Parent's Introduction to Sleep Disordered Breathing

Orthodontics is MUCH more than straight teeth, so to help us provide the best care we would like you to answer a few questions on your child's sleep habits.

Why is my orthodontist asking about my child's sleeping or behavior?

Orthodontic care can make a big difference in overall health. Until recently, Sleep Disordered Breathing (SDB ) has largely gone unrecognized in children but can have serious implications, contributing to: growth problems, failure to thrive, asthma, Type 2 Diabetes, ADD, ADHD, autism, hypertension, stroke and cardiovascular disease.

The most common and significant causes are:

  • Obstructive tissues (enlarged tonsils, adenoids, turbinate bones (in the nose), deviated septum)
  • Lack of room for the tongue (narrow jaws, recessive upper or lower jaws, tongue-tied)

What happens physiologically?

With improper breathing, blood oxygen decreases and carbon dioxide increases. This triggers release of the hormones that increase heart rate and activates muscles to force breathing (cortisol…the "fight or flight" or “survival” stress hormone). Although your child may not actually wake up, if this happens, the reaction disrupts your child’s deep restorative sleep to “catch their breath”. Frequently for children who have a sleep disordered breathing problem, once they begin to relax to the deeper levels of sleep, it happens all over again.
This is hard on the body – like running a race all night long. Your child may wake up exhausted and unrested, but more importantly, prolonged levels of increased cortisol negatively affects the immune system, normal growth hormone production, insulin function, gastric acid production, and learning and memory retrieval, and a host of other organs and body functions.

What are the implications of decreased O2 in a growing and developing brain of a child?

We now know that any airway resistance is not healthy and is harmful to the developing brain- it makes it difficult or impossible to store the information they learned today into long-term memory.


Airway Friendly Orthodontics (jaw expansion, advancement of upper and/or lower jaws to create room for the tongue and open the airway) rather than pulling teeth or using headgear (which can actually decrease the airway)

Referral to an ENT doctor for evaluation of Tonsils/Adenoids or allergy problems

Research has shown that the best results occur when both are done!

Pediatric Sleep Questionnaire

Sleep and airway plays a major role in dental development.

Patient First Name:
Patient Last Name:
Patient Date of Birth:

While sleeping, does your child snore more than half the time?
While sleeping, does your child always snore?
While sleeping, does your child snore loudly?
While sleeping, does your child have "heavy" or loud breathing?
While sleeping, does your child have trouble breathing, or struggle to breathe?
Have you ever seen your child stop breathing during sleep?
Does your child tend to breathe through their mouth during the day?
Does your child have a dry mouth when waking up in the morning?
Does your child wet the bed?
Does your child awake un-refreshed in the morning?
Does your child experience sleepiness during the day?
Has a teacher or supervisor commented that your child appears sleepy or sluggish during the day?
Is it hard to waken your child in the morning?
Does your child wake up with headaches?
Did your child ever stop growing at a normal rate?
Is your child overweight?
Does your child seem to not listen when spoken to directly?
Is your child easily distracted?
Does your child have difficulty organizing tasks and activities?
Does your child fidget or squirm?
Is your child often "on the go" or acting as if "motor driven"?
Does your child interrupt or intrude?
* Has your child had their tonsils removed?
* Has your child had their adenoids removed?