- Phone 614-766-0773
- Location Dublin, Ohio
-
Childhood Sleep Disorders
Sleep is crucial to development. Lack of qualitative, restorative sleep can lead to many daytime problems such as sleepiness, irritability, hyperactivity, impaired learning, and lack of attention. Approximately 25% of all children experience a sleep problem at some point during their childhood.
The following pediatric problems are generally symptoms of an underlying sleep disorder and warrant an evaluation with a specialist. Treating a sleep disorder can improve academic performance and overall health.
- Snoring affects all age groups and is often associated with behavioral control problems and academic failure.
- Excessive daytime sleepiness, or hypersomnia often displays as symptoms of hyperactivity, irritability and inattention.
- Insomnia often manifests in children as a difficulty getting to sleep at night and getting up for school in the morning.
- Abnormal behaviors during sleep such as sleepwalking or acting out during sleep.
Common Sleep Disorders/Issues in Children and Adolescents
Obstructive Sleep Apnea is characterized by repetitive breathing stoppages during sleep, causing the child to either wake up or go a lighter stage of sleep. Snoring may or may not be present even though breathing stoppages occur. The repetitive arousals needed to open the airway fragment sleep, leading to frequent brief awakenings and daytime sleepiness.
Narcolepsy is a disorder of excessive sleepiness which begins during adolescence and is often diagnosed only many years later in adulthood. Although chronic sleep deprivation from late bedtimes and early rise times is a more common cause of excessive daytime sleepiness in children, narcolepsy should be suspected in adolescents and young adults who complain of daytime sleepiness despite allowing themselves adequate sleep at night.
Circadian Rhythm Disorders occur when the brain’s biological 24-hour or “circadian” clock is not synchronized with the desired sleep-wake schedule. For example, the brain’s circadian clock tends to slow down during puberty, leading to a natural tendency for adolescents to go to bed late and sleep in the next morning. When this “phase delay” or slowing of the circadian clock leads to missed school days or distress, the child may have a “delayed sleep phase syndrome”. A delayed sleep phase syndrome is very common in adolescence and can generally be treated easily.
Inadequate Sleep Hygiene is a very common problem in adolescence. In the age of iPhones, text messaging, video games, social networking, and other electronic media, many kids have a long list of excuses to delay bedtimes. By going to bed late and getting up early for school, they tend to accumulate a profound sleep debt by Friday night. They pay back that debt on the weekends, often sleeping in until late morning or noon. Sleeping in for an extra 3-5 hours on days off resets their biological clock to a later or delayed “time zone”. Although physically in Ohio, their clock is now set to Pacific or California time zone.
Read More
On Sunday night, they suddenly need to come back to the Ohio time zone. Although they may go to bed before 9-10:00 PM, their brain is not ready to go to sleep that early and they may be unable to fall asleep. As a result, they wake up sleep deprived on Monday morning. The vicious cycle repeats with the accumulation of another sleep debt during the week waiting to be paid back the following weekend, all the while leading to decreased school performance.
Children with RLS are unable to sit still and are often misdiagnosed for attention deficient-hyperactivity disorder (ADHD). PLMD disrupts sleep and can consequently impact academia or behaviors.
Parasomnias are unwanted behaviors that manifest during sleep such as sleepwalking, sleep terrors, nightmares and sleep-related enuresis. Parasomnias in children tend to improve or resolve over time, but medical intervention may be required, particularly when safety issues for sleepwalkers or social distress is involved.
Symptoms
It is important to remember that children exhibit sleepiness very differently than adults. Children rarely say “I want to take a nap” or “I feel sleepy.” On the contrary, they tend to deny such symptoms even in the face of obvious exhaustion. Instead, children tend to become over-active “race cars” to the point of hyperactivity, a behavior that some researchers feel may represent a means of sustaining wakefulness in the setting of excessive sleepiness. Research has found that many such children may be misdiagnosed as having attention deficit-hyperactivity disorder (ADHD). They may be prescribed Ritalin or a similar stimulant which is also effective in improving alertness and their ability to sit still and concentrate. Any child who snores and has symptoms resembling ADHD should be suspected for having potential obstructive sleep apnea.
Diagnosis
Our provider will determine the nature and extent of the sleep problem through an in-depth interview with the patient/caretakers and a physical examination. If needed, the child may undergo an overnight sleep study (polysomnogram) to monitor brain wave activity, breathing, heart rate, oxygen levels and body movements or behaviors during sleep. In some cases, a Multiple Sleep Latency Test may be performed to evaluate daytime sleepiness.
Treatment
Good sleep hygiene is essential in helping children navigate through the night and establish healthier sleep patterns. Treatments for pediatric sleep disorders vary according to the symptoms experienced and the diagnosis established. Options may include behavioral measures to establish a healthy sleep-wake schedule, surgical procedures or pharmacological interventions depending on the underlying diagnosis.