
50 YEARS OF RESEARCH, 5 MILLION SMILES
The Science Behind Kidlet
Select Condition
- Academic Challenges 10
- Arrested Growth and Development 1
- Asthma 1
- Bedwetting 1
- Chronic Allergies 1
- Crowded Teeth 1
- Disruptive Behavior 4
- Ear Infections 1
- Grinding / Clenching 2
- Headaches 1
- Impulsivity 1
- Infants / Pacifier Breastfeeding 1
- Lack of Concentration 6
- Mouth Breathing 5
- Nightmares / Night Terrors 1
- Sleep Disorder Breathing 8
- Sleep Problems 12
- Snoring 5
- Speech Problems 1
- Tonsils 3
- Underdeveloped Jaw 1
Recognizing Poor Sleep Quality Factors During Oral Health Evaluations
Oral health practitioners routinely perform oral health assessments for the dental patient to determine if oral disease is present. Systemic health is often a contributor to oral health concerns. One area in particular that has a direct effect on oral structures and oral health is poor sleep quality and open mouth breathing. Sleep is a fundamental process of the human body, which regulates core biological functions. Sleep quality reflects a person’s ability to fall asleep, stay asleep, and enter into the various rejuvenating sleep cycles for the full duration. A person who does not obtain quality sleep can exhibit a wide range of oral, systemic, and cognitive health problems. Obstructive sleep apnea, which historically has been considered an adult male disease, is being recognized more often in women children.
Reduced sleep pressure in young children with autism
Sleep disturbances and insomnia are highly prevalent in children with Autism Spectrum Disorder (ASD). Sleep homeostasis, a fundamental mechanism of sleep regulation that generates pressure to sleep as a function of wakefulness, has not been studied in children with ASD so far, and its potential contribution to their sleep disturbances remains unknown. Here, we examined whether slow-wave activity (SWA), a measure that is indicative of sleep pressure, differs in children with ASD.
Inefficient or insufficient encoding as potential primary deficit in neurodevelopmental performance among children with OSA
Memory (M) impairments have been suggested in pediatric Obstructive Sleep Apnea along with attention and executive (AE), language (L), and visuospatial (V) dysfunctions. NEPSY assessment of children aged 5-9 years who were either healthy.
Risk factors and consequences of excessive autonomic activation during sleep in children
The aim of this study was to assess risk factors for excessive autonomic activation during sleep (EAAS) and its association with sleep problems, impaired behavior, and poor academic performance in primary school children.
Reliability of parent report measures of sleep in children with Down syndrome
Behavioural sleep disturbances are common among children with Down syndrome (DS). However, tools used to detect and evaluate behavioural sleep disturbances were developed for typically developing children and have not been evaluated for use among children with DS. The current study evaluates the psychometric properties of three measures of behavioural sleep disturbances that are currently being used with children with intellectual and developmental disabilities, including children with DS.
Relations Between Toddler Sleep Characteristics, Sleep Problems, and Temperament
Two sources of information (parent-reported sleep diaries and actigraph records) were used to investigate how toddler sleep characteristics (bed time/sleep onset, wake time/sleep offset, total nighttime sleep, and total sleep time) are related to sleep problems and temperament. There were 64 toddler participants in the study. Consistent with studies of older children, parent reports differed from actigraph-based records.
Relationships among obstructive sleep apnea, anthropometric measures, and neurocognitive functioning in adolescents with severe obesity
This was a cross-sectional pilot study performed at an academic medical center in 37 severely obese (body mass index [BMI] >97th percentile) adolescents. Study evaluations included polysomnography, BMI, waist circumference, and standardized neurocognitive tests to assess memory, executive functioning, psychomotor efficiency, academic achievement, and an approximation of full-scale IQ. Outcome data were evaluated categorically, based on clinical criteria for the diagnosis of OSA, and continuously to quantify associations between sleep parameters, anthropometrics, and neurocognitive test results.
Altered Regional Brain Cortical Thickness in Pediatric Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) affects 2-5% of all children and is associated with cognitive and behavioral deficits, resulting in poor school performance. These psychological deficits may arise from brain injury, as seen in preliminary findings of lower gray matter volume among pediatric OSA patients. However, the psychological deficits in OSA are closely related to functions in the cortex, and such brain areas have not been specifically assessed. The objective was to determine whether cortical thickness, a marker of possible brain injury, is altered in children with OSA.
Interindividual sleep spindle differences and their relation to learning-related enhancements
We reported earlier that overnight change in explicit memory is positively related to the change in sleep spindle activity (between a control and a learning night). However, it remained unclear whether this effect was restricted to good memory performers and whether a general association of sleep spindles and a “sleep-related learning trait” may not account for this effect. Here we now present a secondary and more detailed analysis of our randomized multicenter study. Subjects were studied over a 4-week study period (including actigraphy and daily sleep diaries), including three overnight stays in the sleep laboratory. In the course of the study, subjects completed test-batteries of memory (Wechsler-Memory-Scale-revised; WMS) and other cognitive abilities (Raven’s Advanced-Progressive-Matrices; APM) and were asked to study 160 word pairs in the evening before being tested by cued-recall. Afterwards, subjects went to bed in the laboratory with full polysomnographic montages.
Intraindividual variability of sleep/wake patterns in relation to child and adolescent functioning: A systematic review
Substantial research attention has been devoted to understanding the importance and impact of sleep in children and adolescents. Traditionally, this has focused on mean sleep variables (e.g., a child’s “typical” or average sleep duration), yet research increasingly suggests that intraindividual variability (IIV) of sleep/wake patterns (sometimes referred to as sleep variability or night-to-night variability) regularly occurs and may have implications for adjustment. A systematic search of five electronic databases identified 52 empirical studies published between 2000 and 2015 that examined correlates of sleep IIV in children and adolescents, with a recent increase in the publication rate of such studies.
Inflammatory markers and obstructive sleep apnea in obese children: the NANOS study
Obesity and obstructive sleep apnea syndrome (OSA) are common coexisting conditions associated with a chronic low-grade inflammatory state underlying some of the cognitive, metabolic, and cardiovascular morbidities. To examine the levels of inflammatory markers in obese community-dwelling children with OSA, as compared to no-OSA, and their association with clinical and polysomnographic (PSG) variables. Methods. In this cross-sectional, prospective multicenter study, healthy obese Spanish children (ages 4-15 years) were randomly selected and underwent nocturnal PSG followed by a morning fasting blood draw. Plasma samples were assayed for multiple inflammatory markers.
Regional brain tissue integrity in pediatric obstructive sleep apnea
Children with long-standing obstructive sleep apnea (OSA) show evidence of neural injury and functional deficits in behavioral and cognitive regulatory brain regions that are reflected in symptoms of altered cognitive performance and behaviors. While we earlier showed reduced gray matter volume and increased and reduced regional cortical thicknesses, such structural changes give little indication of the underlying pathology. Brain tissue integrity in pediatric OSA subjects can reflect the nature and extent of injury or structural adaptation, and can be assessed by entropy tissue texture, a measure of local changes in signal intensity patterns from high-resolution magnetic resonance images.
Is a 2-night polysomnographic study necessary in childhood sleep-related disordered breathing?
There are limited data on the night-to-night variability of childhood sleep-related disordered breathing (SDB). We aim to assess for the presence of first-night effect (FNE) and to examine whether a single-night sleep study is adequate in the assessment of childhood SDB. In a case-control study investigating whether obesity is a risk factor for childhood SDB, the night-to-night variability of sleep and respiratory variables were studied.
Reduced Regional Grey Matter Volumes in Pediatric Obstructive Sleep Apnea
Pediatric OSA is associated with cognitive risk. Since adult OSA manifests MRI evidence of brain injury, and animal models lead to regional neuronal losses, pediatric OSA patients may also be affected. We assessed the presence of neuronal injury, measured as regional grey matter volume, in 16 OSA children (8 male, 8.1 ± 2.2 years, AHI:11.1 ± 5.9 events/hr), and 200 control subjects (84 male, 8.2 ± 2.0 years), 191 of whom were from the NIH-Pediatric MRI database. High resolution T1-weighted whole-brain images were assessed between groups with voxel-based morphometry, using ANCOVA (covariates, age and gender; family-wise error correction, P < 0.01).
Inferior mandibular osteotomy and hyoid myotomy suspension for obstructive sleep apnea: a review of 55 patients
Fifty-five patients with obstructive sleep apnea syndrome (OSAS) were evaluated following inferior mandibular osteotomy with hyoid myotomy and suspension. Patients were objectively examined by polysomnography before and 6 months following the surgical procedure. Thirty-seven patients (67%) had a good response from surgery, and 18 patients (33%) were considered nonresponders. Lung disease, mandibular deficiency, and obesity were factors found to affect the success of surgical treatment.
Relationship between sleep apnea, fat distribution, and insulin resistance in obese children
Obstructive sleep apnea (OSA) is associated with obesity, inflammation, and insulin resistance. The role of fat distribution in OSA pathogenesis has not been established in children. The objective of the study is to examine the relationship between fat distribution, OSA, and insulin resistance in an unselected population of obese children.
Is the airway volume being correctly analyzed
Ten scans from the airway prototype were obtained by using cone-beam computed tomography. The volume from each scan was measured with 8 values (25, 50, 70, 71, 72, 73, 74, and 75) of the threshold tool from the Dolphin software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). The gold standard method used was the actual volume of the airway prototype, which was compared with the different threshold values. An intraclass correlation coefficient test was applied to evaluate the intraexaminer calibration and verify differences among the airway volumes measured in all cone-beam computed tomography scans. Analysis of variance with the Tukey post-hoc test was used to compare differences among the measurements with different threshold values with the gold standard.
Resting-state fMRI in sleeping infants more closely resembles adult sleep than adult wakefulness
Resting state functional magnetic resonance imaging (rs-fMRI) in infants enables important studies of functional brain organization early in human development. However, rs-fMRI in infants has universally been obtained during sleep to reduce participant motion artifact, raising the question of whether differences in functional organization between awake adults and sleeping infants that are commonly attributed to development may instead derive, at least in part, from sleep. This question is especially important as rs-fMRI differences in adult wake vs. sleep are well documented. To investigate this question, we compared functional connectivity and BOLD signal propagation patterns in 6, 12, and 24 month old sleeping infants with patterns in adult wakefulness and non-REM sleep.
Brief report: An epidemiologic survey of the prevalence of sleep disorders among children 2 to 12 years old in Beijing, China
This survey was conducted to examine the prevalence of sleep disorders in 2- to 12-year-old children in the Beijing area of China.
ADHD and Sleep Disorders: Examining Links with Movement Disorders, Parasomnias. Hypersomnias, and Circadian Rhythm Disturbances.
Recent evidence has been accumulating that the sleep of individuals with attention deficit hyperactivity disorder (ADHD) is not only disrupted in a nonspecific way but that ADHD has an increased association with simple sleep related movement disorders such as restless legs syndrome/periodic limb movements in sleep (RLS/PLMS), rhythmic movement disorder (body rocking and head banging), and parasomnias, such as disorders of partial arousal (sleep walking, sleep terrors, and confusional arousals). In addition increased associations have been reported between ADHD and hypersomnias such as narcolepsy and sleep apnea as well as circadian rhythm disorders, such as delayed sleep phase syndrome. These relationships are reviewed and the implications for such associations are explored. Patients with sleep disorders should be queried about the symptoms of ADHD and vice versa.