Friday, November 19, 2010

Health: Is your child sleeping well?

Sleep apnea in childhood can lead to poor growth and performance in studies, warns an ENT surgeon. ANNIE FREEDA CRUEZ writes

WITH 20 per cent of Malaysian children being obese, Dr Raymond Tan Suan-Kuo, a consultant ENT surgeon and snoring specialist says that sleep apnea can be a problem for youngsters as much as it is for middle-aged men.

Dr Tan, who is attached to Pantai Ampang Hospital, estimates that five to 10 per cent of Malaysian children suffer from sleep apnea.

Sleep apnea is characterised by brief but numerous involuntary breathing pauses during sleep. These pauses make it impossible for sufferers to enjoy deep, restorative sleep. Sufferers often feel sleepy during the day and their concentration also suffers, he says.

“While being overweight or obese are risk factors for sleep apnea, being thin does not preclude a diagnosis.” The repercussions of sleep apnea and poor sleep for children are vast. When children do not get enough sleep, they are at risk for health, performance and safety problems. Difficulties in school are often the result. Sleep deprivation in children is often overlooked or attributed to attention-deficit or behaviour disorders.

Parents should be aware of night and day symptoms of sleep apnea. These include: • Snoring • Breathing pauses during sleep • Restless sleep • Mouth breathing • Difficulty getting up in the morning, even after getting the proper amount of sleep • Hyperactivity • Inattention • Behaviour issues such as aggressive behaviour, problems at school • Sleepiness • Headaches Other symptoms of sleep apnea are: • large tonsils and adenoids • an ‘Adenoids face’ — Long face with flat cheeks, open-mouthed look with thick lower lips due to years of mouthy breathing and little air entering the maxillary (cheeks) sinuses. • high blood pressure • poor growth (failure to thrive) and also, paradoxically, obesity • heart problems such as heart failure, and lung problems To help a child get a good night’s sleep, Dr Tan says parents and children should plan a daily schedule that includes the basic sleep requirements for a particular age group. This schedule should be maintained on the weekends, though students can be permitted to sleep in one or two hours on weekend mornings if necessary. While individual sleep needs can vary, the amount of sleep a night for particular age groups are: • 18 months — 12-14 hours • 3 years — 11-13 hours • 3-5 years (10-11 hours/ night) and • 5-12 years — 9.25 hours Dr Tan advises to “create a bedtime routine. Bedtime routines are important, regardless of a child’s age. It should include at least 15-30 minutes of calm, soothing activities. Discourage television, exercise, computer and telephone use, and avoid caffeine (found in beverages, chocolate and other products). It is important to also achieve a balanced schedule. “Identify and prioritise activities that allow for downtime and sufficient sleep time. Help students avoid an overloaded schedule that can lead to stress and difficulty coping, which will contribute to poor health and sleep problems.” To help children maintain a healthy body weight, parents need to be supportive. “Plan family activities that involve exercise. Instead of watching TV, go hiking or biking, wash the car or walk around the mall. Offer choices and let your children decide,” he says, adding that it is crucial to eat meals together as a family unit and to eat at the table, not in front of the television. “Eat slowly and enjoy the food,” he adds. He also stressed that food should not be used as a form of reward or punishment. Children should not be placed on restrictive diets unless asked to do so by a doctor (for medical reasons). Children need food for growth, development and energy.

If parents suspect that their child is suffering from sleep apnea, they should seek treatment from an ENT doctor. Obstructive sleep apnea may develop even in infancy. Retrospective studies note that many parents with children diagnosed with obstructive sleep apnea recall that their child’s snoring began within the first months of life. Most children with obstructive sleep apnea are aged between two and 10 years. The mean age at diagnosis has been reported to be 14 months, plus or minus 12 months.

Treatment for obstructive apnea involves keeping the throat open to aid air flow, such as with adenotonsillectomy (surgical removal of the tonsils and adenoids) or continuous positive airway pressure (CPAP), which is delivered by having the child wear a nose mask while sleeping.

Read more: http://www.nst.com.my/nst/articles/Health_Isyourchildsleepingwell_/Article#ixzz15ktjKNwm

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