Greetings, jelly beans, and sweet dreams! Pediatric health touches all chambers of my heart. The future of well-being and civilization stems from growth and development of our awesome youth. With that being said, when does growth and development of children take place???? Did you say during sleep? Well my friends, you are correct. Growth hormone is secreted during stage 3 sleep (deep sleep). Memories, thoughts, and experiences are compiled during stage 3 sleep. Memories, thoughts, and experiences are stored during REM sleep. Elimination of protein plaque build up (reduces cognition, creates brain fog, reduces or eliminates short term memory, creates neurological imbalance) in the brain is carried out by the glymphatic system during REM sleep. By correcting a child's nocturnal breathing dysfunctions, the likelihood of neurological and physical dysfunction (intelligence and physical growth delays), social ineptitude, aggressive behavior, and bed wetting will be reduced, if not eliminated. Also, as the child grows into an adult, they will not be plagued with idiopathic co-morbidities, such as hypertension, diabetes type 2, heart dysfunction, and gastrointestinal dysfunction.
Sleep disordered breathing (not just sleep apnea) is a multi-faceted beast of burden. Sleep disordered breathing disrupts the natural sequence and consolidation of brain activity during sleep.
1 - Growth hormone is responsible for physical growth of a child's tissues, including bone. It is excreted during deep sleep. If deep sleep is fragmented, growth hormone secretion will be compromised, resulting in reduction of physical growth rate.
2 - The maintenance and fostering of neurocognitive faculties occur during the delicate stage of REM sleep. I say delicate stage due to the fast brain activity, making it a light stage of sleep. When REM sleep is disrupted or eliminated due to repeated disruptions of brain activity, functions such as memory and learning are jeopardized.
3 - Sleep deprivation is most usually the cause of sleep walking, sleep talking, nightmares, depression, lack of motivation, emotional instability, and daytime sleepiness. Reduction in sleep time may be unknown due to repeated arousals and disruption of consolidated sleep. If a child has restless sleep, snores, gasps,
or has pauses in breathing during sleep there is an increased likelihood of sleep deprivation.
4 - The sympathetic nervous system (SNS) is a gift and a curse. The fight or flight response, vital for survival, is quite baneful during the times of growth, replenishment, and restoration (also known as sleep). The body responds to airflow restriction and obstruction as life threatening; dramatically reducing blood flow to virtually every organ except the heart, lungs, and eyes. In addition, blood vessels are damaged from repeated constriction, cortisol is secreted causing increases in glucose, reduction in insulin, and oxidative stress (inflammation).
5 - Among a few believed causes of enuresis (bed-wetting) in children, the most commonly associated is increased negative intrathoracic pressure caused by reduction in airflow. This causes increased pressure on the heart, making the heart believe there is a fluid overload; in turn stimulating secretion of atrial natriuretic peptide (ANP) and reducing atrial diuretic hormone (ADH), causing urination.
The detrimental effects of pediatric sleep disordered breathing have been best validated by tangible outcomes in relation to correction of anatomical upper airway deficiencies. Adenotonsillectomy does not necessarily correct sleep disordered breathing. If at all possible, an attempt at understanding the cause of adenoid and tonsillar hypertrophy should be made before removal. Correction of structural deficiencies has been proven to reduce or eliminate signs and symptoms associated with pediatric sleep disordered breathing; to include, but not limited to, ADHD, impaired cognition, impaired growth, emotional instability, anxiety, and enuresis.
If you or your patients have a child who breaths through their mouth, displays concerning behavior, excessive daytime sleepiness, or has impaired growth. They may have a sleep disorder and not realize it.
Better Sleep is Better Health!