33- Identifying Sleep Disorders in Children

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I have read and today were going to talk about how to help their children distinguish between curable reasons for ADHD and we have a special guest that can help us with that because how often do we suffer old, my child, 80 ADHD. My tongue cannot concentrate and many of the things that we do worry about our children and Dr. Michelle Addison can really help us with these answers she works with Dr. John Addison family dentist in Miami, Florida. Implementing advanced any therapies and technologies in their practice and Dr. Addison's dental practice is gold certified by the eco-dentistry Association and Dr. Addison specializes in dental services that treat sleep apnea Corporation with patient's primary care physicians and Michelle Addison is the director of the Florida dental sleep Center, Michelle, thank you for joining us the pleasure Michelle. There is so much more to dentistry lately that I wanted to talk to you about that start with the South Florida dental sleep center. Can you tell us a little bit about that. Of course Florida dental sleep center is actually the only practice that dedicated to treating sleep apnea and sleep disorders in adults and children using custom-made dental devices and some of the things that concerns us all is the health of our kids some symptoms of the kids can send link to your work, such as under icicles for postures short upper lid over 10 mouth breathing, recessed chin what those things mean how can we recognize and what the 62. There are many symptoms that we can see in children that some parents have gotten used to dissing their children this way and don't realize that they are actually symptoms of sleep disordered breathing.

Sometimes kids will have chapped lips. Or they'll have underwrite circles like you mentioned or they'll put their head a little bit forward and you'll see that not going a little bit forward.

All those are symptoms of kids that have constricted airways that is affecting how they are breathing and is therefore affecting how they're sleeping so you're seeing underwrite circles because kids are tired. They're not getting the proper ear while they're sleeping and they're not breathing properly. You're also seeing things like chapped lips. Frequent throat infections you see a lot of kids nowadays and have to have their tonsils and adenoids removed. This is because kids are trying to breathe through their mouth water sleeping many times because they're not getting proper air when they're trying to breathe through their noses.

So these are all symptoms that can point to the fact that children are not properly breathing water sleeping. I suppose the details not sleeping right is a sector they may be a little bit irritable and with these throat infections. I know working in the medical field that they can lead to infections and sometimes like you said we see Lips and we don't think anything of it. Throat infection think that the kids getting constant zoning ear infections and were only treating the symptom, not the sweater really and so we have to look at where it's coming from and it's not necessary that the kids immune system is low, but the kids may not sleeping right and from what I'm hearing you can tell these things by the symptoms.

If you see your child breathing with the mouth open.

I know my daughter has a little bit of a recessed chin. That's because she's got 3Q 29 micro deletion syndrome which gives her pixie look pixie face look right. But these things. I mean even the I didn't know under eye circles.

I mean, I know that that's a problem with sleeping but that can lead to these things to and when you're talking about forward posture is not so much the back. The head is forward on the right slightly inclined forward which you'll see a lot of younger kids. If you win now when you're at the grocery store standing in line or you're looking at your own children, you'll see people will have their head slightly forward in their neck is a little bit down when you make that posture that opens up your airway so that is a way of getting better oxygen it's done subconsciously when these airways are constricted so the person is trying to get oxygen something that we would even realize or notice right and the right.

The upper lip over jet obviously is just upper lip extending a little bit further than the bottom wall yet another issue that what's causing that is because when you have this mouth breathing both at night and during the day it will affect the growth of the jaw, so you will see a narrower jaw and the pallet will be very high up where you place your tongue will be become higher and higher and that will lead to crowded and crooked teeth that will that affect the way the lips look so it is it is affecting the way these kids are developing and that is that is a big focus for us because we want their jobs to develop properly, not so much to straighten their teeth like happened later with braces, but to really help their jaw develop so that there airway is not constricted as they become adults and that is important because these things I didn't know. I suppose other people don't know also. So is if you're looking at these things that your child then it's the best thing to do is look in to the dentist and look into if these are one of the things that are causing the problem.

First, right in my getting that right that would be a good a good way to, you know, we see so many children that you know their parents will bring the manna may have fallen tonsils and adenoids, and they also have ADHD. Well the first thing we want to look at is, do they have sleep disordered breathing because that may be the reason that their mouth breathing, which is causing the tonsil and adenoid problem and that they are unable to focus because they're tired, so if we can get to the root of what's causing it. Half of the kids that are diagnosed with ADHD actually may have sleep disordered breathing.

They're finding now and wants to sleep disordered breathing is correct and what is the successfully where the symptoms disappear they will completely grow out of it because what were doing is were helping their jaw develop properly so this this treatment that we do is as a child grows until their jaws developed and it's just custom-made mouthguard that they're sleeping with. But it guiding the proper growth, which means that there airway will be completely open. It will not get constricted by the narrowing of the jaw and all of the other developmental issues that will follow. If it's not corrected any proper acts oxygen your brain to work properly, obviously.

And these things are very important, especially early ignition and prevention so that it doesn't cause problems later on. For those that are tuning in on you host any coupling you're listening to the care. This show is focusing on diseases in children and adults can be treated by your dentist. We are joined by Michelle Addison to help it. It's wonderful that you do. You are the director. This did help with these things because it's so common in today's world that so many kids are diagnosed with ADD and ADHD, and it can't possibly be true that so make it happen.

So it makes sense that he could just be a simple thing of making sure the sleep right if he needs them, and device to help them and need to be looked at and so these are the things that we need to really focus on so that we can be better parents and assess the situation better so that we can all go about normal life that I Boris yeah he's from Bulgaria and I know that the dental the dental practices are very different there and need your brother and he have a recessed chin that he get is that why he has teeth and gums. I know that they can to Dr. others. There were no may resort it will do that. That's a great idea where the dots gums to show the.

The families are important. Like for example to the show is representing the whole Florida practice of Dr. others of the better half really right that's true through that's cowardice. But anyway so Michelle can you tell us the your website.

If people want to look it up and make an appointment sure our website is www.D like other than Sam effort in Florida.

South Florida dental D, SC.com and the South Florida dental sleep Center.

If you want to Google it that will take you to our sleep site. We have a separate dental website which is www.addisonaddiso1-dental.com also googled Dr. Jonathan Riddell great so let's continue with the conversation about well sleep I wanted to ask you about mouth breathing and sneering that Bishop is becoming very associated with lower learned a new word SPD sleep disorder. Yes, it comes to get them out. Breathing is very important because were truly meant to breathe through our nose. So when we bring to our node were getting warm humidified air that's written nitric oxide with Warden for overall health. Yeah, but when you're breathing through the mouth. You're getting cold, dry unfiltered air so that is affecting the way the tonsils and adenoids are going to be a part of help because when they're getting that unfiltered air they're going to swap become enlarged and what that does is that closes up the airway, even more so now.

The kids already had a constricted airway started, mouth breathing, another tonsils and adenoids will now they can get even less oxygen it and once her mouth breathing is also keeping their tongue from being in the right place, which means that their jaw isn't growing properly and also their muscles that they used to speak and swallow into are not developing properly.

So over time you getting kids that are tired that in school, maybe not functioning as well. We see lower science and math grades.

We see lower overall IQ scores when kids aren't sleeping properly. Speech delays. All of these things that then affect how these kids go through their overall schooling. Because of this is undiagnosed is going to affect them as they apply to colleges can affect them later in life. So the really important that we get a handle on it as young as possible referrals from primary care physician so the beauticians because there will be the first people to see something others that are prescribed violence or do we do we can cushion from primary care doctors from ENTs from speech pathologist. Some psychologists so we do more, getting more and more. At the same time we are having to educate a lot of nationals because we tend to know about these studies before they do the coming right to us was a book about the number so what is mouth speaking and snoring is pretty significant because I see that 9/10 children have one or more symptoms of sleep disordered breathing while 60% of the nine of nine children have one or more symptoms of the sleep disorder is 90% and of the study, 60% of the sample had four or more symptoms while also between the age of four and 12 feet between the ages of four and 1292.6 symptoms did not self-correct lot 30% worsening with age can tell us a little bit about that because I didn't know, mouth breathing and snoring was so important, they are very important and snoring is already assigned that somebody is not getting proper oxygen intake. So that's already a sign of sleep disordered breathing soon as you hear snoring. No child should nor though we often have parents come in and they think that the snoring is something cute that their child doing but in reality no child should be snoring about the goals nor no snoring way to state that everything is as it is and you know it should not be. It should not be considered something normal so any child snoring should definitely be evaluated.

Looking at all of these these different you know symptoms that they have grinding of teeth is also something that the parents will sometimes bring their children because they notice the grinding their teeth grinding their teeth is means that the child is trying to move their bottom jaw forward water sleeping to open up their airway because when you bottom jaw is pulled forward that opened up your airway. They do that repeatedly throughout the night and not make that noise that would alert you that your child is grinding his or her teeth. That's why it's happening so all of these are things that happen what the child weeping that are signals that something needs to be done.

That evaluation should take place with some steamy cattle six years will return shortly and now we continue with daily gobble in the 218 80. Welcome back to the cell for this. I just have a by Michelle Addison and were talking about how to help our children early early dental preventative care and proper sleep patterns. Michelle I wanted, I found something very interesting that you had sent me. I wanted to talk a little bit more about compromised airways because it says that the last auction when you receive next oxygen in the brain. There's an inability to flush out unhealthy plaque from the brain and this could be responsible for unhealthy plaque buildup leads to dementia and Alzheimer's later on in life can yeah spend more and more studies are actually being released that are showing that sleep is very crucial to getting rid of these deposits. So when we have children that are already having sleep disordered breathing and already unable to flush out these this plaque buildup you we are seeing now. Studies coming out showing that it is a cause of Alzheimer's and dementia over time which is even more reason why we want to address this as early as possible because if we can correct the way that the job is growing and have it developed properly and have the airway not be constricted then were going to have adults that are not dealing with sleep apnea because of obstruction of the airway, which is what is then very difficult to treat because were either going to have to use a CPAP machine or a dental device or combination of both, and were not can I have the same effectiveness as we would if we just had the job developed properly initially so that the airway is not constricted in the first place and fastest education because people that this could lead to dementia and Alzheimer's. Not only that but the problem is not bidding patterns. It can affect normal, proper function of the tongue and or official muscles and also deal with speaking and swallowing and showing definitely, definitely, there are so many ramifications that really can be addressed early and can give kids the best chance of succeeding not only in school all but later in life as far as her health is concerned and also the court yes we we always say to parents. We would rather be treating them as children then have them here as an adult, trying to correctly but demented is overlooked snoring or what we don't think it's a big deal but was no you don't pay attention to it is not painful, and we don't know about the ramifications writer. That's why it's important. Just like you Michelle, thank you for you all.

Thank you, thank you for having me on here, but it really is ignored and it's often you know way to joke around you see it on sitcoms on TV and being thrown out of the bedroom because he snoring. It made more of a joke, but really sleep apnea for adults is you know is sleep disordered breathing that had gone uncorrected and so has ramifications is implicated in diabetes, higher rates of Alzheimer's. You know, different kinds of kidney diseases and the list goes on and on high blood pressure, heart disease, so really you know when were were treating this for kids were not only treating it for what were seeing at the moment which is having them be able to concentrate better at school and having them be able to you know if they're wetting the bed stop wetting the bed or you know so many different things, but also when they become adults do not have higher risk factors for all these other diseases.

While I understand I mean these things now can you tell me how this crooked teeth come into play well because crooked teeth is now a sign that the jaw has not developed properly so it's starting to develop up to narrow and so you have the people not having enough space to grow in when the adult teeth are coming in and so now you'll see, for example, many of the kids around us will be eight years old and they're doing pretty orthodontic, so they have braces very young, and then they take them often have braces again later, and what that doing is the braces initially are trying to open up the pallet up where the tongue rest to try and give more room for these teeth to come in the plot limited by the time you're doing that the already the jaw didn't develop properly so we want to get to this as early as possible so that we can guide the jaw to develop properly then we don't need to expand those pallets we don't need any orthodontia, because the teeth are going to come in in the right places and they're going to come and straighten speaking about getting to this early.

What are your thoughts about bottlefeeding, pacifier in thumbsucking money recommendations well when kids are bottle bottlefeeding thumbsucking or using a pacifier that's going to increase the chance that the pallet is higher because it's making an indentation up in the pallet that normally would not be there if they were breast-feeding which does not create that so when you do have, you know, prolonged use of the pacifier like we see a lot of kids now walking around their toddlers using that for their still drinking. And though in a bottle when their two and three years old that alt.all contributing to the pallet not developing properly the same thing for soft diet. Now kids eat a lot of the little pouches or to eat the little path that will melt in their mouth.

It's not encouraging the proper chewing motion that kids used to have when they would eat harder foods and so that is causing all of the jaw to develop in a different way.

Ray and I recommend more than six months of bottlefeeding are pacifier thumbsucking is not the same when it comes to breast-feeding because I breast-fed my daughter for two year old no no impact because the breath within the babies mouth is not having that same indent pattern into the pallet that something that's not natural is going to be having soda pacifier. We don't recommend longer than six months. We recommend that bottlefeeding usually ends around six, 6 to 8 months six is better if you can switch over to a sippy cup and then trying to introduce foods that are good to have baby chewing versus foods that are going to be so soft is best dispensed a funny thing that I saw that studies show that half of the kids are diagnosed with ADD and ADHD actually suffer from this sleep disordered breathing that was speaking about right. We recommend that any child really that's been diagnosed with ADHD undergo a sleep study, it's really important to really understand how their sleeping and if they're getting quality sleep if they're getting into REM sleep. We really need to see what percentage of their sleep is divided between light deep in RAM. How many times are waking up during the night more complicated and much is something to the dentist, Dr. Thomas, we dutifully study you at home. They don't know. This motion is to give the mother to the know know we we we have different machines now so they're very simple to use and you can use them in the comfort of your own bed. We show that we saw the patient how to use it, whether it be kids or adults and we can't, we will have the you know will run the machine when it comes in and see exactly what the results are. It's read by a board certified sleep physician and then we have a diagnosis that we can present the patient is important because a long time since effects of sleep disorder that the sleep disordered breathing in regards ADD ADHD is that 50% are held back one grade and 30% are held back to grades so it is it is very important. I don't have a long-term effect on their IQ. IQ with sleep disordered breathing can go down by 10 to 20 points which can make a difference, and it's actually valued at something like $170,000 over a lifetime of a child in what then when they start working but they're able to achieve careerwise based on you know the holdback that they had when they were in school and everything else that we do try as much as possible of a parent has gotten an ADHD diagnosis to get the sleep study done.

And sometimes we do have to do you know when in lab sleep study because there may be other things that were concerned about. And if that's the case, we work with a lot of specialists and were able to refer patients to them and work together to get them treated so it is very something that we very much recommend if there is an ADHD diagnosis of their excellent that's great to hear just tuning in, so you can listen to us every Friday at 2 PM on the radio or podcasts again on Sunday at five on Sirius XM 10 131 or through your book your now we continue with daily gobble in the 218 80 and this is the chair with your hosting Mikado life every Friday at 2 PM and on Amy.com or call in number is 305541350 again that's 305-541-2350. Please call if your child has been wrongly diagnosed with ADHD would like to hear from you. We are joined by Michelle the director at the South Florida sleep center so thank you for stainless with us. Michelle, I wanted to ask you once you know there is a diagnosis of ADHD or ADD and take you bring the child or the person goes to the dentist and wanted to know if if sleep disorders.

The corrected without medications or is there instances where medication is needed. While we begin with. System called helping question greatly here that with Dr. Addison is a certified star provider and so what that is is a series of habit correctors and custom-made little mouthguard that are placed in the child's mouth water sleeping. Sometimes when the younger we do have them put it in like maybe an hour during the day. Water coloring or watching TV, just to get used to it, all the appliances are BPA free.

Their phthalate free. They have no latex, no silicone, so they are very safe and what we do is we will. This is of process that takes several years that were doing this while the child is growing to promote proper growth of the job.

So the child will sleep with these devices and are they outgrow them. We will change them out in different ones have different functions until their job is developed to a point where we know that you know the airway will not be constricted and the people growing properly and the jaw has no develop properly so as far as caucuses because I know that that's something. Parents want to know this is about the same cost as it would be to get braces. However, the differences that were not only straightening the teeth were making sure that the job develop properly which will lead to straight teeth but also making sure that the airway developing properly so that were giving the child the optimal chance for health treatment process depends on the severity on each individual case. It turns on the child. But really, you know, we can start as little as two years old so we can see signs already in certain kids that you know they're having, you know, teeth grinding or certain other behavioral issues so we can start as early as two we will usually go up until about 12 years old, because that will show that now we have developed the job properly and that this child will be set up for success.

We can stop you know, honestly, our daughter started when she was eight years old, because that's really when we had become certified and really understood this process which has been very slow in coming to Miami and to Florida but overall there's 4 million cases that have been done with healthy start was regulated awareness is not enough awareness.

Exactly. So if you were up in Boston or you were in Chicago.

There are many practitioners doing this for children every day. I hear there has been a lack of awareness and a lack of practitioners becoming certified to offer this treatment and so unfortunately that means that kids just haven't been exposed to the possibility of taking advantage of it had been around for 50/51 years, so it's not new. It is just new and really the medical community also accepting it as a treatment about the major problem right regular doctor so much interested in doing it because of the way. what well, for one, for one, i think that you know it.

it just better known to dr. that there are certain medications that address the and it just seems like well we should give the medication the zombies. that's very good to know that they were in business for the cultists of the dozen materials to show her nose in for school where she was on our daughter first grade comes home with a pamphlet of adhd medication. nobody will say the mental promoted and unfortunately that's just what's more well known and even parents when they think about their child being diagnosed with add or adhd. that's really the only thing that they've usually heard people talking about is that their kids have been on meds for add or adhd, and it had become become so common it's almost like you're taking vitamins in the morning, you know, i think the men in their and their adhd medications so it's just nice for those parents. you know there's people that the medicines may work for them and they are having their children on them. but this is really for those parents that i wondering if there's something else that maybe they could do because they don't necessarily want their kids a medication or even if they do need to have medication one and want to at least try and see if there's you know we disordered breathing might be a reason and not adhd. and so this really just gives another avenue to explore that could maybe mean treating these children without having them to be on medication so young lives almost common practice you.

so much of kids that are adhd and add that when stop being normal kids. why does just being a little bit hyper become adhd. i think it's overused and also is a lack of education because i did not know my kids sleeping with the mouth open in maybe a problem or if my kid snoring. i even know you take your kid to the dentist at two years old. my parents are doctors and they had a friend with a dentist in come over and open your mouth on everything that's good, that's it. we never went to the dentist we are nine great thank god nothing.

we know we can have all teeth fell out.

but now we do what we do we go visit with physicians, pediatricians, you know, when we sit down and we have lunch with them and we go over all of these studies and explain everything to them and really just try to increase awareness because it would be nice to have you know on the form. the pediatrician give you when you bring your child in for a physical to be asked of your child snores more euros are you listening listening listening tomorrow and discuss the but it would be nice just to give parents the opportunity to think about whether your child is exhibiting the symptoms and if there's something that you like to do to address it so much better to go the natural way and try to correct something at least as less invasive as possible because medications have side effects, so if it's something as easy as just training or correcting something over time that would be more ideal. so if i were to have a child that has adhd or add or probably are concentration problems or behavior problems.

i think look at this. first, because i know that i'm guilty of it sometimes. as parents we don't really see when a kid is going to sleep.

are they on the phone like yesterday on 24th. if i do live bill yesterday was full of but we don't know how much it's harming. i can think of no better know they need adequate sleep and i mean all this has been so very informative michelle because now i'm definitely going to be a parent. make sure her top sleep and that every effort by making sure they're getting good adequate lead and even if not a behavioral issue. it's not adhd.

there are so many other symptoms that you know we can look at even even the issue of crap you know that kids have all the time you see crooked teeth and get the time.

just seeing it more as it's not a cosmetic issue as much as it is an issue that the job is underdeveloped and that we were having this issue and that's affecting the airway and we need to look at how those teeth that are crowded are really a sign of something bigger going on with the child and so that's really what we want to have parents focus on you know if you're going to put braces on your child. think about all yes it's either coming and crooked. but what's happening with my child's health overall and and that's really what we want to get to and want to try to help children really have better health. that is amazing.

that is so great that you sent that because there's so many kids that get braces and they just think that's what it is kids and the kids to get braces understand that there's an underlying problem that can be causing this crooked teeth. it doesn't just have to be genetics that you just happen how patchy it can be that there is misalignment of something compromising your airway and wow that's amazing because i know my sister all three of her boys got braces. i wonder if one of them had this sleep disorder it. i mean they they really won't outgrow its overtime don't know you know we get patients coming in in their young 20s. you know that are snoring and have realized it or had other people tell them. and so once they go to the sleep study and we can see that you know now they have obstructive sleep apnea, which means the airways, collapsing water, sleeping, and it's due to you know all the factors that weren't properly cared for.

when they were kids more because nobody know so we can't really blame the parents and that in that respect. nobody was really aware to do anything about it.

i grind my teeth was something for it that i think that's i wake up a few times and what you need to do another kit. it's never too late to do that late and always going to help you because those little awakenings you don't even know people will do the sleep study and they'll have had 40 micro awakenings. i mean there.

second, you don't even know that you're awake but what that's doing is taking you out of your deep sleep in your rem sleep which is where you need to be run.

sleep is where your where you're really getting good restorative sleep.

that's where your cementing your short-term memory. so if you find yourself often thing where my keys you know that that you may not be getting that really good restorative sleep and so that's really important for your health overall. over time, i knew it. add psychiatrist goodness that is just an easy michelle and i have to tell you this. this is all available… and since dental office, which by the way he's an dentist have to admit, we found out about dr. addison because he found out about when my daughter was almost killed on valentines 2016. her mouth was broken and her teeth are broken in this wonderful dentist contacted and fixed her teeth just out of the kindness of his heart charging is nothing just because he cared me tell you something in today's world that is super hard to find medications for people michelle. it's been a pleasure.

i think you guys, really. i really loved having you. it's been great and thank you so much.

it's really great what you're doing such a great service to society. i really appreciate thank you. well guys, it's come to the end of another shell.

it's hard to believe it's been wonderful spending time with you guys and now i'll be leaving you to work with amy, was brought to you by i am only see research 786-310-7477 or www.godisthekeyword.com.

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