Sunday, August 04, 2013

Pediatric Sleep Disorders

This article discusses all about pediatric sleep disorders and indicates when it is necessary to get help to treat them.

Bedwetting, sleepwalking, night terrors. Sleep disturbances that cause concern when seen in adults can actually be “part of the normal developmental process in children,” according to Dr. Kirk Watkins of the Intermountain Dixie Regional Sleep Disorder Center.

“In most instances, nothing is wrong with the child and they will grow out of it in time,” said Watkins.

But even things that are normal can be disruptive to families. When should you seek treatment for your child’s sleep disorder?

“When it begins to cause bigger problems,” said Watkins. He lists three examples:

• When it affects the safety of the child. For instance, if you find a sleepwalking child “on the next block walking down the middle of the street.”

• When it affects the child’s daytime function in terms of behavior, personality changes, or schoolwork.

• When lack of sleep disrupts regular family routines.

In those instances, “Pediatricians and family practice physicians have a lot of experience helping families deal with sleep disorders. They can reassure parents and help find the reason the child is aroused from sleep,” said Watkins.

When the usual methods fail, it may be time to seek help from a sleep specialist. According to Watkins, the three most common causes of parasomnia (abnormal or disruptive sleep disorders) in children he treats include:

 Obstructive sleep apnea. “Sleep apnea is not widely recognized in children because if a kid snores, the general practice is to perform a tonsillectomy. In about 65 percent of cases, it works. For the rest, it is really hard for anybody to objectively pick up from a child that excessive sleepiness is going on, so we often have to rely on other indicators. By middle school kids who snore will lose 1.5 grade points on average. They can cause social disturbances at home. A child with obstructive sleep apnea may be seen as always causing trouble, but is not typically defiant. Often they will sleep on their hands and knees with the rear end in the air. They may tear the entire bed apart at night. Mouth breathing at night in children who don’t have congestion during the day is also a classic symptom.

• Acid reflux at night. “Acid reflux is a significant pathology that should always be addressed. Again, it can be hard for a child to verbalize their symptoms, but if they had acid reflux as an infant and now wake up screaming every night, resuming treatment may help.”

 Restless leg syndrome. “Restless leg is the sleep disorder with the highest association with ADHD. Symptoms can be vague in children, and are sometimes described as ‘growing pains.’ Often restless leg is associated with iron deficiency that is easily treatable. If not, there are medications that while not well studied in children can sometimes be effective.”

Chronic sleep disorders in children can cover “the compendium of a parent’s worst nightmares,” acknowledged Watkins. “In most cases, however, they are very treatable.”
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