A sleep ring? That’s a conversation starter with Dr Shifa Shamsudeen, preventive paediatric and sleep dentist as she rings in a month-long celebrations on sleep awareness. She has launched an upgraded sleep passport 2.0, a booklet for parents and children with pointers for a healthy sleep routine from infancy to 18 years. It provides pictorial description of low quality sleep, and highlights the symptoms, causes, and effects of mouth breathing and sleep disordered breathing (SDB), an upper airway dysfunction and throws light on the AI integrated Belun sleep ring. “The ring is a big leap in sleep diagnosis. Earlier, the screening was invasive with all wires or big machines attached. Now, AI does this for us,” says Shifa, founder of We Little, a paediatric dental clinic in Coimbatore. While the ring measures oxygen levels, pulse, movements and other signals while the child is asleep, it helps to understand if the sleep is healthy or there are signs like snoring, sleep apnea or simply poor-quality sleep. “Dr Umakanth Katwa, pediatric sleep specialist, and faculty at Harvard Medical School evaluates the data and gives us a report every week,“ she explains adding that the sleep passport is an educational guide where children can also journal.

Reflecting on her 14 year journey, her message is that many problems with the mouth that result in poor sleep can be prevented. They can also be solved early, with myofunctional therapy. “This involves breath, muscle and sleep re-training exercises,” she says. An example is to place the tongue behind the upper front teeth without touching the teeth for 10 seconds. “I actively got into sleep education from 2018.We have grown from one centre in Coimbatore to eight centres across seven cities.”

As a paediatric dentist, she has seen misaligned jaw lines and under-developed tongues that narrow the airways. While earlier, these problems were thought to be only genetic, today, research says that a number of oral cavity problems in children are a result of poor lifestyle habits, such as bottle feeding, and infections, like recurring inflamed adenoids. “ Sleep issues in children is an upcoming slow epidemic. When we started teeth alignment for children with myoline exercises, their sleep quality improved greatly. Mothers shared feedback on the positive impact it had on the overall behaviour and performance of children,” she recalls. This led her to complete a mini-residency in paediatric sleep (2019) and a fellowship in dental sleep medicine (2020) at Tufts University. “ I came back and started the Institute of Craniofacial Myology And Paediatric Sleep to encourage young dentists to treating crooked teeth holistically. Twenty five students have finished their fellowship here.”

While the American Academy of Sleep Medicine recommends sleep duration of 10 to 13 hours for children aged between three and five, Dr Shifa says quality sleep matters. “There are various stages to sleep. A quality deep stage sleep is the key to neurocognitive growth. Their brain will be refreshed and rejuvenated. If not addressed early, this can affect their quality of life,” she says adding that this led her to collaborate with schools to take the awareness forward through an initiative called We Circle. “ We talk to parents and teachers to help identify symptoms like attention deficiency in children early on. We want to have a smile passport for every children to evaluate their sleep. In most children, mindful breathing helps correct such issues. We want to build communities.” There is also plan to launch an app to track a child’s sleep regimen.

While she rues that sleep health is overlooked in a country still battling with eradication of communicable diseases, such communities can be a game changer. She adds, “It’s the right of the child to have good sleep. For the last five years, we keep aside a month towards the year end to nurture communities and drive home this message.”