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“I just don’t know what to do doctor!” The anxious mom said on her first office visit with her son. “His teacher tells me he daydreams or seems spacey most of the time he’s in class or she finds him asleep with his head on his desk.” “His grades can’t go much lower or he will fail this year.” “His father and I have tried everything we can do to make him get a better night’s sleep or focus on his school work.” “We had his pediatrician start him on ADHD medications to help his concentration, but it’s still not working.” Most parents don’t realize sleep apnea can occur in children, and for the same reasons as in adults.

This ten year old was a perfect example of a sleep apnea affected kid. He was only four foot six inches in height, but weighed 137 pounds. His neck was very thick, he had a large abdomen, was short of breath just from walking down the hall, and his entire nasal-throat-upper airway passages were narrow and clogged with clear mucous. His mother was surprised when I asked if he snored at night. Her answer was quick, “So does his father!” “He got that naturally”. Further questions revealed what I suspected; he ate a lot of junk food, watched television and played video games during his awake hours, and avoided exercise like the plague. He was irritable when asked to do chore or homework and kept a bad attitude. Mom had blamed his weight problem on heredity and avoided enforcing the need for good nutrition and exercise in order to keep family peace.

The obesity epidemic we’re currently seeing in children is probably responsible for most of the obstructive sleep apnea (OSA) diagnosed in kids. When a short child gains weight, it tends to cause neck, throat, and nose tissues to grow very thick, thus decreasing effective airflow through these areas. A large abdomen pushes up on the diaphragm and breathing muscles, further decreasing the child’s ability to move air in and out of his lungs.

Kids can suffer from central sleep apnea (CSA) just like adults and some studies show that the brain breathing control centers in overweight kids may not function properly in the face of obesity. CSA can likewise occur in kids of normal weight and height and losing weight will not help these children’s sleep apnea.

When should you suspect sleep apnea in your child?

When your child:

Shows excessive daytime sleepiness
Sleeps poorly at night with frequent awakening
Experiences a lot of nightmares
Seems to daydream or act spacey a lot
Can’t concentrate or focus at school or work/grades are worsening
Is irritable most of the day or complains of frequent headaches
Avoids exercise and complains of being tired a lot
Has rapid weight gain and complains of shortness of breath
Has developed “asthma” without a cause
Develops bedwetting not previously noted
Has unexplained seizures

So, once you suspect the disorder what should you do? In all cases, a parent should discuss these symptoms and the concern about possible sleep apnea with the child’s doctor. At that point, blood studies may be necessary to rule out other diseases and a sleep study to confirm presence of sleep apnea.

What about treatment in kids? For obese kids, weight loss is critical, along with control of symptoms of asthma, allergies and correction of air flow problems. Some children get a little relief from the use of allergy medications and antihistamines. It is very important for overweight children to receive a diet that promotes weight loss and start an exercise program.

CPAP or continuous positive airway pressure can be used to treat sleep apnea in children from birth into adulthood. Rarely do children require laser surgery on the soft tissues of the throat, but having adenoids and tonsils removed can help in select cases. For further information, please see our articles “ Tips on using CPAP to treat your sleep apnea” and “ Snoring, chainsaws and sleep apnea”.

Helping your kids overcome their sleep related problems at a young age would improve their quality and length of life.

Dr. Frank

Copyright Frank Barnhill 2003
Comments: drfrank@drhuggiebear.com

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Almonds Can Lower Your Cholesterol

Here's another tip you can use to lower your cholesterol. Last month it was avocados and this week it's almonds.

In a study conducted last year, researchers found that when people ate 3 1/2 ounces of almonds a day, their cholesterol level dropped 20 points. This study conducted at the YMCA Cardiac Rehabilitation Unit in Palo Alto, California worked with 30 people who added nuts (both whole and ground almonds) to a low-fat diet.

The results showed the cholesterol drop came from the harmful LDL and the good, protective HDL was unchanged.

So here are some tips about eating nuts and avocados. You can add either one of them to salads or eat them as snacks. Avocados can be sliced and used on sandwiches. Here is one of my wife's favorite lunches. Lightly toast whole bread, then spread a little Dijon mustard on it, followed by slices of avocado, cucumbers, and tomatoes.

These health tips can only be found in Dr.Osgoodby's Body Transformations Newsletter. Join me next month and we'll talk about ways to get a good night's sleep. .

Live in Passion and Good Health,
James Groves

Obesity Increases Breast Cancer Risk

It's well-understood that obesity raises the risk of all kinds of chronic disease, especially heart disease and cancer. Mechanisms by which excess stored fat contribute to these diseases are the subject of intense study in laboratories all over the world. A study published in a recent issue of the Journal of the National Cancer Institute helps to explain the link between obesity and lifetime risk of breast cancer.

Researchers in Britain, Japan, Italy, and the U.S. evaluated eight groups of women who had passed menopause. Those who developed breast cancer-a total of 624 subjects-were compared with a control group of 1,640 cancer-free women of the same age. Across the board, the more the women weighed, the higher their breast cancer risk. Women with a body mass index higher than 30 had an 18 percent higher risk of breast cancer than women with BMI of 25-the highest you can go on the BMI scale without being considered overweight. And the more the women weighed, the higher their levels of the strongest form of the hormone estrogen, called estradiol.

Estradiol is known to be carcinogenic in excess. It promotes the growth of cells, and has potent growth-accelerating effects on cancers, especially those that are estrogen-sensitive-as most breast cancers are. Fat cells release excess estradiol into the blood.

If you'd like to calculate your BMI, follow these calculations. Multiply your weight in pounds by 2.2 to get kilograms. Then convert your height by multiplying your height in inches (five feet seven would be 67 inches, for example). Now multiply that number by 0.0254. Square the result of that calculation. Divide your weight in kilograms by your height in meters squared. The result will be your BMI. The BMI categories are as follows:

18.5 or below = underweight
18.5 - 24.9 = normal weight
25 - 29.9 = overweight
30 or above = obese

It follows that if you're overweight or obese, losing weight will help you to prevent breast cancer. Avoiding conventional hormone replacement therapy (HRT) and taking steps to balance your estrogen-to-progesterone ratio will help you to avoid this terrifying disease. For more on this, read the new book by John Lee, M.D. and coauthors Virginia Hopkins and David Zava, What Your Doctor May Not Tell You About Breast Cancer (Warner Books, 2003).

Visit http://keith.freelife.com/

You will find this "StressTip Message" helpful to stay focused and on purpose. You can put this message to work by reading it often throughout the day.

My beliefs help me create events to further my goals. With demonstratable facts I make progress on my goals that have been hampered by broken promises, doubts and indecision.

~ Need help with this? Contact The Baum Group at: mailto:TheBaumGroup@YourStressMatters.com

If you need to lose weight, you must be in caloric deficit. This can be accomplished by cutting down your caloric intake, or increasing the amount of calories you burn by exercising. I recommend both. Even though a calorie is a calorie when it comes to weight loss, a calorie is not a calorie when it comes to your health. Make sure your daily diet includes several servings of fruit and vegetables and whenever possible, avoid foods that contain trans fat.

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