Pediatric Sleep Disorders
Medical Conditions Often Associated with Sleep Disorders in Children:
- Frequent snoring
- Mouth breathing
- Difficulty sleeping and restless sleep
- Excessive daytime sleepiness
- Daytime cognitive and behavioral problems, including inattention, aggressive behavior and hyperactivity
- Frequent nighttime awakening
- Morning headaches
- Night sweats
- Respiratory pauses
- Sleep Walking
- Premature birth
- Enlarged tonsils and adenoids
- Craniofacial abnormalities
- Genetic abnormalities (e.g. Down’s Syndrome)
- Spina Bifida
- Low muscle tone
- Treatment resistant epilepsy
- Sickle Cell Anemia
- Visual impairment
- Developmental delay
- Psychiatric conditions
How serious is sleep apnea in children?
It is a potentially life-threatening condition that requires immediate medical attention.
The risks of undiagnosed sleep apnea in children include learning problems, developmental delays, and other behavior problems. The neuro-developmental consequences related to untreated sleep apnea can have a lasting impact affecting school performance and behavior. In some cases, failure to grow, heart problems and high blood pressure can be linked to sleep apnea. In some children and adolescents, obstructive sleep apnea causes daytime sleepiness that can result in personality changes, lost productivity in school and interpersonal relationship problems. When a child has sleep apnea, he or she may lag behind in many areas of development. The child may become frustrated and depressed. Once sleep apnea is treated, these symptoms may be reversed.
How does the doctor determine if my child has Obstructive Sleep Apnea?
A sleep test, called polysomnography (PSG) is performed to diagnose sleep apnea. An overnight polysomnography test involves monitoring brain waves, muscle tension, eye movement, respiration, oxygen level in the blood and audio monitoring. (for snoring, gasping, etc.). The test is painless.
How is Sleep Apnea treated in children?
In children, there are different treatment options based on the severity of the sleep apnea. It may require the removal of tonsils or adenoids, CPAP (continuous positive airway pressure), medications, or a dental device. CPAP is a machine that blows air into your nose through a mask, keeping the airway open. The sleep doctor will “prescribe” the pressure for the CPAP setting. A home healthcare company will set up the machine and provide training in its use and maintenance. Our doctors have extensive experience in using CPAP in children and have developed techniques to assist children in its use at home.
What is Insomnia?
It is a sleep disorder that results in a difficulty to fall and/or stay asleep. People with insomnia have one or more of the following symptoms:
- Difficulty falling asleep
- Waking up often during the night and having trouble going back to sleep
- Waking up too early in the morning
- Tired upon waking
Many children have behavioral insomnia of childhood.
Here are two common causes in children:
1. Sleep-onset association
All of us wake up briefly a number of times during the night. This occurs most often during the stage of sleep when we have most of our dreams. This sleep stage is known as rapid eye movement (REM) sleep. Usually, we are unaware of these awakenings and return to sleep quickly.
Young children may cry when they wake up. Parents naturally may feel that they need to help their child return to sleep. Parents do this by feeding, rocking, holding or lying down with their child. As a result, many young children become unable to fall asleep on their own. They depend on their parents help instead of learning to comfort themselves. The child learns to connect or associate going to sleep with a person or activity. If this describes your child, then he or she may have a problem with sleep-onset association. A parent may recognize this problem by saying something like this: I am exhausted. I have to rock my child to sleep every night and for every nap. If she wakes up during the night, she is unable to fall asleep until I rock her again. This child appears to be connecting the action of falling asleep with being rocked. She is unable to fall asleep when that action is missing.
2. Limit-setting problems
Limit-setting problems usually begin after the age of two. It occurs when your child refuses to go to bed, stalls, or makes it hard for you to leave the bedside. Limit-setting problems can occur at bedtime, nap time, or when your child wakes up during the night. Parents need to assert that they are the ones who decide when it is time for bed. They should enforce this time even if the child disagrees or seems active and alert. Children can get very creative when they want to stay up later. They may ask for one more hug, a tissue, a drink of water, another story, to have the light turned off or on, or to tell you something important. It can be hard to know what is real and what is simply a delay tactic. You need to be firm and consistent when you respond to the delays. Giving in to them will only encourage the behavior. Parents need to give their children well-defined limits.
If your child or you have an ongoing sleep problem, then you should talk to your pediatrician or to a sleep specialist.
It is important to instill healthy sleeping habits in your child. Medical studies have demonstrated that sleep plays a role in brain development. A tired child may have developmental or behavioral problems. Your child’s sleep problems not only affects him/her, but can also be a source of stress and concern for the entire family. For this reason, it is important to make sure that your child gets enough sleep and sleeps well.
The recommended sleep requirements for age:
How much sleep should my child get?
- Infants (3 to 11 months): 14 to 15 hours
- Toddlers: 12 to 14 hours
- Preschoolers: 11 to 13 hours
- School-age children: 10 to 11 hours
Here are some tips to help your child sleep better:
- Follow a consistent bedtime routine.
- Set aside 10 to 30 minutes to get your child ready to go to sleep each night.
- Establish a relaxing setting at bedtime.
- Interact with your child at bedtime.
- Don’t let the TV, computer or video games take your place.
- Keep your children from TV programs, movies, and video games that are not right for their age.
- Do not let your child fall asleep while being held, rocked, fed a bottle, or while nursing.
- At bedtime, do not allow your child to have foods or drinks that contain caffeine. This includes chocolate and sodas.
- Try not to give him or her any medicine that has a stimulant at bedtime. This includes cough medicines and decongestants.
- A child who gets enough sleep and sleeps well is more likely to be cheerful during the day. The better the child sleeps, the happier the entire family will be.