Recently, when a young boy was shown on TV in San Francisco snoring loudly, as part of “America’s Funniest Home Videos”, the crowd predictably laughed their heads off. However, while the video may look funny to those who do not know better, what it was exposing was a young person who suffering from severe sleep apnoea, said Carole L. Marcus, Director of The Sleep Centre at the Children’s Hospital of Philadelphia.
To Carole Marcus, snoring is no laughing matter. Nor does she think it should be for anyone else. She commented, “Snoring is something that people often don’t take seriously, but it could be a symptom of a very serious underlying condition.”
The American Academy of Paediatrics recently released new guidelines regarding children being screened for snoring every time a visit is made to a paediatrician. Snoring is often related to sleep apnoea, and loud or severe snoring is almost certainly a sign of the affliction. What is worse, sleep apnoea is health concern not only directly, but also indirectly, as it manifests in both behavioural and health problems. Unfortunately, despite the obvious connections, the symptoms often go ignored in health screenings.
These new standards were released recently after her team of researchers reviewed over 3,000 studies. Paediatricians throughout the whole of the United States will adopt their standards but yet again the United Kingdom is shown to be lagging behind in snoring research and recommendations for its treatment.
“I can tell you from my clinical experience how many children fall through the net,” Marcus said. “Sleep apnoea is just so incredibly under diagnosed in kids.”
Sleep apnoea is the cause of repeated interruptions in breathing during a person’s sleep cycle. Children who suffer from the condition are more irritable and often wish to sleep during the day. Many of these children experience headaches and have difficulty focusing in school and with retaining information and commands.
“Parents need to make a point to watch and listen to their children while they are sleeping,” he said. “They definitely need to pay attention to snoring just as they pay attention to height and weight, and raise it with their paediatrician.”
Sleep apnoea affects between 2-5% of children; however, only a much lower percentage is diagnosed and receives any type of treatment. For every five children diagnosed with asthma, there should at least one child diagnosed with sleep apnoea.
“We’ve all heard the comment made, ‘This kid has asthma,’ but how often do you hear ‘This kid has sleep apnoea?’ It’s rare – far too rare.”
While removing their tonsils can cure some sleep apnoea, many others will need a vastly different type of treatment ranging from continuous positive airway pressure, usually in the form of machines that pump air through a tube and mask into the child’s airway, or the less problematic use of an oral mouthpiece, a chinstrap, or a combination of the two.
These new recommendations by The American Academy of Paediatrics break new ground in their steps for sleep medicine regarding children, and it is high time that this sort of focus took place here in the UK.
The key AAP comment was “It’s a big deal because it shows that we recognize the importance of sleep disorders in children. It’s a big change, and an important one.”
Canada meantime is heading down the same path under the leadership of CHEO, the Children’s Hospital of Eastern Ontario, where one of the few fully equipped Sleep Laboratories is specially addressing this problem and they are starting to make key findings available.
Their key findings include the conclusion that children from the age of five to ten years old need a minimum of ten hours of sleep per night for proper development, while teenagers need at least eight and a half hours.
These findings include that children from five to ten years old need a minimum of ten hours of sleep per night for proper development, while teenagers need at least eight and a half hours.
“We know that short sleepers eat more and move less as a result of tiredness and a lack of sleep,” said CHEO’s Dr. Jean-Philippe Chaput. “We also know that watching TV, using a laptop, and using mobile phones before going to bed will impact on their sleep quality.”
This lack of quality sleep can lead to problems such as diabetes, weight gain and even some forms of cancer down the road – all issues that CHEO is trying to address – and prevent.
By John Redfern
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