Neurology Consultant publishes a case review of a young girl being evaluated for ADD/ADHD who had a history suggestive of sleep disturbance.
The girl had been a long-time snorer (albeit not loudly) since toddlerhood, was restless when she slept, and had difficulties with arousing, taking longer than 30 minutes. The girl slept in extension rather than the typical curled-up position, and she rarely slept in the same position throughout the night. She was rarely well rested when she awoke and often fell asleep during class in the late afternoon.
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Removing tonsils and adenoids was an excellent first move to improve her airway by enlarging her posterior airway.
The proper second move is to enlarge her nasal airway with orthodontic palatal expansion by a dentist educated in this procedure.
This 2 prong attack increases the entire airway into the lungs. BOTH are needed in a case such as this.
With an improved nasal airway, as well as posterior airway, it is probable that CPAP use would not be needed.
CPAP use for a growing child is a last resort. The pressure from the strap around the head can have adverse effects on the head of a growing child. It can deform head growth, even when only worn at night. Orthodontists alter head growth all the time with appliances named “head gear” that is usually only worn at night.
History books have pictures of royal family members with deformed heads and/or feet due to wraping during growth. CPAP use for a growing child should be a last resort only after T & A AND palatal expansion.
All the above is explained in detail in my book written for the general population.
William P. Smith, Jr., D.D.S.
Author of:
GROWING A HEALTHY CHILD, SECRETS FROM A WISE OLD DOC