Do you have unexplained sleep disturbances?

This is the abbreviated version of a very long story.

Morgan had daily recurrent sleep disturbances for over a year.  She woke up many times during the night and then when she woke up in the morning she would go into a seizure.  This pattern was disturbing to me.  Over the course of a year, I discussed these problems with several of Morgan’s doctors.  The answer I received was always the same.  First, given your daughter’s medical history, it is not uncommon for her to be having these problems.  Second, her neurologist stated that “transition seizures” are common in children with brain injuries and cerebral palsy so I did not need to be concerned.  However, my instincts were still telling me that there had to be more to the story so I continued to talk about Morgan’s issues to whoever would listen.  Morgan had also been seen numerous times by one of my doctors in the past.  During one of Morgan’s visits I was explaining her on-going sleep and seizure problems.  Keep in mind, Morgan had been on anti-seizure medicine during this entire timeframe.  The doctor said, “You’re going to think I am crazy but you need to take Morgan to see this dentist.”  I was shocked by this statement but told her I trusted her opinion.  We made an appointment to see Dr. Thomas Bosma, D.D.S. at Montgomery Dental Medicine in Cincinnati, Ohio.  Prior to the visit, we had to provide Morgan’s medical records for his review.  At the first visit, we went over her medical history and discussed her problems with sleep.  As a part of the visit, he takes an x-ray of the airway and checks her oxygen level. Her oxygen level, after a few minutes of monitoring was 83 and would only go as high as 85. He came back into the room and said, “Here is the first problem, her adenoids are huge and are blocking her airway but I am not an ENT so I am going to refer you for a diagnosis. This is why she tilts her head back – because her airway is physically blocked and that is the only way she can breathe so do not force her head forward when she is sitting. After the ENT resolves her physical obstruction, then make another appointment with me because I am sure that I can help Morgan.” The ENT confirmed that it was her adenoids but that her tonsils were okay.  Her adenoids were removed in June 2009.  After she healed, Morgan continued to have sleep disturbances so her ENT referred her to a pulmonary doctor for his opinion on a sleep study.  Morgan’s sleep study revealed that she had hypoventilation and obstructive sleep apnea.  With that diagnosis, Dr. Bosma stated that he could make a mouthpiece that would reposition her mandible and tongue to open her airway and asked the ENT and pulmonary doctor if we could proceed with this course of action prior to medicine and ventilation interventions.  The doctors agreed and Morgan was fitted for a mouthpiece.  She began sleeping through the night and did not have anymore morning seizures upon waking.  The pulmonary doctor was still unsure that the mouthpiece alone would solve the problem so the sleep study was repeated 10 months later – with the mouthpiece in place.  The results indicated that the mouthpiece had resolved her hypoventilation and obstructive sleep apnea and was therefore medically necessary. Morgan’s progress will be closely followed for any needed modifications to her protocol.  In short, Dr. Bosma made a huge difference in Morgan’s quality of life and we are grateful for his expertise.  Dr. Bosma has had to adjust her mouthpiece several times to meet her growing needs.  Dr. Bosma’s intervention has resolved close to 95% of Morgan’s seizure activity.  Thus, in this situation, Morgan did not need an increase in anti-seizure medicine – she just needed the ability to breathe through an unobstructed airway!

To this day, Dr. Bosma is the only person who she tells me she needs to see.  She'll say "mama, me need Dr. B, please."  The valuable lesson that I have learned is to listen to her and trust her instincts too because she knows how she is feeling - she just has difficulty expressing her thoughts.  When we go to see Dr. Bosma, he sits in front of Morgan and talks directly to her (not her mother) and listens very carefully to what she is saying and then he fixes whatever is bothering her.  It is apparent that she trusts him because she can feel how much he has helped her.  Morgan calls her mouthpiece her teeth so at night she says "me need teeth in." 

You can read more information about Dr. Bosma at http://www.montgomerydentalmedicine.com/team.html