Pediatric Sleep Questions and Answers
Teen Sleep, click here to learn more
from the 2006 National Sleep Foundation
Sleep in America Poll results
about the sleep habits of America's teens.
Pediatric OSA (Obstructive Sleep Apnea)
OSA differs in children and infants. In children OSA is characterized by a partial and persistent obstruction of the airway. Adults tend to experience more episodes of total intermittent obstructions. The early diagnosis and treatment of OSA in children is very important and may prevent future problems. The long lasting partial airway obstructions in children can be as detrimental as intermittent total obstruction is to adults. The tonsils and adenoids are the most common cause of airway obstruction in children 2-8 years of age.
Obstructive sleep apnea is caused when the airway is blocked by soft tissue in the back of your throat. An obstruction may be caused for several reasons. Research suggests that the soft palate is the most common cause of airway obstruction in infants less than one year old. Some studies suggest that infants are at a greater risk for sudden death (SIDS) associated with OSA due to a decreased ability to wake up when the airway is obstructed.
| Pediatric Sleep Resources | |
| Star Sleeper Program | www.nhlbi.nih.gov |
| Sleep for Kids | www.sleepforkids.org |
| National Sleep Foundation | www.sleepfoundation.org |
| Baby Center | www.babycenter.com |
| Kids Health | www.kidshealth.com |
| Children Today | Articles about Sleep |
In children and infants, OSA is often associated with hyperactivity, behavior problems, learning disabilities, sudden infant death syndrome, increased risk of infections, failure to thrive, neurological damage, and even death.
The American Academy of Pediatrics recommends that all children should be screened by pediatricians for snoring. Snoring is the most obvious and easily identifiable symptom of OSA.
Treating children with OSA is often difficult. The choices of interfaces at this young age are limited, and compliance is always an issue. Parents struggle to get their children to cooperate with mask placement, and if they're successful, the children usually remove the masks during the course of the night. Over time, many parents give up the battle, and the patients go untreated. Some of these children ultimately require more invasive treatments. However, GLSD offers another option, a new option! Great Lakes is amongst the first to use a high-flow nasal cannula (HFNC) to titrate and treat OSA in infants and young children. Megan Rauch, RRT, Clinical Director of Great Lakes Sleep Diagnostics, was one of the first to identify and utilize this technology to treat infant and pediatric sleep disordered breathing, ( Pediatric Obstructive Sleep Apnea and SDB, Another Option to Treat OSA in Youngsters ). The HFNC may be an option for children who continue to suffer from residual OSA after upper airway surgery, for children who aren't candidates for surgery, or for those who can't tolerate continuous positive airway pressure.
Infant Sleep Resources
Guarding Your Baby Against SIDS
Circumstances that complicate sleep training
http://www.babycenter.com/refcap/baby/babysleep/7749.html
My baby isn't sleeping -- what's wrong?
http://www.babycenter.com/refcap/baby/babysleep/7744.html
Sleep concerns: Bottles as sleep aids
http://www.babycenter.com/refcap/baby/babysleep/7590.html
National Sudden Infant Death Syndrome Resource Center
http://www.babycenter.com/refcap/baby/babyills/sids
How can I allay my fears about SIDS?
http://www.babycenter.com/expert/baby/babyills/sids
Baby sleep: Get off to the right start
http://www.babycenter.com/refcap/baby/babysleep/7742.html
Children Sleep Resources
Children with ADHD: Too Much Energy to Sleep
Sleep Resources for Classroom Teachers
Teacher Resources from Star Sleeper
Resources for Physicians
Questions about Pediatric Sleep
At GLSD we believe in a multidisciplinary approach to the diagnosis and treatment of sleep disorders in children. We provide testing and evaluation for children ranging in age from newborn to 18 yrs and offer a wide range of pediatric services. Identifying sleep disorders in children is often challenging, but extremely important! Failure to diagnose and treat a pediatric sleep disorder may lead to such serious complications as: impaired growth, behavioral problems, learning disabilities, and even cardio-respiratory failure. However, with accurate diagnosis and effective treatment most complications associated with sleep disorders in children are reversible
- Do children experience sleep disorders?
- What is a sleep study or polysomnogram?
- Why do Children need sleep studies?
- My child snores and has behavior problems in school, should I ask my pediatrician for a referral to a sleep lab for a sleep study?
- How many different types of pediatric sleep disorders are there?
- How do I know if my child suffers from a sleep disorder?
What is a sleep study or polysomnogram?It is estimated that 20-30% of children under the age of five suffer from some type of sleep disorder; 1-3 % of children suffer from sleep disordered breathing.
Why do Children need sleep studies?A polysomnogram is a procedure performed to record your child’s sleeping patterns. The type of study performed varies depending on the physician’s order and the needs of your child. Several body functions are recorded during a polysomnogram:
- Brain Waves or EEG
- Heart Rate and Rhythm (EKG)
- Eye Movements (EOG)
- Leg Movements (Leg EMG)
- Chin Tone (EMG)
- Breathing
- Breathing effort
- Oxygen saturation
- Exhaled Carbon Dioxide
The evaluation of the sleep recording helps us to gain valuable insight into the quality of your child’s sleep. We are able to determine the presence of sleep disordered breathing, movement disorders, as well as a number of other sleep disorders. Few people realize the severity of the consequences associated with childhood sleep disorders such as snoring and obstructive sleep apnea!
My child snores and has behavior problems in school, should I ask my pediatrician for a referral to a sleep lab for a sleep study?Current research clearly demonstrates why:
- A survey conducted by the American Academy of Otolaryngology indicated that eight out of 10 people are unaware that attention deficit hyperactivity disorder and obesity can be a result of sleep disorders in children.
- Breathing Problems During Sleep May Affect Mental Development in Infants. NIH 10/07/2004 A National Institute of Health study indicated that children who have problems breathing during sleep tend to score lower on tests of mental development and intelligence than do other children their age.
- Sleep Apnea Linked to Bed-Wetting in Kids.Journal of Pediatrics 2003- 66 children (41%) out of 160 kids ages 4 to 17 who were referred to a sleep lab for sleep-disordered breathing were also noted to be bed-wetters.
- A study performed at the University of Tuebingen and the Hanover Medical School, both in Germany, clearly demonstrates that children who snore do worse in school,
- Studies conducted by the University of Michigan, Stanford, and the University of Pittsburgh on 866 children found “substantial associations” between symptoms of sleep disordered breathing and inattentive and hyperactive behavior.
- A study conducted by Dr. Chervin at the University of Michigan found that habitual snoring occurs in 33% of kids ages 2 to 18 who are diagnosed with ADHD, compared to 9% of the control group.
- A study performed at the University of Illinois at Urbana-Champaign found that 26% of 69 children diagnosed with ADHD suffered from Periodic Limb Movement Disorder (PLMD).
- According to the article Obesity Hypertension in Children that appeared in the October 2002 edition of. Hypertension published by the American Heart Association, the prevalence of obesity in the United States has grown from 5% in the 1960’s to 11% in the 1990’s. Possible outcomes associated with childhood obesity include hypertension, type 2 diabetes mellitus, dyslipidemia, left ventricular hypertrophy, nonalcoholic steatohepatitis, obstructive sleep apnea, orthopedic problems, and psychosocial problems.
How many different types of pediatric sleep disorders are there?Yes, it is recommended that all pediatricians screen children for snoring, especially since snoring is often a symptom of Sleep Disordered Breathing or Obstructive sleep apnea. However, pediatric sleep disorders are often missed by primary care physicians. For instance, Dr. Judith Owens, M.D., associate professor of pediatrics at Brown University School of Medicine and director of the Pediatric Sleep Disorders Clinic at Hasbro Children’s Hospital in Providence stated in the October 2001 issue of Child Magazine that only 25% of 600 pediatricians interviewed felt comfortable diagnosing and treating sleep disorders.
Treating childhood sleep disorders may be as simple as changing behavior or as complex as upper airway surgery. nasal continuous positive airway pressure.
The most common are:
- Enuresis (Bed-wetting)
- Insomnia
- Excessive Daytime Sleepiness
- Narcolepsy
- Respiratory disorders, including obstructive, central sleep apnea and hypopnea syndrome.
- Night Terrors
- Somnambulism
- Restless Legs Syndrome
- Periodic Limb Movement
- Circadian Rhythm disorders
- Newborn conditions of disrupted sleep.
- Siblings of infants who have died of SIDS
- Infants who have experienced an apparent life threatening event.
How do I know if my child suffers from a sleep disorder?
Look for the following signs and symptoms: During Sleep:
- Snoring
- Witnessed apnea
- Choking noises
- Increased work of breathing
- Paradoxical breathing
- Enuresis (bed wetting)
- Bruxism (teeth grinding)
- Restless sleep
- Diaphoresis (night sweats)
- Hyperextended neck
- Frequent awakenings
- Dry mouth
During Wakefulness:
- Poor school performance
- Aggressive behavior
- Hyperactivity
- Attention deficit disorder
- Excessive daytime sleepiness
- Morning headaches
There are many other factors associated with a high risk for obstructive sleep apnea: Neurologic Abnormalities:
- Seizure Disorder
- Head injury
- Cerebral palsy
- Hydrocephalus
- Arnold-Chiari malformation
- Head injury
- Prematurity
- Central apnea
- Meningomyelocele
- Myotonic dystrophy
Craniofacial Abnormalities:
- Micrognathia
- Macroglossia
- Retrognatia
- Maxillary hypoplasia
Syndromes:
- Achondroplasia
- Apert’s
- Down
- Pierre Robin
- Prader-Willi
- Klippel-Feil
- Beckwith-Wiedemann
- Treacher Collins
- Stickler’s
- Fetal alcohol
- Marfan’s
- Hemifacial microsomia
Anatomic Obstructions:
- Excessive soft tissue of the neck
- Short neck
- Lingual tonsil hypertrophy
- Redundant oropharyngeal mucosa/long uvula
- Enlarged Adenoids
- Enlarged Tonsillar
- Pharyngeal flap surgery
- Nasal stenosis
- Choanal atresia
- Septal deviation
- Larygeal papillomas/tumors
- Subglottic stenosis
- Subglottic hemangioma
- Nasal polyps
- Laryngeal web/stenosis/mass
Diseases:
- Hypothyroidism
- Goiter
- Morbid Obesity
- Crouzon’s disease
- Gastroesophageal reflux
National Sleep Awareness Week 2004 Call to Action
Sleep is important for a child's health and overall development. In light of the findings from the 2004 Sleep in America poll, the National Sleep Foundation (NSF) calls upon parents and physicians to make sleep a priority for their families and patients:
Parents
Parents have a responsibility to implement healthy habits for themselves and their families. NSF recommends parents make sleep a family priority by doing the following:
- Make sufficient sleep a family priority. Understanding the importance of getting enough sleep and how sleep affects the overall health of parents and children is the first step towards making sleep a family priority. Parents/caregivers need to determine the amount of sleep each family member needs and take steps to ensure their individual needs are met. Every family member must make a good night's sleep a regular part of his/her daily schedule.
- Embrace good sleep habits. Regular bedtime routines, creating a quiet and comfortable bedroom, and adhering to appropriate bedtime and wake times can go a long way to better sleep. Televisions and computers need to be out of the bedroom and caffeine should not be part of a child's diet.
- Learn to recognize sleep problems. The most common sleep problems in children include difficulty falling asleep, nighttime awakenings, snoring, stalling and resisting going to bed, having trouble breathing, and loud or heavy breathing while sleeping. These sleep problems can be evident in daytime behavior such as being overtired, sleepy or cranky.
- Talk to your child's doctor about sleep. Parents/caregivers should discuss their child's sleep habits and problems with their child's doctor, as most sleep problems are easily treated.
- Visit www.sleepfoundation.org for information, resources and tips on healthy sleep.
Doctors
The family doctor is often the first person a parent turns to when it comes to issues affecting their child's health. The National Sleep Foundation urges physicians to promote healthy sleep habits for families through the following:
- Ask parents about their child's sleep and offer tips for how to implement healthy sleep habits.
- Evaluate children for possible sleep disorders and when necessary refer them to a sleep specialist.
- Educate parents on the importance of making sleep a priority.
The National Sleep Foundation is an independent nonprofit organization dedicated to improving public health and safety by achieving public understanding of sleep and sleep disorders, and by supporting public education, sleep-related research, and advocacy. NSF is based in Washington, DC.
Click here view the findings of the 2004 Sleep in America Poll.
| About Us | Sleep Diagnostic Services | Physician Resources | News | Affiliates | Feedback and Testimonials Sleep Test | Sleep Study Locations | Resources | Questions | Glossary | Adults | Pediatrics| Contact Us | Home |
| Great Lakes Sleep Diagnostics | 44968 Ford Rd. Suite G | Canton, MI 48187 Phone: 734-335-6662 | Fax: 734-335-6618 |
| Copyright © Great Lakes Sleep Diagnostics, All rights reserved. Site Design by VR Metro LLC |