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Ask Oz and Roizen: Catastrophizing and Sleep Apnea in Kids

Ask Oz and Roizen: Catastrophizing and Sleep Apnea in Kids

Here’s what the experts have to say on coping with trauma and recognizing the symptoms of sleep apnea.

Q: My husband escaped a house fire a couple of years ago—everything turned out okay as far as physical health and insurance went—now, however, he sees a potential catastrophe around every turn. What can be done to get him back to his old self? — Jayne D., Aurora, CO

A: Chances are that cognitive behavioral therapy is the best place to start for this kind of post-traumatic stress disorder and resulting anxiety (catastrophizing is an anxiety disorder). One of the things you can tell your husband is that everyone catastrophizes from time to time and he’s not losing his marbles—he just needs to line them up better! And if your husband agrees to get help, he’s going to be in the vanguard of smart mental health care.

According to the National Institute of Mental Health, tens of millions of Americans need help dealing with such feelings that seem beyond their control (they’re not) and only half of them ask for assistance.

You and he can start by finding out what his medical plan offers for mental health care. Then, suggests the American Psychological Association, he should ask his physician or another healthcare provider for referrals to several well-trained and certified therapists. You can also ask friends if they know of therapists who deal with anxiety issues. Then he can start interviewing the therapists so he can find a good match.

Assure your husband that once he decides on a therapist, he’s taken an important step forward. He will discover there’s a lot that can be done to help him deal with his anxiety. And if his therapist is an M.D., the doc may prescribe an antidepressant as part of his therapy. The combination of talk therapy and meds is often the most effective approach. Just by looking for help, you both are ahead of the game.

Q: My eight-year-old heads to bed at a good hour but complains of being tired all the time and I’ve noticed that he thrashes around during the night—I can tell by the way the covers get all knotted up. Any theories about what’s going on? — Leslie J., Lafayette, IN

A: Your child may be contending with sleep disordered breathing or SDB. We often think of SDB and obstructive sleep apnea, it’s most common form, as problems that affect adults who are obese, smoke, drink too much or have diabetes. However, studies on SDB in children makes it clear that kids can be affected, too—and there are potentially life-long consequences if left untreated.

According to the American Osteopathic Association, up to 15 percent of kids struggle with some form of SDB—but 90 percent may go undiagnosed. That means nightly many kids are repeatedly roused from deep sleep, during which neurocognitive development, cellular regeneration and tissue and bone growth occur. This interferes with brain development and memory formation—and can trigger emotional and behavioral problems.

Symptoms of SDB in children include (as expected) snoring and restless sleep, but bedwetting, migraine headaches, jaw clenching and teeth grinding are potential signs as well. One often-overlooked trigger, says the study published in the Journal of the American Osteopathic Association, is early-in-life “dysfunctional craniofacial development,” which causes poor jaw structure and airway problems.

Treatment: Removing tonsils and adenoids may improve breathing. If that doesn’t help, some children benefit from being fitted with a maxillary expander—an adjustable brace temporarily placed across the roof of the mouth to increase the volume of the nasal cavity and improve breathing.

Unfortunately (unlike you, Leslie), too many parents overlook a child’s erratic sleep patterns. Parents these days often fail to notice that their child is obese—and that can also contribute to disordered breathing.

So, check for signs. If they’re present, consult your pediatrician and, if needed, a pediatric ENT, sleep specialist and a dentist trained in craniofacial development. A child’s future health and happiness depend on it.

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