has been implicated as a major recent factor in sleep disorders.
• Create a bedtime routine, and go through it with your children.
• No caffeine at least 12 hours before bedtime. This includes chocolate, whose caffeine content can have a big impact on kids' ability to get to sleep. Substitute oatmeal cookies instead of chocolate chip.
• A regular bedtime is a big help for kids getting to sleep. Set a bedtime and stick to it. If your kids are having trouble transitioning between weekdays and weekends, you need to set the same bedtime for every day.
• Stand up for sleep. Kids often want to stay up for chatting with friends or another story, but you need to set firm limits.
• Keep your kids' rooms cool at night. This emphasizes to the circadian rhythm system that it it's night and time to sleep.

If you are noticing that you are doing all this, but your child is still showing signs of daytime sleepiness, bad mood, or inability to concentrate, they may actually be suffering from childhood sleep apnea, which is a major health risk and should be treated.

To learn more about treatment solutions for childhood sleep apnea, please contact a local sleep dentist today.

How Corticosteroids Treat Childhood OSA

Although the largest portion of obstructive sleep apnea sufferers are adult males age 50 or over, childhood obstructive sleep apnea (OSA) is a serious problem. Childhood sleep apnea can result in behavior problems, school difficulties, and serious health consequences for its victims. Unfortunately, treatment of the condition can be difficult, and the preferred first line of treatment, surgery, is not as effective as doctors would like. Some studies estimate the effectiveness of surgical treatment to be as low as 50%. When you add in the risk of surgical complications, it seems that a nonsurgical treatment option may be a better front-line treatment.

Fortunately, one alternative sleep apnea treatment is the use of nasal corticosteroids. The most commonly studied steroid is fluticasone, which has shown reasonable success. In one study, children receiving nasal steroids saw a reduction of arousals due to apneic events of 3.5/hr. In addition, less than half of children treated with nasal steroids went on to have surgery, compared to three-quarters of children treated with placebo.

In the most recent study, researchers looked at the mechanism that allows the corticosteroid to treat sleep apnea. They found that corticosteroids significantly decreased the amount of cytokine IL-6, which has been associated with cardiovascular risk and death. Although the study is brief and involved only a small number of children, it does point to an important treatment option for childhood OSA sufferers.

If your child is having trouble in school or suffers from behavior problems, you should consider the possibility of childhood obesity among other potential causes. To learn more about how to get the best treatment for childhood sleep apnea, please contact a local sleep dentist today.

Childhood Sleep Disorderes, ADD, ADHD and other "Mental Disorders"

I was directed here from a childhood sleep forum after investigating the connection between sleep and ADHD and other mental illnesses from the book It's Not Mental and the blog on sleep being a causative factor.

I didn't know alternative devices to CPAP even existed, and have a family member who absolutely hates the CPAP and the parents will be very happy with the information you have provided.

Thank you!

Dr Shapira Response: Research is finding that sleep is involved in almost every physiologic and disease process to some extent. I believe that early intervention with young children willl make incredible changes in developing children. Research has shown that the speed of brain development is strongly affected by the quality of sleep (especially in the case of sleep apnea). Patients with undiagnosed and untreated sleep apnea have permanent changes in brain development.

Treatment of pediatric sleep apnea is often limited to removal of tonsils and adenoids and this can be a grave mistake. The developmental changes in the oral, nasal and pharyngeal tissues do not normalize after T&A surgery.

Orthopedic widening of the maxilla (and maybe mandible) is incredibly safe and effective in children should always be considered as part of the total treatment. It has also been suggested that Rapid Maxiallry Expmansion or RME be considered prior to removal of tonsils oradenois to reduce surgical risk and morbidity. I frequently build expansion into appliances that treat sleep apnea. The same bite changes that are considered problematic in some adults are actually beneficial to children wearing oral appliances.

Parents in the Midwest have access to Dr Alexander Golbin (http://chicagosbmi.com/about-us) who is a leading expert on children and sleep disorders. He wrote the book on Children's Sleep and was head of Child Psychiatry at cook County Hospital for 25 years. He is an excellent resource for parents of children with Autism, ADD, ADHD, and bedwetting and other developmental challenges.

I have an adult practice with the exception of children with sleep disordeers, TMJ disorders, TMD or chronic headaches. Chronic headaches in children and adolescents are almost always related to the stomtognathic sytem including teeth, jaws, jaw joints, jaw muscles, sinus regions and the all important Trigeminal Nerve.

I have thousands of visitors sent to my site from other health blogs and I thank you for listing my site on those blogs. We can improve the health and quality of life for patients

SLEEP APNEA IN CHILDREN IS FREQUENTLY TREATED WITH REMOVAL OF TONSILS AND/ OR ADENOIDS. ORTHOPEDIC APPLIANCES AND SLEEP APPLIANCES ALSO HAVE A ROLE.

Dawn: My 5yo daughter had T&A sx at 22mos which seemed to help her osa up until about 8months ago. She is now going to start using a cpap for severe osa. I now know she will need orthodontic and/or maxillofacial close monitoring. I am wondering if any of thes oral applianced are used with children this young also, and if there is anyone in the northern ******** area who is best trained for this.

Dr Shapira: Dear Dawn,

There is an excellent Sleep Apnea Dentist in your area Dr *********** I just talked to him and he would be happy to work with you and your daughter. If there are any questions during treatment we can discuss it as treatment pprogresses.

There would actully be two appliances involved a nightime appliance and a daytime appliance. This will allow the widening of the maxilla while using an appliance to prevent apnea...Dr ******* has a great deal of experience in treating sleep apnea.

This will not only treat the sleep apnea but begin treating the underlying orthopedic problem. You child will still need orthodontics (probably) in the future but the early orthopedic therapy will make future orthodontics easier.

MORE ON THIS TOPIC: SLEEP APNEA IN CHILDREN IS FREQUENTLY TREATED WITH REMOVAL OF TONSILS AND/ OR ADENOIDS. ORTHOPEDIC APPLIANCES AND SLEEP APPLIANCES ALSO HAVE A ROLE IN TREATING CHILDHOOD SLEEP APNEA TREATMENT.

There is a question whether tonsilectomy and adenoidectomy should occur before of after widening of the maxilla. Widening the maxilla will improve the airway and possibly lower post-op complications. If T&A is done prior to widening studies have shown that it does not correct the development orthopedic problems. All patients should be reevaluated for sleep apnea and for maxillary expansion.