Is Your Child Acting Out? It Might Be a Sleep Disorder
Jay Reeck, MD, ENT, recalls one distraught mother who stayed with her child all night and, every time he stopped breathing, she would give him a little nudge to wake him up.
It was obstructive sleep apnea (OSA), a disorder that blocks the airway, causing wakeful, restless sleep. A child with OSA may stop breathing for a moment, but will awaken and start to breath again. “It really scares parents,” says Reeck. “And they should seek medical advice.”
The best place to begin is with a sleep evaluation and sleep study. Rogue Valley Sleep Center in Medford is now offering sleep studies for children, the only pediatric program in the region.
“We are now seeing children ages 3-17,” says Annemarie Day, a family nurse practitioner with Pulmonary Consultants & Sleep Specialists, a physician group that works with Rogue Valley Sleep Center. Day recommends seeing your physician, who can help with a sleep questionnaire and then make a referral.
Obstructive sleep apnea leaves adults tired and droopy all day. But it often has the opposite effect in children, causing symptoms that mimic attention deficit hyperactivity disorder (ADHD).
“If a child is snoring, they might be arousing multiple times a night and have fragmented sleep,” says Lee Harker, MD, pediatric sleep specialist and Chairman of Women and Children's Services at Asante Rogue Regional Medical Center, “Poor sleep affects school performance and certainly can result in behavior problems.”
If your child exhibits symptoms of OSA, he or she should be evaluated. A sleep study is the only certain way to make a diagnosis.
"We can diagnose all pediatric sleep disorders," says Beth Mortonson, Clinical Manager of Rogue Valley Sleep Center. "And we have seen remarkable turnarounds in the behavior of children treated for sleep apnea."
For the child at the start of this article, a study at the Rogue Valley Sleep Center diagnosed his OSA. The pediatrician sent him to Dr. Reeck, who removed the child’s tonsils and the OSA stopped. “It’s great to have parents come back and say, ‘Oh my gosh, they are sleeping so well!’ It’s amazing to see their faces just light up,” says Reeck.
To get a sleep study for your child, contact your physician. For more information, call the Rogue Valley Sleep Center at 541-774-5750.
Can it Affect My Child's Health?
A child with OSA may have poor health and growth, difficulty concentrating and/or developmental delay, hyperactivity and behavioral problems.
“Deep sleep releases hormones necessary for growth and building muscle,” says Annemarie Day, FNP, a pulmonary specialist. A child with sleep apnea may never reach or maintain deep sleep, preventing the release of growth hormone and making his or her heart work overtime by constantly speeding up to try and overcome the apnea so they can breathe.
So, What is Child Obstructive Sleep Apnea?
Jay Reeck, MD, often treats children with obstructive sleep apnea. According to Reect, sleep apnea can affect a child’s health and, “Paradoxically, cause hyperactivity instead of sleepiness during the day.”
Here are some facts about sleep apnea he says parents should know.
What it is
Childhood obstructive sleep apnea (OSA) is characterized by episodic upper airway obstruction that occurs during sleep.
In non-obese and otherwise healthy children younger than 8 years, OSA occurrence is estimated at 1-3 percent. Obesity confers 4-fold to 5-fold added risk for sleep-disordered breathing.
Large tonsils and adenoids are the most common cause of obstructive sleep apnea in children.
What to do if OSA is suspected
Parents should consult with their child's primary care provider for a referral to certified sleep experts such as Pulmonary Consultants & Sleep Specialists for evaluation and possible sleep study. If apnea is diagnosed, the child may be referred to an ear, nose, and throat (ENT) physician for further diagnosis and treatment.
Ten Signs That Point to Sleep Disorder
If your child exhibits any of the following signs, a sleep evaluation and/or study might be needed:
- Sleeps restlessly, maybe in an abnormal position, with head off the bed or propped up with many pillows.
- Snores loudly and often
- Stops breathing during the night for a short period—followed by snorting or gasping or completely waking up
- Sweats heavily during sleep
- Has school discipline or other behavioral problems such as irritability, aggression, or simply “cranky”
- Is difficult to wake up, even after a long sleep.
- Has headaches during the day, particularly in the morning
- Falls asleep or daydreams in school or at home
- Has attention deficit disorder with hyperactivity (ADHD)
- Bedwetting that isn’t outgrown at a typical age, especially if snoring is present
Is a Sleep Study Really Necessary?
Even if a sleeping disorder is strongly indicated, a parent should get a sleep study for her child before seeking treatment, recommends Lee Harker, MD., neonatology, Newborn Critical Care Associates.
“With a proper diagnosis, insurance is more likely to pay for an overnight stay after a tonsillectomy,” Harker explains.
Recent studies have shown that children with sleep apnea are particularly susceptible to serious complications after tonsillectomy. “That first night can be pretty rocky,” Harker continues, “I recommend you discuss having a sleep study with your doctor. If your child has true sleep apnea then he or she should be watched overnight in the hospital after surgery.”