children prepare to return to the classroom this week, parents should be aware of the effects sleep disorders have on their child's health, wellness and performance. Three separate studies in the September 1st issue of the journal SLEEP link sleep-related breathing and movement disorders in children to attention-deficit and behavioral problems as well as neurobehavioral deficits, that all affect a child's memory, performance, functioning and ability to socialize.

Link between childhood sleep-disordered breathing and neurobehavioral deficit A study into sleep-disordered breathing (SDB), conducted Dean W. Beebe, PhD, of the University of Cincinnati, evaluated and synthesized the findings of 61 studies of the relationship between childhood SDB and neurobehavioral functioning. There is strong evidence that childhood SDB is associated with deficits in behavior and emotion regulation, scholastic performance, sustained attention, selective attention and alertness. There is also evidence that SDB has minimal association with a child's typical mood, expressive language skills, visual perception and working memory.

SDB is a group of disorders characterized by abnormalities of pauses in breathing or the quantity of ventilation during sleep. Obstructive sleep apnea (OSA), a condition that causes your body to stop breathing during sleep, and occurs when the tissue in the back of the throat collapses and blocks the airway, keeping air from getting into the lungs, is the most common such disorder. OSA, although more common in men and women of any age, may be diagnosed in those children with large tonsils.

Snoring, a symptom of increased upper airway resistance during sleep, is another form of sleep-disordered breathing. Studies have shown that 10 to 12 percent of children snore.

Periodic leg movements, which can impact a young person's mental capabilities, occur more often during the daytime.

Periodic leg movements, experienced by persons of all ages, reach the level of a disorder, periodic limb movement disorder, which may be a factor in causing a person to have depression, bad memory, short attention span or fatigue.

Marie-Héléne Pennestri, BSc, and colleagues of the Sleep Disorders Center, Hôpital du Sacré-Cœur, studied 67 healthy subjects between the ages of five and 76. They discovered that periodic limb movements during wakefulness was higher in subjects younger than the age of 40, including children, while periodic limb movements during sleep more often occurs in those over the age of 40.

Periodic limb movements occurs when a person experiences episodes of simple, repetitive muscle movements and is unable to control them. It does not involve a change in body position, stretching a muscle, or a cramp. Instead, the movements tend to involve the tightening or flexing of a muscle. It occurs most often in the lower legs. It can occur at two different times: while you sleep and while you are awake. An episode will normally last from a few minutes to an hour. Within that time, movements tend to occur every 20 to 40 seconds.

Those whose sleep is severely disrupted by this condition can be very tired the following day, while those who experience it during waking hours are often disrupted in their daily life.

Children with bruxism experience more attention behavior problems.

Bruxism, a condition common among children, can affect a child's ability to sleep and, consequently, have an adverse effect on his or her attention and behavior patterns.

A study on children with bruxism was conducted by Marcela Herrera, DMD, of Drexel University in Philadelphia, Pa. It focused on 10 children, each of whom completed a dental evaluation, a nighttime polysomnogram and cognitive behavioral tests. It was discovered that eight of 10 children had clinically significant bruxism and the two remaining patients had recent tooth damage. Sixty-six percent of the bruxism group experienced disturbed sleep, out of which 40 percent had significant attention and behavior problems.

A child should undergo early screening for bruxism by a pediatrician, noted Herrera.

"Although a polysomnographic evaluation may not be essential for the evaluation of most children with sleep bruxism, it is important to screen children for bruxism in the general pediatric office because these children appear to be at higher risk for having somatic complaints or problems, as well as behavior and attention problems," the authors wrote.

Bruxism is the grinding or clenching of teeth during sleep. It is common for the jaw to contract while you sleep. When these contractions are too strong, they produce the sound of tooth grinding. This can cause dental damage by wearing the teeth down. In most severe cases, hundreds of events can occur during the night. In milder cases, the grinding may vary from night to night.

The rate of bruxism seems to be highest in children. About 14 percent to 17 percent of children have it. It can begin as soon as a child's upper and lower teeth have come through the gums. Around one third of children with bruxism will still have it when they are adults. About eight percent of young to middle-aged adults have it. The rate continues to decrease with age.

Parents of children with a sleep disorder should consult with the child's pediatrician, who will determine whether a visit to a sleep specialist is necessary.

SLEEP is the official journal of the Associated Professional Sleep Societies, LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

American Academy of Sleep Medicine

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