There's No Shortcut to Better Sleep for Your Child
A behavioral sleep doctor's perspective on why consistency beats quick fixes
A couple weeks ago, I took Eleanor to the dentist, who warned that Eleanor might soon need a palate expander. Immediately, my mind turned to a scary headline about palate expanders that I saw in the Atlantic, so I went to Google a review on the evidence for them. One thing that came up in the literature was the use of palate expanders in treating pediatric sleep disorders. Ever the skeptic, I consulted with my friend Andrea Roth, who is an expert on behavioral sleep interventions for kids. Here’s what she had to say on the topic.
The most common sleep disorder in childhood is behavioral insomnia of childhood, affecting an estimated 10–30% of children. Decades of research consistently show that behavioral interventions—whether implemented by caregivers or directly with the child—are the most effective, evidence-based treatment for these sleep difficulties. That said, I’m frequently asked about faster, easier solutions. Parents and caregivers understandably want something that works now. Traditionally, those questions center around medications or supplements, but more recently, I’ve been hearing a new one: could dental or orthodontic treatment be the missing piece to better sleep? Is this an overlooked, insurance-covered solution, or just another “quick fix” that doesn’t live up to the hype?
Before we even answer that question, it’s important to note that when we work with children on sleep behaviorally, we always begin by screening for underlying medical concerns, including sleep-disordered breathing and obstructive sleep apnea. Some of the most common red flags we look for are snoring, pauses in breathing during sleep, and night sweats. If those symptoms are present, further medical evaluation is absolutely warranted.
So where do dental and orthodontic interventions fit in? The answer is that they can be very helpful, but only for the right group of children. There is solid evidence supporting the use of oral appliances—such as palate expanders, Twin Blocks, and mandibular advancement “mouthguards”—in reducing snoring and obstructive sleep apnea. However, research also tells us that sleep apnea and related breathing disorders affect only about 1–4% of children. When you step back and look at those numbers, it becomes clear that the vast majority of children presenting to me with sleep concerns are not experiencing apnea—they are experiencing behavioral insomnia.
So, will a retainer fix Bobby’s sleep? Probably not. But what will are consistency, predictability, clear routines, and thoughtful parental responses. These are the interventions that are most strongly supported by research and most likely to lead to meaningful, lasting change. And yes, those approaches take time, effort, and follow-through. I say this not just as a clinician, but as a parent: life is busy, and the appeal of a quick fix is very real. But when it comes to children’s sleep, the evidence is clear—lasting improvement comes from putting in the work, not bypassing it.