Obstructive Sleep Apnea (OSA) – Could It Be Why?

Lazy, dumb, slow, trouble maker, etc...all common labels on students not making the grade in school. However, a child’s academic performance may not be lack of intelligence or even poor behavior. School difficulties may, in fact, be caused by poor quality sleep. 18 Million people, including both children and adults, suffer from a problem called Obstructive Sleep Apnea (OSA). Unfortunately, 80% to 90% of Sleep Apnea sufferers are undiagnosed. This medical condition is caused by the closure of the trachea (breathing tube) during the night. Breathing stops, and then vital oxygen ceases to nourish the brain. What causes this condition?

Several factors may influence this serious health hazard:

• Enlarged tonsils and adenoids 
• Overweight and obesity 
• Large neck size (in children, more than 15 inches) 
• Smoking and/or Drugs 

Sleep Apnea increases the risk for…

• Daytime sleepiness and fatigue 
• Driving accidents 
• High Blood Pressure 
• Heart Attack and Stroke 
• Diabetes 
• Memory Problems 
• Irritability 
• Headaches 

When students do not get enough sleep as a result of OSA, their school work is affected because the are fatigued, sleepy and unable to concentrate in class. Home assignments are either incomplete or completely avoided. Behavior becomes affected and the student becomes a disciplinary problem.

Partial obstruction occurs when the tongue relaxes at night, particularly when sleeping on your back, allowing little air to go through. This can cause snoring, an early sign of complete closure of the throat. In any case, medical or dental intervention is essential and may include any of the following:

1. Continuous Positive Airway Pressure (CPAP) – considered the first line of defense for those that suffer from severe OSA. It can prove 100% effective...when worn. The CPAP method of forced air delivery uses a mask that fits over the mouth and nose and is secured with straps to ensure an airtight seal. This sometimes is too invasive for over 50% of patients. They find it uncomfortable, claustrophobic and inconvenient. 
2. Surgery – includes removal of enlarged tonsils, adenoids and/or the uvula; the tissue that hangs down from the palate in the back of the throat. 
3. Weight reduction – considered important together with or without other treatment options. A good diet with exercise is essential for the general health as well as reducing the likelihood of OSA. 
4. Oral Appliance Therapy – devices that are worn in the mouth, similar to orthodontic retainers or sports mouth guards. These appliances help prevent the collapse of the tongue and soft tissues in the back of the throat, keeping the airway open during sleep and promoting adequate air intake. Dentists with training in Oral Appliance Therapy are familiar with the various designs of appliances. They will work with your physician as part of the medical team in the diagnosis, treatment and on-going care. 

The ability to have a restful sleep at night, without disturbance in breathing may make a huge difference in a child’s performance in school and his/her behavior at home.

For further information in Obstructive Sleep Apnea or finding help please contact Dr. Gary Cohen at gacohendds@comcast.net. Dr. Cohen is a retired member of the Academy of Dental Sleep Medicine.