Sleep Apnea Can Turn Your Child Into a School Bully

Image courtesy of Grant Cochrane / FreeDigitalPhotos.net

This statement is supported by a published study indicating that poor sleep, whatever the cause, can be a factor leading a child to bully or display other aggressive behaviors. Among 341 kids who were evaluated, 23% had conduct problems. Of these kids with conduct issues compared to those without, a significant number had symptoms suggestive of a sleep disorder indicated by sleepiness scoring as well as snoring.
It is already known that the prefrontal cortex governs social behavior which is also influenced by sleep. As such, poor sleep can deleteriously influence the brain leading to behavior problems.

Of course, there are other factors that can contribute to sleep problems as well as bullying... such as an unstable family as well as too much technological stimulation (cell phone, internet, television, etc).

As such, as with most things, more study is needed.

But here's my two cents... Applying some common sense here, ask anybody who has pulled an all-nighter whether they are grouchy the next day and I bet you most will say "of course, no duh"!

Well, here's a study that supports that! (No duh!)

All kidding aside, if a child is having behavior issues, it may behoove the parents to see if obstructive sleep apnea is present which would lead to poor sleep quality. At least for kids, obstructive sleep apnea can be addressed surgically by removing the tonsils and adenoids leading to markedly improved sleep quality (and hopefully improved behavior as well!).

Reference:
Aggressive behavior, bullying, snoring, and sleepiness in schoolchildren. Sleep Med. 2011 May 25. [Epub ahead of print]

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Singulair May Help Reduce Tonsil and Adenoid Enlargement

Singulair is a medication often prescribed for asthma as well as allergies and works by blocking the leukotriene receptor. This mechanism is different than that found in common allergy medications like claritin and benadryl which work by blocking the histamine receptor (anti-histamine).

Singulair has also incidentally been found to possibly help reduce the size of tonsils and adenoids. Given this beneficial affect, singulair may be a helpful intervention in those kids with mild obstructive sleep apnea or nasal obstruction due to adenoid hypertrophy avoid surgical intervention (tonsillectomy and adenoidectomy).

Steroid nasal sprays have also been found helpful to reduce adenoid size.

However, only an association between singulair use and reduction in adenoid/tonsil size has been found. Double-blind, placebo-controlled studies are required for determination of true benefit.

Singulair can be given from the age of 1 year old.

References:
Leukotriene modifier therapy for mild sleep-disordered breathing in children. Am J Respir Crit Care Med. 2005 Aug 1;172(3):364-70. Epub 2005 May 5.

Leukotriene pathways and in vitro adenotonsillar cell proliferation in children with obstructive sleep apnea. Chest. 2009 May;135(5):1142-9. Epub 2008 Dec 31.

The role of mometasone furoate aqueous nasal spray in the treatment of adenoidal hypertrophy in the pediatric age group: preliminary results of a prospective, randomized study. Pediatrics. 2007 Jun;119(6):e1392-7. Epub 2007 May 28.

Intranasal corticosteroids for nasal airway obstruction in children with moderate to severe adenoidal hypertrophy. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006286.

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Voice Sounds Different After Tonsillectomy and/or Adenoidectomy!

Every so often, I hear a parent state that their child's voice/speech sounds "different" after undergoing tonsillectomy and adenoidectomy. Beyond sounding less nasal which is expected, the other comment is sounding higher pitched or more feminine.

This observation is especially true when dealing with a male school-age child.

The reason for this voice (or really speech) change is because the upper airway is much larger and more resonant after the tonsils and adenoids are removed.

Just like a person's voice sounds different when talking in a closet versus a large auditorium, the larger opening through which the voice travels after surgery is much larger than before and as such, the voice/speech has to correspondingly change after surgery as well.

The change is also much more dramatic the larger the tonsils and adenoids are.

SO, do not be alarmed if your child sounds different after surgery, especially if the tonsils and adenoids were extremely large. It is actually an expected occurrence and not an indicator of anything bad, swelling, healing, etc.

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New Webpage on Large Adenoids: Symptoms and Treatment

A new webpage has been created on problems associated with large adenoids and how it can be treated.

Large adenoids cause all sorts of symptoms that may be confused for other etiologies including:

• Nasal obstruction
• Nasal congestion
• Nasal sounding speech
• Runny nose (rhinitis)
• Snotty nose
• Colored drainage
• Allergy like symptoms
• Ear pain, clogging, stuffiness
• Cough
• Post-nasal drainage

Correction of the large adenoids (medications or surgery) may eliminate all these symptoms!

Click here to read more about this as well as to watch videos on this subject.

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Storybooks to Help Prepare a Child for Surgery

Children love stories and as it so happens, there are a few books to help prepare a child for surgery so that hopefully everything won't be as strange or scary. All these books can be purchased from Amazon.com. The first group is for tonsillectomy and/or adenoidectomy. The last group is for ear tubes placement.

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