Pediatric Sleep Disorders
Sutter Children's Center, Sacramento
A good night's sleep is vital to a child's ability to grow and learn. Many children suffer from conditions that affect their ability to rest properly, which can cause mental and behavior problems, as well as medical conditions. Sutter Children’s Center, Sacramento Pediatric Sleep Disorders Program performs comprehensive consultations, diagnostic services and overnight sleep testing in order to diagnose and manage children’s sleep problems.
- Sleep Apnea
Sleep apnea is a common sleep disorder in children. While the word "apnea" means "absence or cessation of breathing", the terminology relates to sleep related breathing disorders in children. It is also frequently not related to being overweight as it is in adults. It is typically caused by an obstruction to the smooth flow of air through the nose down to the lungs which is required for restful deep sleep. Problems can include allergies, problems with nasal and facial structure and enlarged adenoids or tonsils. In some cases, sleep apnea in children can be caused by the brain not sending signals for the child to breathe. Consequences of not addressing breathing related sleep problems in children can be severe including long term effects on learning, attention span, behavior, health problems and physical growth.
- Common Symptoms: Snoring, shallow breathing, gasping, mouth breathing, drooling, waking up multiple times during the night, bed wetting, difficulty waking up in the morning, daytime sleepiness, fatigue, inattention, impulsive behavior or hyperactivity, headaches and behavior problems.
- Treatments: The sleep specialist will provide a comprehensive consultation and if needed, refer the patient for investigations such as an overnight sleep study to confirm the diagnosis and rule out other causes of symptoms. A number of treatments may be prescribed, including medications, surgery to relieve the airway obstruction if any, specialized machines to help keep the air passages open during sleep, or provide extra oxygen during sleep.
Insomnia in children is sometimes hereditary and often leads to long term problems with behavior, learning and physical health. In very young children, there are often problems in establishing healthy sleeping habits to begin with, while in older children there are often associated psychological issues.
- Common symptoms: Difficulty falling asleep at a reasonable time, waking up often during the night for no apparent reason, or waking up too early in the morning, leading to feeling tired, hyperactive, inattentive, and with learning and behavior problems during the day.
- Treatments: The treatment usually involves a comprehensive effort to establish consistent and proper sleep rituals and habits, modification of lifestyle, correcting beliefs related to sleep, and, and sometimes medications. Behavioral or medical conditions associated with insomnia also often need to be treated.
- Disorders of Sleep Rhythms
Children with complex medical or behavioral conditions sometimes have irregular sleep cycles. Normal adolescents often develop sleep patterns that are not consistent with the expectations of society making it difficult for them to perform well in school.
- Treatments: Management involves establishing the diagnosis, modifying lifestyles, medications and addressing underlying behavioral or physical causes
- Restless Leg Syndrome
Restless leg syndrome, sometimes mislabeled as growing pains, is a sleep disorder that can cause a lack of sufficient sleep by keeping the child uncomfortable for long periods at bedtime, and thus causing daytime problems in behavior, learning and performance. This disorder is sometimes hereditary but often related to dietary deficiency of iron in young children and is very much treatable.
- Common symptoms: Often described as aching in legs and sometimes arms, that is worse when resting and feels better with stretching, rubbing, massage or walking around. Symptoms are usually more bothersome at bedtime but can occur throughout the day such as when sitting in class.
- Treatments: Management consists of a diagnostic evaluation by the pediatric sleep specialist, investigative studies if necessary, and appropriate dietary modification, supplements or medications.
Narcolepsy is a sleep disorder of excessive sleepiness that can be hereditary or caused by other medical conditions and is a lifelong disorder with initial presentation in childhood. The condition is associated with abnormal intrusion of REM sleep during periods of wakefulness.
- Indications: Sleepiness during the day in spite of sleeping well through the night, napping in school, home, or even during activities. Sometimes it can be associated with a phenomenon called cataplexy during which the person loses control of parts of the body without losing awareness or consciousness. This can happen during times of excitement or laughing and consist of falling to the knees, dropping objects, jaw dropping or eyes closing.
- Treatments: Establishment of the diagnosis requires a review of the child’s history, family history, evaluation for concurrent illnesses and various investigative tests. Treatment often improves the child’s quality of life significantly.
- Night Terrors, Sleep Walking, Sleep talking and other Parasomnias
Night terrors occur often in younger children, several hours after falling asleep and consist of abrupt awakening while inconsolably crying for several minutes, then going back to sleep and later having no memory of the event in the morning. Sleep walking is often hereditary, sometimes related to stress or anxiety, and can be potentially hazardous if the child walks out of the house, or down stairs. Children often talk in sleep, grind their teeth, and sometimes have repetitive movements such as head banging while sleeping or falling asleep. The whole family’s sleep is disrupted because of the nature of these events resulting in daytime problems.
- Common symptoms: Sudden bouts of apparent awakening, screaming during sleep, sleep walking, sweating, bed wetting, talking, grinding teeth, head banging, rhythmic body movements, looking confused or disoriented on abrupt awakening from sleep, lack of memory of the events, daytime sleepiness, fatigue, hyperactivity or behavior problems.
- Treatments: Seizures and sleep apnea can trigger similar symptoms. However, most children outgrow night terrors and sleep walking without a need for major intervention. Review if the child’s history with the pediatric sleep specialist, investigative tests, and intervention with behavior modification or medicines may be needed depending on the severity of the problem.
As the only comprehensive pediatric sleep disorders program in the area, the our Pediatric Sleep Program offers board-certified pediatric sleep specialists, multidisciplinary clinical teams, advanced diagnostics and child-friendly overnight sleep testing facilities with certified technologists.
Our pediatric sleep specialists are:
Amer Khan, M.D – Board certified in pediatric neurology and sleep medicine
Bradley E. Chipps, M.D. – Board certified in pediatrics - subspecialty pediatric pulmonology
Sutter Sleep Disorder Centers
Sutter Sleep Disorders Centers is the only sleep center in Northern California outside of the Bay Area that specializes in diagnosing and treating sleep problems in children. Our center specializes in overnight sleep testing and is uniquely designed with children in mind – including our specially designed private rooms with smaller beds and cribs, sleeping options for parents, physicians and technologists specifically trained in pediatric sleep disorders, and treatment protocols specifically designed for children.
For more information about the Sutter Sleep Disorders Centers in Sacramento and Roseville, call 916-646-3300.
Modesto Christian elementary schoolteachers could see there was something wrong with little Ryan. He was well-behaved, with his pencil in hand and looking right at the teacher, but when they looked into his eyes, they could tell he was just "spaced out." Ryan's self-esteem was shot and was lucky just to earn C-minuses.
Read Ryan's story
Read More Patient Stories