Sleep disorders leading to groggy children

Treatment for kids differs from adults

September 24, 2014|By Andrea K. McDaniels | The Baltimore Sun

Busy lives, smartphones and poor sleep habits are all contributing to groggy children suffering from the same sleep disorders as adults. But Dr. Laura Sterni, director of the Johns Hopkins Pediatric Sleep Center at Mount Washington Pediatric Hospital, said treating sleep ailments in children takes a different approach form that used for adults.

How common is it for children to suffer from sleep disorders, and what kinds of sleep disorders do children suffer from?

Sleep disorders are very common in children. There are many types of sleep disorders that can be seen in children, and the types of disorders change as children grow.

Infants and toddlers, for example, may have trouble with things such as bedtime resistance, frequent night-waking and nighttime fears. Older children and adolescents may suffer from difficulty falling or staying asleep at night and sleep deprivation because of poor sleep schedules. Insufficient sleep is a significant problem for our teenagers who are challenged by early school start times and multiple daytime and evening activities and demands. Sleep deprivation leads to missed school days and late school arrival and can have a negative impact on mood, behavior and school performance.

Children of all ages can develop obstructive sleep apnea syndrome. Obstructive sleep apnea is seen in 1 percent to 5 percent of all children and can lead to many complications if left untreated. Snoring is the main symptom of obstructive sleep apnea, and children who snore on all or most nights should be evaluated for this disorder. Some children are at higher risk for the disorder, including children who have large tonsils and adenoids, and those that are overweight. Obstructive sleep apnea can lead to trouble with learning, behavior problems (such as hyperactivity), difficulty growing, bed-wetting, high-blood pressure and heart problems.

What causes sleep disorders in children?

There are many factors that lead to sleep issues in children. Obstructive sleep apnea can be seen in families and is more likely to happen in children who have problems such as: large tonsils and adenoids, a history of prematurity, muscle weakness or abnormal muscle tone, asthma and allergies and obesity.

Many other sleep issues are related to poor sleep habits but can also be related to coexisting medical or mental problems. Children with significant sleep issues deserve a comprehensive evaluation to help determine which sleep disorder they have and what may be leading to that problem.

How is treating a child for such disorders different from that of an adult?

Treating many of the sleep problems seen in children often requires family involvement. Many of the bedtime issues we see in children are treated by teaching the child and parent about good sleep habits, appropriate sleep schedules and consistent limit-setting by parents. It is very important to teach families about healthy sleep. Correcting bedtime problems and instituting healthy sleep habits will help avoid the complications of sleep deprivation.

Treating obstructive sleep apnea in children is very different than treating the condition in adults. In children, the disorder is usually treated by removing the tonsils and adenoids. In most children, this cures the disorder. Adult patients with obstructive sleep apnea need to use "continuous positive airway pressure." This involves wearing a small mask over the nose. It's attached to a machine that blows air into the nose and helps open the airway. Some children who cannot have their tonsils and adenoids removed or still have obstructive sleep apnea after surgery also use this treatment option.

Are children able to grow out of sleep disorders?

It may be possible that some children can "grow out of" sleep problems but given the significant complications that can be seen with untreated sleep disorders, we don't recommend waiting to see if sleep issues resolve on their own. If parents are concerned about their child's sleep we suggest discussing this with their primary care provider. If concerns persist we recommend evaluation in a sleep clinic or sleep laboratory depending on the problem.

What are some tips for parents to help their children get a good night's sleep?

•Turn off the cellphone, computer and TV at least one hour, but ideally two hours, before bedtime. The light, particularly blue light, that comes from computer screens and digital devices, and the cognitive stimulation involved in using the devices keeps children's brains active long after they should be resting.

•Encourage your child to read a book or listen to quiet music as they wind down for the day. Avoid exercise, a warm bath or hot shower shortly before bedtime.

•Create a quiet, dimly lit, cool environment conducive to sleep.

•Avoid caffeine-containing foods and drinks which can disrupt sleep. Children should not go to bed hungry. A light snack before bed can be beneficial but avoid heavy meals or snacks within one to two hours before bedtime.

•Most healthy children should get between 9 to 10 hours of sleep each night.

andrea.walker@baltsun.com

twitter.com/ankwalker

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