- Andre Bernath -andre_biernath
- BBC News Brazil in London
According to studies published in recent years, more than half of children sleep with their mouths open.
Frequently, this habit does not draw the attention or sound the alarm to parents and guardians.
But doctors consulted by BBC News Brazil point out that sleeping with your mouth open – linked to allergies, rhinitis or the growth of structures blocking the nose – can be very harmful to your health.
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These children are at greater risk of developing a variety of complications, ranging from cavities and bad breath to changes in posture and learning difficulties at school.
To make matters worse, these harmful effects are not limited to childhood: if nocturnal mouth breathing is not resolved in the first years of life, negative repercussions can last for life.
Understand below the cause of this condition, all the damage to health and the main ways to fix the problem as soon as possible.
As an external structure of the respiratory system, the nose has a very special function: to warm, moisturize and filter the air that enters through the nostrils.
In contrast, when we breathe through the mouth, the oxygen does not undergo this special treatment before reaching the lungs.
This in and of itself is a risk. The air passing through the mouth reaches the rib cage, which is full of impurities, is dry and at the wrong temperature.
“Breathing through the mouth increases the risks of viral or bacterial infections and frequent colds,” says Dr. Alexandre Ordons, of the Brazilian Association of Otolaryngology and Cervical Surgery (ABORL-CCF).
“The person usually also has more burning, wheezing, and mucus blockage in the back of the throat,” he adds.
Opening the mouth during sleep will have more profound effects on the makeup of that individual’s face.
“Facial bones are not developing properly, altering body contours. A child might have droopy cheeks, sad eyes, and dark under-eye circles?” , says otolaryngologist Saramera Bohadana, MD, Digestion Program Coordinator at Sabara Hospital, in São Paulo.
“The dental arch itself also changes. Jawbone [qui supporte les dents supérieures] It becomes very closed and protrudes forward. The specialist explains that the jaw does not develop as expected.
On top of that, these changes in the skull alter the rest of the body. “The neck eventually retracts, the chin inward, and the arches of the chest and abdomen become prominent,” Bohadana describes.
And as if all these physical changes weren’t enough, sleeping with your mouth open also has very serious consequences for the brain and behavior.
Apnea, bad grades, irritability and incontinence
Babies who sleep with their mouths open often have a condition called sleep apnea.
It is characterized by interruptions in breathing during night rest, which in turn leads to small awakenings (often not consciously observed).
In fact, these small arousals prevent a person from reaching the deepest stages of sleep, which is associated with the consolidation of memories and learning.
Now imagine the effect on the still-forming brain.
“We have several studies that show that a child who sleeps with his mouth open does worse in school,” Ordons reveals.
A 2016 research review by scientists from the Federal University of Sergipe, for example, showed that children who breathe through their mouths often have learning difficulties compared to those who use the nose as their primary respiratory source.
According to an otolaryngologist, a lack of restful sleep is also associated with decreased concentration and increased irritability during the early years of life.
“It is not uncommon to have children in our office diagnosed with ADHD who are taking medication to control their condition. Then when we solve the problem of breathing through the mouth, the irritability improves and the medication is no longer necessary.”
Finally, Ordons adds another factor to his long list of consequences: bedwetting.
He knows that “the hormone that controls urine is produced during deep sleep. If its production is not enough, a young child wets the bed and often cannot give up diapers.”
In the face of many dangerous (and unknown) effects, it’s time to find out what could be hiding behind this difficulty breathing through the nose in youngsters.
Stones on the road
In general, breathing is done through the mouth because the airways are closed. Since oxygen cannot pass through the nostrils, the body uses an alternate route to operate the lungs.
Rhinitis is one of the main “barriers” of the nose, which is characterized by an allergic reaction to substances common in the environment, such as dust, dust mites and animal hair.
When a person is in crisis, the lining of the nose thickens under the influence of an inflammatory process and swells. On top of that, the mucus production – bronchitis – ends up clogging the tubes through which oxygen passes. The body produces mucus in an attempt to swallow and expel the “agent” that causes the allergy.
Another common reason for a blocked nose (and the need to breathe through the mouth) is a growth of tissue called adenoids.
“This spongy flesh is found at the back of the nose and is part of the body’s defense system. When exposed to pollution or infectious agents, it increases in size and obstructs the passage of air,” Bohadana explains.
Le gonflement d’autres structures situées dans le visage et au début de la gorge, comme les amygdales ou les turbines inférieures (ces “petits plis” que nous avons à l’arrière des narines), empoxyle transit également l’aglement this area.
But how can parents and guardians suspect that a child is sleeping with his mouth open?
“In the vast majority of cases, it is possible to hear noises, such as snoring or loud breathing,” Ordonis notes.
“Other common signs are a wet pillow due to excess saliva coming out of the mouth and extremely restless sleep, the kind where the child struggles, turns in bed and wakes upside down,” adds the otolaryngologist.
Anticipating diagnosis (and treatment) is key
Whatever the source, doctors insist that spotting the problem early has lifelong benefits.
“If we intervene before the age of four, we can completely reverse most bone and muscle changes,” Bohadana points out.
Let’s be clear: Treatment can improve health and quality of life at any age, but the beneficial effects would be much greater if it was done in early childhood.
If you notice any signs that your baby is sleeping with his mouth open, the first step is to visit an otolaryngologist for an initial evaluation.
In the doctor’s office, the doctor may do an examination called a nasal endoscopy, during which a small camera is inserted into the nostrils to see all the internal structures and check if anything is bulging or out of place.
If the problem is related to rhinitis, treatment consists of modifying the environment in which the child lives (by removing carpets, soft toys and other sources of dust and dust mites from the room, for example) and prescribing medications that regulate and relieve inflammation. Sneezing spells and nasal congestion.
However, if an increase in adenoids (which does not completely disappear with control of sensitivity), tonsils or lower turbinates is detected, it is necessary to resort to surgery.
“The procedure is relatively simple, the child can usually be discharged from the hospital the same day and the post-operative pain is completely tolerable,” Bohadana explains.
“On average, after seven days, the child has already recovered well.”
The otolaryngologist insists that the earlier the intervention, the better the results.
“Sometimes parents are afraid and prefer to wait until their child is a little older before removing the tonsils or adenoids, even though they think it may affect immunity,” she comments.
“We know that if these structures are removed, other parts of the defense system can meet the needs.”
The specialist concludes, “Not to mention that waiting for surgery can aggravate or deepen all oral breathing complications.”
In addition to scalpel intervention, it is often necessary to follow speech therapy sessions, with the aim of strengthening the facial muscles and practicing the ingress of air through the nostrils.
All this ensures calmer and healthier breathing, and this is done for the rest of life through the most appropriate path: the nose itself.
See the link below for a full report on rhinitis causes and treatments.