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ADHD or Sleep Apnea

by on April 24, 2017 | Posted in Sleep Apnea

Has your child been recently diagnosed with ADHD? Do he or she sleep well, or do they toss and turn all night long? Millions of children and adults struggle with symptoms of Attention Deficit Hyperactivity Disorder (ADHD). It is a condition with symptoms of poor concentration, impulse control, organization, and memory. It can be a frustrating and difficult condition, often affecting a child’s performance in school.

What if those children diagnosed with ADHD are, suffering from another disorder — a sleep disorder? Recent studies suggest that Sleep Apnea can be the underlying problem that causes ADHD. A diagnosis of ADHD in children frequently comes about after a child displays behavioral symptoms such as Lack of focus: difficulty paying attention, problems listening, forgetfulness, disorganization; Agitation, excitable, impulsive behavior: excessive talking, inability to sit still, difficulty playing quietly, tendency to interrupt, difficulty sharing or waiting for one’s turn.

In a study published by Sleep Research Society, found that children with obstructive sleep apnea had higher rates of behavioral problems including difficulty paying attention, hyperactivity, communication problems, and aggressiveness. They were also more likely to have learning difficulties and low academic performance than those without sleep-disordered breathing.

In this large-scale study that included 11,000 children, it was found that those with sleep-disordered breathing were more likely to show signs of hyperactivity, trouble interacting with peers, and conduct issues including aggressiveness and inability to follow rules. The study examined the effects of sleep-disordered breathing on children as young as 6 months. Researchers found that very young children who experienced some form of sleep-disordered breathing were, by the age of 7, were 40-100% more likely to have behavioral problems, diagnosed as ADHD.

Often enlarged tonsils and adenoids are the most common causes of sleep apnea in children. But obesity and chronic allergies can also be a cause. People with obstructive sleep apnea have episodes when they stop breathing, because of an obstruction of the airway causing them to temporarily wake up multiple times at night. As with adults, children with sleep apnea will be tired during the day. They may have problems concentrating and might have other symptoms related to lack of sleep.

If you have been told that your child has ADHD it might be wise to have them checked out for Obstructive Sleep Apnea. Sleep apnea in children is treatable. To confirm the diagnosis, the child may get a need a sleep study. At Raphaelson Dental Sleep Center we offer a convenient home sleep study that can help diagnose these symptoms since not every child with enlarged tonsils or with loud snoring has sleep apnea. Our sleep physician will evaluate your child’s test results to rule out OSA, and we will often refer your child to an ENT for follow up treatment. We feel that surgery is often the treatment of choice for kids with anatomical factors that cause OSA such as enlarged tonsils and adenoids. Call us today if you are interested in a sleep study that can be performed in the comfort of your home.

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Did you know that your personalized care at Raphaelson Dental Associates begins the moment you fill out your paperwork? Our dental family cares about you, not just a tooth or your mouth. We find that is it very important to know what is going on systemically with our patients, and sometimes we are given these clues from what we see your mouth. These clues can help us potentially save a person’s life.

Sleep Apnea awareness is becoming more relevant in the media since the terminal crash in Hoboken and the more recent accident in Brooklyn with the LIRR.  We believe Sleep Apnea is not talked about enough, and that is why so many people go undiagnosed. Sleep apnea is very personal to some of our employees and their families. We have seen the negative effects it can have on a person’s health when it is left untreated and that is why we feel it is important to screen our patients for this potentially dangerous sleep disorder.

As mentioned above our personalized care starts with your paperwork- primarily your medical health history. Chronic headaches, high blood pressure, stroke, acid reflux, heart attacks, depression, and stroke have all been linked to Obstructive Sleep Apnea. If you have any of these conditions our team will dig a little deeper into your medical history and look for common physical oral signs of OSA. When the mandible (lower jaw) is pushed back; the tongue, fatty tissue of the neck, and muscles in the upper airway are also displaced backward. This causes an obstruction of the airway when a patient with OSA sleeps on their back (which happens to be the exact position they are in our operatory chairs). As dental professionals, we can see these obstructions and other common physical signs of OSA during a routine check up or dental exam.  These common physical signs include heavy wear on teeth from grinding, a scalloped tongue, a higher Mallampati classification, enlarged tongue or uvula, a soft palate, and a narrow airway. During sleep, a patient with OSA clenches and grinds their teeth in order to wake up and resume breathing, which results in tooth wear. Patients with Class 3 or Class 4 Mallampati (see the picture below) usually have some form of OSA because of the small space in their throat that allows for the passage of air. A patient with a scalloped tongue is trying its best to push forward and open the airway again. When the tongue is in this state, the teeth can easily exert pressure on it to cause scallops or grooves at the edges.

Intraoral Check List for OSA

If our dental professionals observe any of these physical signs of OSA and our patients experience any of its symptoms, we will refer them for a Sleep Study. A Sleep Study or polysomnography is the only way to diagnose OSA. Raphaelson Dental Sleep Center offers a convenient Home Sleep Study that measures the number of times you have stopped or reduced breathing per hour ( known as the Apnea-Hypopnea Index). It also measures the drop in your blood-oxygen levels. Keep in mind that oxygen values under 90 percent are considered low and dangerous. After you have completed your Home Sleep Study, a sleep physician will read the results to determine whether you have sleep apnea. If you have Obstructive Sleep Apnea, the sleep physician will let your know whether your results are mild, moderate or severe.

If you have any of symptoms of Obstructive Sleep Apnea please contact our office for a FREE Consultation.  Common symptoms include: snoring, gasping for air, excessive daytime sleepiness, snoring, gasping during sleep, or insomnia.  At Raphaelson Dental Sleep Center, our patients with Sleep Apnea are treated with an Oral Appliance. Oral appliances are custom and comfortable, they fit like a sports mouth guard or an orthodontic retainer. The oral appliance holds the lower jaw forward keeping the airway open, preventing the tongue and muscles in the upper airway from collapsing and obstructing the airway. Raphaelson Dental Sleep Center works with hundreds of medical insurance companies for Sleep Apnea treatment. Our sleep coordinators will contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your treatment.

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Sudden cardiac arrest kills more than 300,000 Americans each year and often strikes without warning. Recent evidence suggests that there is a link between sudden cardiac arrest and sleep apnea, a common sleep disorder that causes a person’s breathing to pause or become shallow. This sleep disorder increases a person’s chances of developing heart disease and places them at a higher risk for sudden cardiac arrest.

Researchers found people with sleep apnea were 2.6 times more likely to have sudden cardiac arrest while sleeping during the hours of 10pm and 6am “The prevalence of obstructive sleep apnea in Western populations is high, (over 18 million) and will likely only continue to grow given the obesity epidemic and direct relationship between obesity and sleep apnea,” said lead author Dr. Apoor Gami, M.D., MSc, FACC, a cardiologist at Midwest Heart Specialists – Advocate Medical Group in Elmhurst, Ill.   In his study that sought out 10,000 Minnesota residents with suspected sleep disorders, it was determined that 78 percent of them had moderate sleep apnea. These patients were tracked and observed for up to 15 years, with an average follow-up every five years. During this time, it was reported that 142 of these patients had a fatal SCA or required resuscitation via CPR or automated external defibrillator (AED). Which concludes that the overall risk of this study was 0.27 percent. However, given that one in five adults suffer from even mild sleep apnea, this could add hundreds of thousands of people to that risk.

So why is sleep apnea so dangerous to the heart? It all has to do with your low blood oxygen levels. The body’s organs respond to the oxygen interruptions by demanding more blood.  This overworks the cardiovascular system and other major organs, which are supposed to be at rest. These sleep apnea episodes will wake you up from a deep sleep into light sleep stage, as your body reacts with a Flight or Fight response. The low oxygen levels during sleep can make you feel very tired in the morning and will contribute to more restless sleep. The multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat. Individuals with severe sleep apnea, have an 80 percent risk for SCA due to their blood oxygen levels dropping below 78 percent.

Research shows that oral appliance therapy is a very effective treatment option for Obstructive Sleep Apnea. The oral appliance supports the jaw in a forward position to help maintain an open upper airway. It is considered the first line of treatment for OSA by the American Academy of Sleep Medicine. Oral appliance therapy is a benefit provided by many medical insurance plans and our sleep coordinators will be happy to assist you with any questions.

Raphaelson Dental Sleep Center is very proud to be one of the few dental practices on Long Island to help the medical community treat Sleep Apnea. “We are excited to screen our patients for Sleep Apnea, knowing that we are improving their health and potentially saving their lives”. We believe it is our moral responsibility to the health of our patients to screen them for Sleep Apnea. Our sleep specialists are here to help, Transform Your Sleep, Redefine Your Health”.

Symptoms of sleep apnea can include: snoring, silent pauses in breathing, choking or gasping sounds, daytime sleepiness or fatigue, insomnia, morning headaches, feeling irritable, depressed, or experiencing mood swings, and waking up frequently to urinate. Talk to us about your symptoms, we are here to help! Call us for a Free Airway Evaluation today.

 
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