Snoring/ Obstructive Sleep Apnoea affecting up to 25 per cent of Australian Children

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Up to a quarter of Australian children may have OSA.
Up to a quarter of Australian children may have OSA.

Children who regularly snore are likely to have Obstructive Sleep Apnoea (OSA), which has been linked to behavioural problems, inattentiveness, hyperactivity and delayed development says researcher and orthodontist Dr Vandana Katyal.

Dr Katyal attended the 24th Australian Orthodontic Congress in Adelaide and said research was well advanced on OSA in adults but relatively new for the same disorder in children, partly because it was harder to diagnose.

Dr Katyal’s research, in collaboration with the University of Adelaide and the Adelaide Women’s and Children’s Hospital’s busy Sleep Disorders Unit which sees up to 1000 children each year, has found strong correlation between children at risk of sleep-disordered breathing and narrow upper jaws.

“Similar to adults, there is no single cause of sleep-disordered breathing. Levels of childhood obesity in children, which have tripled in the past 25 years, are a contributor, so too are the prevalence of asthma , allergies and other auto-immune responses,’’ she says.

“But children with this disorder show reduced attention capability, lower academic grades, hyperactivity, increased aggression, irritability, emotional and peer problems.”

“Nearly fifty per cent of chronic snorers or those with sleep apnoea have been diagnosed with ADHD. What they may be needing most in their treatment is a good night’s sleep,’’ she says.

Early diagnosis was particularly important to reverse detrimental effects, which were amplified at vulnerable periods in a young child’s development, she said.

“One study showed that 13-year-old children with low academic performance were more likely to have snored during early childhood compared with children of high academic performance,’’ Dr Katyal says.

Estimates are that between 10 to 12 per cent of Australian children have either chronic snoring or sleep apnoea, some research has it higher at 25 per cent, she says.

Parents needed to be aware that, outside of a cold or other influences, snoring in children is not normal and those who regularly snored, more than three nights a week, should be screened for OSA.

Part of her research, has shown sleep apnoea was common in children with a narrow jaw and palate (nearly 70 per cent of cases), which can be helped by an orthodontic appliance, or plate to widen the upper jaw. Children best suited to this treatment were aged between 6 and 16 years. The research also indicated that frequent snorers regularly showed lower quality of life and this was normalised after the expansion of upper jaw by a plate.

While an Adenotonsillectomy, or removal of tonsils, was the first line of treatment for children with OSA, up to half of those with removed tonsils continued to have OSA, she says.

Dr Katyal hoped future research would lead to a greater degree of collaboration between sleep medicine, ear, nose and throat specialists and orthodontists to establish a successful treatment for each child.

Dr Katyal’s research, read a review on the Australian Orthodontic Journal Vol 29, November 2013 (below). She also has had recent publications in the American Journal of Orthodontics & Dentofacial Orthopaedics.

The research was partly funded by the Australian Society of Orthodontists Foundation for Research and Education (ASOFRE).

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