BEYOND THE BEDROOM: HOW SOCIAL AND ENVIRONMENTAL FACTORS SHAPE A CHILD'S SLEEP AND AIRWAY HEALTH
Feb 3
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Quality, restorative sleep is essential for a child's overall health and development. It plays a crucial role in physical growth, brain function, emotional regulation, and immune system strength.
Similarly, optimal airway health supports all of these functions. Optimal airway health is essential in obtaining good quality sleep, which children need to support their overall health.
CONNECTION BETWEEN SLEEP AND AIRWAY HEALTH
Sleep and airway health have a deeply interwoven connection. Without optimal airway health and development, restorative quality sleep cannot be achieved.
In order to cycle through all of the sleep stages, including REM and deep sleep, optimal nasal breathing needs to occur. Nasal breathing ensures steady oxygen flow, which is critical for brain activity during REM sleep and deep sleep. Mouth breathing can cause oxygen fluctuations, leading to micro-awakenings that interrupt sleep cycles.
Nasal breathing supports sleep quality in several ways:
Optimized Oxygen Exchange – The nose filters, humidifies, and warms the air, leading to better oxygen uptake and circulation, which helps the body relax and recover overnight.
Balanced Nervous System – Breathing through the nose activates the vagus nerve and allows the body to enter into the parasympathetic nervous system (rest-and-digest mode), promoting relaxation and deeper sleep.
Enhanced Nitric Oxide Production – The nasal passages produce nitric oxide, which improves blood flow, enhances oxygen delivery, and has anti-inflammatory properties that aid in better breathing and sleep.
Kids can be at risk of poor airway health and development due to:
Low tongue posture
Orofacial myofunctional disorders
Low muscle tone
Narrow jaws
During sleep, the muscles of the airway relax. This can cause obstructions or collapses of the airway, leaving kids susceptible to mouth breathing, snoring, or sleep apnea, especially if the above risk factors are present. Additionally, there are social and environmental factors that can play into kids' airway health and development – we will get more into those in this blog!
Supporting optimal sleep quality and airway health and development in kiddos is a top priority since it is foundational for their development and lifelong health.
SOCIAL FACTORS AFFECTING SLEEP AND AIRWAY HEALTH IN CHILDREN
Social factors are the environmental, cultural, and economic conditions that influence a child's overall well-being. These include family dynamics, socioeconomic status, access to healthcare, education, nutrition, and social interactions. These factors shape a child's general health and their airway health and development, which are crucial for proper breathing, sleep, and facial growth.
1. Family & Parenting Practices
Parental habits, such as encouraging nasal breathing and proper oral posture (tongue position, lip seal), influence airway development. Parents who recognize signs of sleep-disordered breathing (snoring, mouth breathing, restless sleep) can seek early intervention, preventing long-term developmental issues.
Bottle-feeding vs. breastfeeding: Breastfeeding promotes proper jaw and airway development, while prolonged bottle or pacifier use can contribute to narrowed airways and mouth breathing habits. Mindful bottles and pacifiers can be used to support growth.
2. Socioeconomic Status & Access to Healthcare
Limited access to dental and medical care can lead to undiagnosed issues like narrow jaws, crowded baby teeth, malocclusion, tongue-tie, allergies, enlarged tonsils, or sleep-disordered breathing. Access to airway-focused practitioners can feel few and far between. We are always here to help you locate the nearest airway-focused team! You can also direct your pediatric dentist or other practitioners in your community to check out our website and resources for practitioners to learn more about airway health and development.
Lower-income families may have reduced access to nutritious food, impacting proper craniofacial development. Processed, soft foods may limit jaw muscle use, leading to underdeveloped airways.
3. Nutrition & Diet
A lack of proper nutrition (e.g., vitamins D, A & K, magnesium, and calcium deficiencies) can lead to weaker bone development, affecting jaw and airway structure. Soil has become depleted over time, leading to less nutritious food.
Diets high in soft, processed foods can contribute to smaller jaws, crowded teeth, and airway obstruction (leading to mouth breathing).
4. Cultural Norms & Lifestyle Choices
In some cultures, kids are encouraged to breathe through their noses and eat more challenging foods, promoting stronger jaw and airway development.
Increased screen time and poor posture (e.g., looking down at devices) can lead to forward head posture, negatively impacting airway alignment.
5. Sleep Hygiene & Environment
Sleep hygiene refers to the habits and practices that promote consistent, high-quality sleep. It includes maintaining a regular sleep schedule, creating a comfortable sleep environment, limiting screen time before bed, and adopting relaxing bedtime routines to support deep, restorative rest.
A child’s sleep position, pillow choice, and bedroom air quality impact airway health.
6. Peer Influence & School Environment
Schools that promote outdoor and physical activity and good posture help with lung capacity and respiratory health.
Bullying or stress can trigger chronic mouth breathing or anxiety-related hyperventilation, worsening airway issues over time.
ENVIRONMENTAL FACTORS IMPACTING SLEEP AND AIRWAY HEALTH IN CHILDREN
Environmental factors like air quality, noise, and light pollution significantly impact both sleep quality and airway health. Poor air quality, caused by allergens, dust, and pollutants, can lead to nasal congestion, inflammation, and an increased risk of mouth breathing, which disrupts sleep and affects airway development over time. Noise pollution from traffic or household sounds can trigger micro-awakenings, preventing deep sleep and increasing stress levels. Similarly, exposure to artificial light, especially blue light from screens or streetlights, interferes with melatonin production, making falling and staying asleep harder.
To optimize sleep and airway health, improving indoor air quality by using air purifiers, keeping bedrooms dust-free, vacuuming frequently, and maintaining proper humidity levels (40-60%) can help reduce respiratory irritants. Encouraging nasal breathing with saline rinses or nasal strips can also improve airway function. For noise reduction, using white noise machines, earplugs, or soundproof curtains can create a quieter sleep environment.
To combat light pollution, blackout curtains, dimmable lights, and reducing screen time before bed can help regulate melatonin levels. By addressing these environmental factors, individuals can enhance both their sleep quality and long-term respiratory health.
WHAT CAN PARENTS DO TO HELP WITH A CHILD'S SLEEP AND AIRWAY HEALTH?
Many of these factors can be out of our control as parents, so let’s focus on what we can do! Awareness of what impacts airway health and development allows us to take small but meaningful steps toward improving our children's health.
Our kids’ nervous systems mirror our own as parents, so investing in our own well-being is crucial for their health. When we are stressed (sympathetic nervous system response), we are more prone to mouth breathing than when we are relaxed (parasympathetic nervous system response). The sympathetic nervous system state encourages rapid, shallow breathing, preparing the body for action in response to stress—fight, flight, fawn, or freeze.
Finding ways for each family member to regulate their nervous system during times of stress supports nasal breathing and overall health. Practicing slow, intentional nasal breathing during stress can further enhance nervous system regulation. The Buteyko app offers helpful breathwork exercises for all ages: Buteyko Clinic App.
When introducing solids, incorporating resistant foods and meat can benefit craniofacial development and provide the necessary nutrition to support healthy airway growth. Foods that require more chewing, such as raw vegetables, whole fruits, tough meats, and nuts, help develop strong jaw muscles and improve oral function.
Encouraging children to chew thoroughly and avoid overly processed, soft foods can help promote proper jaw alignment and airway health. Chewing also stimulates saliva production, which supports digestion and oral hygiene. Developing strong chewing habits early on not only aids in facial structure development but also helps maintain good breathing patterns and overall health throughout life.
Encouraging healthy social habits is another key aspect of supporting airway health and sleep. Structured routines, emotional support, and stress management strategies help kids feel secure, reducing anxiety-related breathing issues. Activities such as mindfulness exercises, family bonding time, and open communication about emotions can create a balanced environment that fosters healthy development.
Setting a strong foundation of sleep hygiene and optimizing the sleep environment are also critical in airway health and development. With good habits in place, kids can manage and maintain their sleep hygiene as they grow.
Sleep hygiene strategies include:
Observing sunlight within 1 hour of waking to support melatonin production and circadian rhythm
Eliminating blue light after sundown, including stopping screen time at least two hours before bedtime
Reducing overhead light within an hour of bedtime, opting for amber or red hues when possible
Incorporating a warm shower or bath— a drop in body temperature can signal sleep readiness for most
Prioritizing oral & nasal hygiene— brushing, flossing, and using nasal spray or rinsing as needed
Engaging in a relaxing activity before bed— addressing sensory needs, reading, journaling, practicing gratitude, or deep breathing exercises
Maintaining a consistent bedtime and wake time
Using natural fibers for bedding and reducing/eliminating stuffed animals
Keeping the room at a cool temperature
RECOGNIZING THE SIGNS OF SLEEP AND AIRWAY HEALTH ISSUES IN CHILDREN
If your child is struggling with behavioral issues such as frequent emotional outbursts, irritability, difficulty concentrating in school, or excessive daytime sleepiness, it may be beneficial to observe their sleep to determine whether it is of optimal quality and supporting their health and development.
Signs to look for include:
Persistent mouth breathing
Open or slack-mouthed posture; unable to seal lips (awake or asleep)
Snoring or noisy breathing
Night terrors
Late-stage bed-wetting
Chronic nasal discharge/runny nose
Dark circles or allergic "black eyes"
Tossing, turning, thrashing, and restless sleep
Messy sheets and blankets (from drooling or restless sleep)
Nail-biting
Oral habits like thumb or finger sucking, extended bottle, sippy cup, or pacifier use
Crooked teeth
Crowded teeth such as baby teeth without gaps between them
Frequent earaches or ear infections
Awakening feeling unrefreshed or with headaches most days
If you notice these signs, seeking out an airway-focused care team to assess nasal breathing ability and craniofacial growth can be beneficial. If you need assistance finding an airway-focused care team, check out our locator or contact our Parent Liaison, Christi, at Christi@childrensairwayfirst.org.
A good starting point typically includes working with a myofunctional therapist and an airway-focused dentist, who can then provide referrals to other specialists such as an ENT, sleep physician, or allergist as needed.
AIRWAY HEALTH: TO INFINITY AND BEYOND
Recognizing and addressing airway health early can have lifelong benefits for children. Parents can play a crucial role by advocating for awareness in schools and communities about environmental impacts on children's health. Small, meaningful changes—whether through improving sleep hygiene, reducing environmental stressors, or encouraging proper breathing habits—can have a profound impact on a child’s well-being.
Visit Children’s Airway First for expert tips and resources to support your child’s airway and sleep health.
SPOTLIGHT BOOK RESOURCE FOR PARENTS
One of our top recommended readings, Sleep Wrecked Kids by Sharon Moore, provides invaluable guidance on optimizing sleep hygiene and improving airway health.
Kids often suffer unknowingly from the consequences of sleep problems because their issue is frequently missed or dismissed by both health professionals and parents.
Sleep disorders are a major public health issue that can kick-start a lifetime pattern of health, behavior, and learning problems. From ages 4-10, at least 25 percent of kids have sleep problems. Sleep Wrecked Kids guides parents towards good sleep as the norm, allowing themselves and their children to grow and thrive.
Speech pathologist and myofunctional practitioner Sharon Moore teaches parents why ‘bad sleep’ is connected to a myriad of health problems, what ‘good sleep’ actually means, how to identify red flags for sleep problems, how to improve sleep quality by improving airway health, and so much more! Parents are empowered to not only get more sleep themselves, but also to help their children get the sleep they need―every night.
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