Alaska Sleep Education Center

What to Look for in a Pediatric Sleep Center

Posted by ASC Pediatric Medical Director, Dr. Harry Yuan on May 30, 2018 9:03:00 AM


Children require special attention when undergoing sleep studies so be sure to choose a sleep center with specific pediatric expertise in childhood and adolescent sleep disorders.

Here are a few things parents should be aware of when finding a sleep center appropriate for their child;

The Sleep Physician should have experience in the evaluation and treatment of the pediatric patient. This includes the understanding the differences of communicating with a 4 year old versus a 12 year old. It is also important for the Sleep Physician to be able to communicate with the parents of the child as well.

Technicians should be specially trained sleep experts in pediatrics. Even more specifically, they should be experts in calming the fears of nervous young patients, in providing quality, kid-focused care and helping children get well, all in the comfort of a relaxed, non-threatening environment.

Be sure to choose a center that is Accredited by the American Academy of Sleep Medicine (AASM, and specializes in pediatric sleep disorders including;

  • Breathing problems such as snoring and sleep apnea
  • Nightmares/night terrors
  • Problems falling asleep and staying asleep
  • Excessive sleepiness and trouble waking
  • Insomnia
  • Teen sleep problems
  • Sleep walking
  • Bedwetting

Once you’ve found a sleep center that works, there are a few things to be aware of. Sleep studies for children are 9-10 hours long which is 30-40% longer than most adult studies. During a child’s sleep study, parents are required to stay overnight with them. A second bed is often in the room so both parent and child can be comfortable. Parents are encouraged to to bring any items that may make your child more comfortable, such as a favorite stuffed animal or a DVD they watch regularly before bed.


Pediatric Sleep Disorders

We all know that a good night’s sleep can make our children healthy and strong as they grow. Yet a good night’s sleep is often out of reach for many children.

We often think of sleep disorders as an issue that only older generations have to deal with. The reality is that anyone from birth and onward can suffer from sleep related disorders. Untreated sleep disorders can have a long lasting impact on your little one’s growth, development, and mental wellbeing.

When your child is struggling to sleep through the night, it not only has an effect on your little one’s health, but it also can be highly disruptive to your whole family. A child who struggles to fall asleep or wakes frequently can cause parents to become chronically sleep deprived as they struggle to find sleep solutions.

Finding a solution for a sleeping problem will not only give your child a better opportunity for learning, growth, and overall health and wellness, but it will lessen the stress felt by the whole family from lack of sleep.

Understanding Normal Sleep Behavior

Unusual sleep behavior is one of the most common concerns that parents of young children have. The first step to solving sleep problems is to recognize whether your child’s sleep patterns fall within normal sleep behavior for their age group. For example, frequent night waking is considered normal in a two-month-old baby but would be considered abnormal behavior for a two-year-old.

Let’s start by looking at early-infant sleep behavior. Newborns and babies younger than four months spend about 16-18 hours a day sleeping. At this age, babies tend to stir more and look restless while sleeping since they can’t control their reflexes yet. Newborns also need to eat more often and have not yet learned how to soothe themselves back to sleep so they need extra help falling back to sleep as they cycle between deep and light sleep. At this point sleep is fragmented.

At six months, infants are usually ready to sleep through the night in six-twelve hour stretches. Some babies will have a few months of sleeping through the night only to be interrupted from illness, life changes, teething, or separation anxiety. This sudden change of sleep patterns is referred to as sleep regressions and are usually only a temporary phase.

Sleeping through the night becomes easier by the age of one. At the same time, the number of naps your child needs decreases over the next three years. By the age of four, most children can sleep through the night and no longer need a daytime nap. By the time your child is an adolescent, their sleep needs are similar to an adult’s who need an average of 8-9 hours of sleep per night.

Sleep Disorder Symptoms

Some children with sleep issues such as not sleeping through the night or trouble sleeping will outgrow them as they get older. Some children will not. About 25% of healthy kids under the age of 18 experience some level of sleep difficulty. The number jumps with children who have medical, developmental, or mental health issues. Knowing the symptoms of sleep disorders is important for parents to recognize.

Sleep related symptoms such as difficulty falling asleep, daytime sleepiness, and snoring can be persistent and may become worse as a child grows. In some cases, sleep related symptoms are signs of a sleep disorder rather than “just a phase”.

Sleep disorders can make your child feel irritable, sluggish and sleepy during the day, but it can also make your child feel hyperactive, wired, and moody. A lack of good sleep can also lead to academic problems and difficulty concentrating. The most common symptoms of a sleep disorder include:

  • Snoring
  • Breathing pauses during sleep
  • Difficulty falling asleep
  • Irritability
  • Hyperactivity
  • Difficulty staying asleep
  • Daytime sleepiness
  • Bedwetting
  • Unexplained decrease in school performance
  • Unusual events during sleep (sleep waking, nightmares, night terrors)

Other factors may increase the chance your child will have a sleep disorder. A family history of sleep disorders will increase your child’s chances for a sleep disorder. Chronic nasal congestion, or large tonsils or adenoids can make breathing more difficult. A lack of a regular bedtime routine, or stress at school or home can make sleeping more difficult. Trauma or posttraumatic stress disorder (PTSD) can cause children to not be able to fall asleep or stay asleep through the night. Certain medications can also cause side effects that make sleep difficult.

If your child shows any signs or symptoms of a sleep disorder, it is important to make an appointment with your child’s physician to discuss whether a sleep disorder is to blame for troubled sleep.

Common Sleep Disorders

The causes and types of pediatric sleep disorders are varied. Sleep problems are broken up into two categories: behavioral or medical. Behavioral sleep conditions are usually from poor sleep hygiene caused by the lack of a routine, poor sleep environment, and insufficient sleep. Sleep problems based on behavior can often be overcome after parents help to make changes to sleep routines and sleep environments.

Medical sleep disorders are linked to either an obstruction blocking breathing or a central nervous problem that is preventing sleep. Common medical sleep disorders include:

  • Obstructive sleep apnea (OSA): Children with OSA have difficulty moving air during sleep. OSA can be caused by an obstruction of the airway (usually enlarged tonsils and adenoids) or by obesity. Children with conditions that cause decreased muscle tone or craniofacial abnormalities or children with nasal obstruction can also be at risk for OSA.
  • Central apnea: In children with central apnea, the part of the brain that controls breathing doesn’t properly maintain the process. Central apnea is common in premature infants since the respiratory center of the brain is still immature.
  • Hypoventilation: Hypoventilation means inadequate breathing or ventilation at night, which can lead to abnormal blood gasses. Hypoventilation in children is usually associated with complex medical disorders.
  • Narcolepsy: Children with narcolepsy usually have excessive sleepiness, dream-like behavior while awake, and a sudden loss of muscle tone.
  • Parasomnia: Parasomnias include sleepwalking, night terrors, and confusional awakenings.
  • Circadian rhythm disorders: Circadian rhythm disorders describe a disruption to an individual’s internal body clock causing children and teenagers to sleep at a time that is not normal for the rest of the family.
  • Periodic limb movement disorder: With Periodic limb movement disorder, there is frequent twitching or movements of the legs or feet during sleep. This can lead to daytime sleepiness because of the interruption to sleep.

Finding Answers

If you suspect your child has abnormal sleep patterns or has symptoms of a sleep disorder it is important to alert your child’s pediatrician to any concerns you might have. The first step to getting your child a better night’s sleep is to let your doctor know the nature of your child’s sleep problem. Your doctor might ask you whether your child’s sleep environment could be causing the sleep issues. Pay attention to your child’s sleep environment to see if that could be a cause. Also, take note what your child’s typical day and night routine are. You should look at your child’s activities leading up to bedtime are and how they get ready for bed. A sleep diary kept over several weeks can help you spot patterns of sleep disturbances and problems that arise from sleep.

Communicating with your child’s pediatrician can help you determine if your child’s sleep disturbances are behavioral or medical. Your child’s doctor will check for underlying physical conditions if a medical sleep disorder is suspected. Further sleep testing by a board-certified sleep medicine physician may be recommended before a diagnosis can be made.

Treatment Options For Sleep Disorders

Treatment options depend on the particular type of sleep disorder your child has as well as your child’s individual needs. Behavioral sleep disorders can often be corrected through behavior changes such as establishing a bedtime routine and removing electronics from the bedroom. Medical sleep disorders will require further treatment. The most common treatments include:

  • Surgical options include tonsillectomy (removal of tonsils) and adenoidectomy (removal of adenoids)
  • Dental procedures include wisdom teeth extraction or jaw expansion.
  • An allergy evaluation and treatment of seasonal allergies to improve nasal breathing.
  • The use of a continuous positive airway pressure (CPAP) machine for the treatment of snoring and sleep apnea.
  • Lifestyle modifications including losing weight, getting regular exercise, and other lifestyle changes.
  • Behavior therapy to help change behaviors that could be interrupting sleep.

Do you want to know more about pediatric sleep disorders? Check out the video below where Dr. Harry Yuan, a pediatric pulmonologist and sleep medicine physician in Anchorage AND Alaska Sleep Clinic's Pediatric Medical Director, discusses pediatric sleep disorders.

Remember that sleepy children are not only tired and cranky, but they can be suffering from behavioral and learning problems as well as suffering from the physical symptoms of a sleep disorder. Finding a solution to your child’s sleep disorder will lead to a healthier and happier child in the future. At the Alaska Sleep Clinic, we specialize in treating both the adult and pediatric patient with their sleep disorders. For a free pediatric phone consultation, clink the link below.

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