Children with issues in classroom may have sleep disorder

Children who show ADD or ADHD symptoms in the classroom may be experiencing a sleep disorder.

More parents are waking up to the fact that sleep disorders are more common than most of us think. Now the American Academy of Pediatrics and doctors continue to warn parents that sleep disorders can trick you into thinking you’re dealing with something else all together.

Dr. Akinyemi Ajayi, the Medical Director of Children’s Sleep Lab, says that when a child is tired and can’t focus in the classroom or they’re fidgeting to stay awake, a teacher sees that and may presume the child has ADD and ADHD.

Parents Garrett and Joey Myers had the same problem with their twin daughters Monica and Megan. The girls were never diagnosed with a learning disorder, and it was a journey of many doctor visits to figure out why there girls where having behavioral problems.

“It’s a never ending battle of what looks like eating disorder or anxiety or OCD,” said Garret Myers, the girls’ father.

As the parents visited one medical expert after the next, mom Joey Myers, tried to ask doctors if the twins could possibly have narcolepsy, like she was diagnosed with in adulthood. So finally, the Myers met Dr. Ajayi, who after a series of test, determined the twins did have narcolepsy.

The girls are now being treated at separate therapeutic boarding schools out of state. “They basically have to finish growing up,” said Garrett Myers. “They stopped and at 10-years old, they regressed.”

Now the parents are trying to educate others moms and dad to be vigilant if they feel their child might be experiencing problems because of a sleep disorder.

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Sleep apnea in children and behavioral problems

This article explains the link between sleep apnea in children and behavioral problems such as ADD and ADHD.

Attention deficit hyperactivity disorder (ADHD) is the most-commonly diagnosed behavioral disorder in children. The current standard of care for youngsters with attention deficit disorder (ADD) and ADHD is prescription medication such as Adderall, Ritalin and Dexadrine. These medications may have concerning side effects such as reduced height and weight, cardiovascular effects, tics, evidence of carcinogenic and reproductive effects, and substance abuse.

Sadly, many of these children are being misdiagnosed. A child who exhibits behavior problems or difficulty paying attention at home or school may actually be suffering from another disorder, an underlying undiagnosed sleep-related breathing disorder known as obstructive sleep apnea (OSA).

Dr. Stephen Sheldon, professor of pediatrics at Northwestern University School of Medicine and director of the Sleep Medicine Center says, “There are a number of sleep disorders that if looked at, an attention deficit problem can be identified. If you take a large number of children that have attention deficit and you evaluate them for sleep-disordered breathing, about a fifth to a quarter of those youngsters will have pediatric obstructive sleep apnea.”

He continues, “The most important aspect of evaluating a child for ADHD or other attention problems is to do a sleep evaluation in every single child. One hundred percent of these children need a sleep evaluation.”

...

Nighttime symptoms of youngsters with sleep-related breathing disorders are: snoring, bruxism, mouth breathing, bed wetting, frequent awakenings, nightmares, insomnia and physically restless sleep. Resulting daytime symptoms and findings are neurocognitive impairment, headaches, hyperactivity, behavioral issues, tiredness and poor school performance.

Lack of sleep and/or poor-quality sleep affects a child’s physical and emotional health, cognitive function, behavior and academic success. Parents, teachers, counselors or anyone concerned with the growth and development, academic performance, or health and well-being of a child must have greater awareness of sleep issues. Sleep screening and interventions to improve sleep must become part of every child’s routine clinical exam.

Early diagnosis and treatment of pediatric OSA is vital if we are going to have an impact on the epidemic of OSA in our country. Today, research indicates that one in four adults in this country suffers from obstructive sleep apnea. Of these, 80 percent remain undiagnosed and untreated. Although there is a growing awareness and therefore an increase in the number of adults treated for OSA, the key is prevention and early intervention.

A YouTube video, “Finding Conner Deegan,” tells a mother’s story of her struggling son who was labeled a “troubled child” early in his life. Having exhausted every resource, potential diagnosis and treatment known to his medical community, there appeared no other options. But through his mother’s perseverance, love, relentless search and striving to understand her son, her prayers were answered. Conner, in fact, suffered from undiagnosed pediatric OSA. He simply couldn’t breathe!

Parents, teachers, counselors and doctors need to be made aware of the need to screen children for sleep-related breathing disorders and understand the significant role timely diagnosis and thorough treatment play in the healthy growth and development of our children.

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Study: Extra medication for aggressive children with ADHD

A study shows that children who have ADHD and are also aggressive show modest improvement in behavior when a psychotropic drug is introduced.

Children with attention-deficit/hyperactivity disorder (ADHD) who also are extremely aggressive might benefit from taking an antipsychotic drug along with their stimulant medication, a new study suggests.

Prescribing powerful antipsychotic medications to children with behavioral problems is controversial. Little is known about the long-term safety of these medications, which are approved by the U.S. Food and Drug Administration to treat severe mental illnesses such as schizophrenia and bipolar disorder. And previous studies have provided little evidence to support the idea that they help quell youngsters' violent outbursts.

But the new study, which was published online in the January issue of the Journal of the American Academy of Child and Adolescent Psychiatry, suggests there might be some merit to the idea, at least for severely troubled kids.

The study looked at a subset of children with ADHD who also are physically violent, meaning they're either destructive or aggressive toward themselves or others, the researchers said.

"The children who participated in this trial had far more significant behavioral issues than the typical child with ADHD alone," said study author Michael Aman, director of clinical trials at Ohio State University's Nisonger Center.

"These are children who are really in conflict with their communities and their families," Aman said. "They seem to be in a spiral they can't get out of."

The 168 children in the study were between 6 and 12 years old with a diagnosis of ADHD and oppositional-defiant disorder or conduct disorder. All had displayed recent episodes of serious physical aggression in which they destroyed property or, at a minimum, left bruises on themselves or others.

All were started on a stimulant medication -- typically long-acting methylphenidate (sold under the brand name Concerta), which is a common treatment for ADHD. Their parents got special training in how to manage impulsive behaviors.

After three weeks, those who had not been helped enough by the basic measures were allowed to start a second medication, which was assigned at the start of the study. Sixty-one kids who started the second medication took the antipsychotic risperidone (Risperdal) for six more weeks, while 69 children continued basic treatment and got an added placebo pill.

After nine weeks, children who took Risperdal in addition to their stimulant medication saw modest but significant improvements in behavior compared to those who continued on the stimulant by itself.

"I don't think it's a grand slam, but I do think it indicates that there is some justification for what doctors have begun to do, which is to combine treatment," Aman said.

Aman said the average improvement on Risperdal was moderate. "Buried in that moderate are kids who did much better, kids who did somewhat better and some kids who didn't do better at all," he said.

Aman said scientists really need to look more closely to understand why some children had big improvements with the addition of Risperdal while others got no further help.

In some cases, Risperdal seemed to cancel some of the most bothersome side effects of the stimulants, including loss of appetite and trouble falling asleep.

But Aman cautioned that antipsychotics must always be prescribed with great care since they cause weight gain and increase the risk for type 2 diabetes.

The study was sponsored by a grant from the U.S. National Institute of Mental Health.

About half of children with ADHD who are referred for psychiatric help have behavioral disorders as well as ADHD, according to the U.S. Centers for Disease Control and Prevention.

An expert who was not involved in the research praised the study and said it would help doctors sort out what is often a tricky treatment decision.

In kids with ADHD and aggressive behavior, "recent guidelines say you should try to treat the ADHD first," said Joseph Blader, an associate professor at the University of Texas Health Science Center at San Antonio. "Then the issue is, how long do you spend doing that if the child is having these explosions, these meltdowns, potentially hurting people, on the threshold of getting kicked out of school? Two weeks? Three weeks?"

Blader said that, because so many of the kids in the study's placebo group continued to improve on the stimulant medication alone, doctors might be justified in waiting a few more weeks to see if the aggression improves along with the ADHD.

"I think this study shows that you get a lot of bang for your buck with stimulants and parent training," he said. "Unless it's a very extreme situation, it's optimal to let those play out [before trying a second medication]."

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What changes quality of life in a child with epilepsy? An action plan for families and neurologists.

This study looks at children recently diagnosed with epilepsy and determines their health-related quality of life which can be changed by medications, cognitive problems or behavior, parental depression and family demands.

The objectives of this study were to document trajectories of health–related quality of life (HRQL) and to identify predictors of the trajectory group in children with new–onset epilepsy. Results suggested that children with epilepsy are not homogenous but rather consist of groups with different trajectories and unique predictors of HRQL. Problems associated with child behavior and cognition were the strongest predictors identified. Given that several risk factors are modifiable, it is important to examine these as potential targets within a family–centered framework to improve HRQL of children with new–onset epilepsy.

Methods

• Data were obtained from the Health Related Quality of Life in Children with Epilepsy Study, a prospective multisite study of children 4–12 years old with new–onset epilepsy followed for 24 months.
• Health–related quality of life was measured using the Quality of Life in Childhood Epilepsy questionnaire.
• Trajectories of HRQL were investigated using latent class trajectory modeling.
• Multinomial logistic regression was used to identify child, parent, and family predictors of HRQL trajectories.

Results

• A total of 374 families responded at baseline and 283 (76%) completed the study.
• Five HRQL trajectories were observed: low–increasing (4%), moderate–decreasing (12%), moderate–increasing (22%), high–increasing (32%), and high–stable (30%).
• Many children in the low–increasing, moderate–increasing, high–increasing, and high–stable had clinically meaningful improvements in HRQL: 82%, 47%, 63%, and 44%, respectively.
• In contrast, the majority of children in the moderate–decreasing group (56%) experienced clinically meaningful declines in their HRQL.
• Factors predicting trajectories were number of antiepileptic drugs prescribed, presence of comorbid behavior or cognitive problems, parent depression, and family functioning and demands.

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Preschoolers who sleep less have more behavior issues

A study shows that toddlers and preschoolers who do not get enough sleep have more behavior problems than those who get adequate sleep.

Four-year-olds with shorter than average sleep times have increased rates of "externalizing" behavior problems, reports a study in the July Journal of Developmental & Behavioral Pediatrics, the official journal of the Society for Developmental and Behavioral Pediatrics. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"Preschool children with shorter nighttime sleep duration had higher odds of parent-reported overactivity, anger, aggression, impulsivity, tantrums, and annoying behaviors," according to the new research by Dr. Rebecca J. Scharf of University of Virginia, Charlottesville, and colleagues. They recommend that parents and health care providers discuss steps to improve sleep habits for preschool-age children with behavior problems.

Shorter Sleep Times, More Behavior Problems

The researchers analyzed parent responses from a nationally representative study of approximately 9,000 children, followed from birth through kindergarten age. When the children were four years old, nighttime sleep duration was estimated by asking the parents what time their child typically went to bed and woke on weekdays.

On a standard child behavior questionnaire, parents rated their child on six different "externalizing" behavior problems such as anger and aggression. (Externalizing behavior problems are outward behaviors, distinguished from "internalizing" problems such as depression and anxiety.) The relationship between sleep duration and behavior scores was assessed, with adjustment for other factors that might affect sleep or behavior.

The average bedtime was 8:39 pm and wake time 7:13 am, giving a mean nighttime sleep duration of about 10½ hours. Eleven percent of children were considered to have "short sleep duration" of less than 9¾ hours (calculated as one standard deviation below the average).

On the child behavior questionnaire, 16 percent of children had a high score for externalizing behavior problems. Behavior problems were more common for boys, children who watched more than two hours of television daily, and those whose mothers reported feeling depressed.

After adjustment for other factors, "Children in the shortest sleep groups have significantly worse behavior than children with longer sleep duration," Dr Scharf and colleagues write. The effect was greatest for aggressive behavior problems, which were about 80 percent more likely for children with nighttime sleep duration of less than 9¾ hours.

Shorter sleep times were also associated with 30- to 46-percent increases in rates of the other externalizing behaviors studied, including overactivity, anger, impulsivity, tantrums, and annoying behaviors. In a linear analysis, as sleep duration increased, troubling behaviors decreased.

Previous studies in smaller groups of children have identified shorter nighttime sleep duration as a risk factor for behavior problems in preschool children. The average 10½-hour sleep time in this nationally representative sample is less than in studies performed in past decades, and less than currently recommended for four-year-olds.

The new results, along with other recent studies, add to the evidence that preschoolers who sleep less will have more behavior problems, including disruptive behaviors like aggression and overactivity. Although the study can't draw any conclusions about causality, "there is good reason to believe that short nighttime sleep duration leads to externalizing behaviors," the researchers write.

Dr Scharf and coauthors recommend that doctors and health care providers ask about bed and wake times when talking to parents about young children with behavior problems. They add, "Advocating for regular sleep habits, healthy sleep hygiene, and regular bedtime routines may be helpful for young children."

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Study Claims Sleep Problems In Young Children Linked To Greater Need For Special Education

A study shows that children with sleeping problems are more likely to require special education.

Kids who snore may be more likely to have behavioral problems, but that may not be all. A new study, published in Pediatricsthis month, found that children with sleep problems through the age of 5 were more likely to require special education by age 8.

Karen Bonuck, a professor of family and social medicine at Yeshiva University's Albert Einstein School of Medicine, led the study that gathered data from 11,049 children with sleep-disordered breathing -- a general term covering snoring and sleep apnea -- and 11,467 children with behavioral sleep problems. Bonuck found that children with one of these disorders were 30 percent more likely to need special education, while children with behavioral sleep problems, such as bedtime refusal or delayed sleep onset, were an additional 7 percent more likely to require speciality courses.

"What we found was that absolutely both behavioral and respiratory problems did increase the likelihood of special education," Bonuck told CBS News' HealthPop. "The take home from this is we need to be looking at these breathing and behavioral sleep problems at very young ages in these children."

The research follows from an earlier study led by Bonuck, published in Pediatrics in March, that linked sleep disorders in young children to the development of behavioral problems such as hyperactivity and aggressiveness.

"This is the strongest evidence to date that snoring, mouth breathing, and apnea can have serious behavioral and social-emotional consequences for children," Bonuck said in a statement.

Though Bonuck's new study does not prove cause and effect, sleep problems in young children may lead to a host of other issues outside the behavioral realm, including special education needs.

"We've got a generation of children potentially at risk from long-term developmental deficits that might occur from these sleep problems," Bonuck told HealthDay. "Parents need to be vigilant."

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Researchers Show Migraines Linked To Behavioral Problems In Kids

New research claims that children who suffer from migraines are more likely to have behavioral issues, anxiety, or depression.

Children with migraines are much more inclined to suffer from behavioral issues, such as anxiety, depression, and social and attention issues than those who do not have headaches.

The more recurrent the headaches, the more likely the chance of a behavioral disorder developing, according to the new study published in Cephalagia. 

Marco Arruda, director of the Glia Institute in São Paulo, Brazil, together with Marcelo Bigal of the Albert Einstein College of Medicine in New York, conducted a study of 1,856 Brazilian children ages 5 to 11 which looked at the connection of emotional symptoms with migraine and tension-type headaches (TTH).

The study used headache surveys, in addition to the Child Behavior Checklist (CBCL), to measure emotional symptoms. The researchers instructed teachers how to walk parents through the questionnaires, step by step.

Children with migraines had a much greater probability of irregular behavioral scores than children without headaches, primarily in social, anxiety-depressive, internalizing, and attention areas. 

Children with TTH were affected in the same areas, but to a lesser extent. With more frequency of headaches, abnormal behavioral scores increased. Over half of the migraine sufferers had issues with internalizing behaviors. Externalizing behaviors, such as breaking rules or becoming aggressive, were no more likely among the children with headaches. The authors advised that the CBCL may not be efficient enough to measure this correlation in detail.

Arruda explains:

"As previously reported by others, we found that migraine was associated with social problems. The 'social' domain identifies difficulties in social engagement as well as infantilized behavior for the age and this may be associated with important impact on the personal and social life."

Children frequently suffer from migraines, which affect over three percent to one fifth of children from early childhood to adolescence. Earlier research has suggested that children with migraines are more likely to have other psychological and physical problems, includingdepression, anxiety, hyperactivity, and attention disorders. 

Authors suggest including factors, such as headache frequency, is important, although often left out of studies - until recently. Health providers can now be aware of this possibility in children and properly treat the problem.

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Loud Snoring in Young Children May Predict Behavior Issues

A new study claims that young children and preschoolers that snore may predict behavior issues in the future.

Persistent and loud snoring in young children is associated with problem behaviors, according to a new study published online in Pediatrics.

These behaviors include hyperactivity, depression and inattention, according to Dean Beebe, PhD, director of the neuropsychology program at Cincinnati Children's Hospital Medical Center and lead author of the study.

"The strongest predictors of persistent snoring were lower socioeconomic status and the absence or shorter duration of breastfeeding," says Dr. Beebe. "This would suggest that doctors routinely screen for and track snoring, especially in children from poorer families, and refer loudly-snoring children for follow-up care. Failing to screen, or taking a 'wait and see' approach on snoring, could make preschool behavior problems worse. The findings also support the encouragement and facilitation of infant breastfeeding."

The study is believed to be the first to examine the relationship between the persistence of snoring and behavior problems in preschool-age children. Persistent, loud snoring occurs in approximately one of every 10 children.

Dr. Beebe and colleagues at Cincinnati Children's studied 249 children. The researchers surveyed the children's moms about their kids' sleep and behaviors. The study showed that children who snored loudly at least twice a week at the age of 2 and 3 had more behavior problems than children who either don't snore or who snored at 2 or 3 but not at both ages.

"A lot of kids snore every so often, and cartoons make snoring look cute or funny. But loud snoring that lasts for months is not normal, and anything that puts young kids at that much risk for behavioral problems is neither cute nor funny," says Dr. Beebe. "That kind of snoring can be a sign of real breathing problems at night that are treatable. I encourage parents to talk to their child's doctor about loud snoring, especially if it happens a lot and persists over time."

Infant breastfeeding, especially over longer periods of time, seemed to protect children against persistent snoring, even after taking into account other factors, including family income.

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A window of opportunity for intervention? Early identification of sleep problems in preschool children with behavioral problems.

This is a very interesting article. It is well known that children develop cognitive problems when they have sleep apnea. IQ drops. Neuronal in the hippocampus  is lost.  However,  there may be a window to intervene early  before the evolution of cognitive problems.  


This article suggests that children with behavioral problems should be screened for sleep apnea early before cognitive problems are noted. JR

Sleep-disordered breathing in preschool children is associated with behavioral, but not  cognitive, impairments.

Jackman AR, Biggs SN, Walter LM, Embuldeniya US, Davey MJ, Nixon GM, Anderson V, Trinder J, Horne RS.

Source

Sleep Med. 2012 Jun;13(6):621-31. Epub 2012 Apr 13.Psychological Sciences, The University of Melbourne, Melbourne, Australia.

Abstract

BACKGROUND:

Sleep-disordered breathing (SDB) has been associated with impaired cognitive and behavioral function in school children; however, there have been limited studies in preschool children when the incidence of the disorder peaks. Thus, the aim of this study was to compare cognitive and behavioral functions of preschool children with SDB to those of non-snoring control children.

METHODS:

A clinical sample of 3-5year-old children (primary snoring [PS], n=60; mild obstructive sleep apnea syndrome [OSAS], n=32; moderate/severe [MS] OSAS, n=24) and a community sample of non-snoring control children (n=37) were studied with overnight polysomnography. Cognitive performance and behavioral information were collected.

RESULTS:

Children with PS and mild OSAS had poorer behavior than controls on numerous measures (p<.05-p<.001), and on some measures they had poorer behavior than the MS OSAS group (p<.05). In contrast, all groups performed similarly on cognitive assessment. Outcomes related more to sleep than respiratory measures.

CONCLUSIONS:

SDB of any severity was associated with poorer behavior but not cognitive performance. The lack of significant cognitive impairment in this age group may have identified a "window of opportunity" where early treatment may prevent deficits arising later in childhood.

Link to abstract here

Being Left Out Puts Youths at Risk for Depression

The challenges that come with battling a chronic medical condition or developmental disability are enough to get a young person down. But being left out, ignored or bullied by their peers is the main reason youths with special health care needs report symptoms of anxiety or depression, according to a study to be presented`123 April 29, at the Pediatric Academic Societies (PAS) annual meeting in Boston.

Being bullied has been shown to increase students' risk for academic and emotional problems. Little research has been done specifically on how being a victim of bullying affects youths with special needs.

In this study, researchers led by Margaret Ellis McKenna, MD, senior fellow in developmental-behavioral pediatrics at Medical University of South Carolina, investigated the impact of bullying, ostracism and diagnosis of a chronic medical condition on the emotional well-being of youths with special health care needs.

Participants ages 8-17 years were recruited from a children's hospital during routine visits with their physicians. A total of 109 youths and their parents/guardians completed questionnaires that screen for symptoms of anxiety and depression. Youths also completed a screening tool that assessed whether they had been bullied or excluded by their peers.

The main categories of youths' diagnoses included attention-deficit/hyperactivity disorder (39 percent), cystic fibrosis (22 percent), type 1 or 2 diabetes (19 percent), sickle cell disease (11 percent), obesity (11 percent), learning disability (11 percent), autism spectrum disorder (9 percent) and short stature (6 percent). Several children had a combination of these diagnoses.

Results of the youths' answers on the questionnaires showed that being bullied and/or ostracized were the strongest predictors of increased symptoms of depression or anxiety. When looking at both parent and child reports, ostracism was the strongest indicator of these symptoms.

"What is notable about these findings is that despite all the many challenges these children face in relation to their chronic medical or developmental diagnosis, being bullied or excluded by their peers were the factors most likely to predict whether or not they reported symptoms of depression," Dr. McKenna said.

"Professionals need to be particularly alert in screening for the presence of being bullied or ostracized in this already vulnerable group of students," she added.

In addition, schools should have clear policies to prevent and address bullying and ostracism, Dr. McKenna suggested, as well as programs that promote a culture of inclusion and sense of belonging for all students.

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Unruly Behavior May Be Caused By Mental Disorder

When children behave badly, it's easy to blame their parents. Sometimes, however, such behavior may be due to a mental disorder. Mental illnesses are the No. 1 cause of medical disability in youths ages 15 and older in the United States and Canada, according to the World Health Organization.

"One reason we haven't made greater progress helping people recover from mental disorders is that we get on the scene too late," said Thomas R. Insel, MD, director of the National Institute of Mental Health (NIMH) and the featured speaker at the American Academy of Pediatrics' Presidential Plenary during the Pediatric Academic Societies (PAS) annual meeting in Boston.

Dr. Insel discussed signs of mental illnesses in young children and the importance of early diagnosis and intervention in his presentation, "What Every Pediatrician Needs to Know about Mental Disorders," on April 29, in the Hynes Convention Center.

As the first line of defense, pediatricians can detect mental disorders early and ensure children get treatment as soon as possible, Dr. Insel said. While questionnaires currently are the best way for doctors to screen for mental illness, better tools are on the horizon, such as cognitive and genetic tests.

It's also important to understand that mental illnesses are a developmental brain disorder even though they can look like behavior problems, Dr. Insel explained.

"The future of mental illness has to be at the point where we aren't treating behavior separately from the rest of the person," he said. "There needs to be full integration of behavior and medical concerns to ensure that we are able to care for the whole person and not just one system."

In addition to serving as director of the NIMH, Dr. Insel is acting director of the National Center for Advancing Translational Sciences, a new arm of the National Institutes of Health that aims to accelerate the development of diagnostics and therapeutics.

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Excessive Sleepiness May Cause Learning, Attention and School Problems

Children who have learning, attention and behavior problems may be suffering from excessive daytime sleepiness, even though clinical tests show them sleeping long enough at night, a new study reports.

Penn State researchers studied 508 children and found that those whose parents reported excessive daytime sleepiness (EDS) -- despite little indication of short sleep from traditional measurements -- were more likely to experience learning, attention/hyperactivity and conduct problems than children without EDS.

The culprits? Obesity, symptoms of inattention, depression and anxiety, asthma and parent-reported trouble falling asleep have been found to contribute to EDS even among children with no signs of diminished sleep time or sleep apnea.

"Impairment due to EDS in cognitive and behavioral functioning can have a serious impact on a child's development," said Susan Calhoun, PhD, the study's lead author. "When children are referred for neurobehavioral problems, they should be assessed for potential risk factors for EDS. Recognizing and treating EDS can offer new strategies to address some of the most common neurobehavioral challenges in young school-age children."

Calhoun said researchers were surprised that most of the children studied showed few signs of short sleep when tested, nor was short sleep associated with any of the learning, attention and behavior problems. She said parents and educators are good resources for determining if a child seems excessively sleepy in the daytime and the complaint should be taken seriously. Previous research found EDS prevalent in 15 percent of children from a general population sample.

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Parents: How to know if your child has a sleep disorder

There are more than 100 sleep disorders. Isn’t that an amazing figure? Some sleep disorders are more common in infants, children and adolescents than adults. All affect sleep quality. Poor sleep may result in behavioral and learning problems, not to mention moodiness during the day.

If you answer yes to one or more of the following questions, your child may be suffering from a treatable sleep disorder. Does your child:

Snore or have breathing pauses in sleep?

Wake up gasping for air or choking?

Have problems falling or staying asleep night after night?

Wake up too early most mornings before getting sufficient sleep?

Experience unusual sensation in the legs regularly at night, such as a pins-and-needles feeling?

Have growing pains more than twice a week?

Have restless sleep – your child constantly tosses, turns, flails and never seems to settle down?

Sweat excessively in sleep?

Wake up unrefreshed after sufficient sleep?

Awaken with morning headaches?

Experience daytime difficulties in focus, attention, memory or concentration?

Sleep excessively during day and night, or falls asleep at inappropriate times?

Have ADD-ADHD like symptoms?

Have difficulty getting up in the morning most days?

Of course, plenty of children experience occasional growing pains or have difficulty falling asleep from time to time. But I believe in parents’ instinct. If any of the descriptions above fit your child and you think it’s possible your child has a sleep disorder, contact your pediatrician or call a pediatric sleep specialist for evaluation.

Evaluation includes a physical exam of your child, an analysis of your child’s medical history and possibly an overnight sleep test called a polysomnogram. Most pediatric sleep centers have a quiet, comfortable room with a bed for the child and for a parent. Sleep testing is not painful: There are no shots. Many centers allow you to bring familiar objects such as the child’s pillow, blanket, or stuffed animal.

The good news: Once diagnosed, sleep disorders can be treated. That means a better night’s sleep for the child and for the parents.

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Read more here: http://www.charlotteobserver.com/2012/04/17/3181085/how-do-i-know-if-my-child-Rrerererer

Children's Sleep Problems Signal Later Emotional Troubles

A milestone in child development, at least for many parents, is when the kid finally sleeps through the night. But a recent study suggests that it’s a good idea for parents to monitor how the wee ones are sleeping as well as how long.

Published in the journal Pediatrics, the study shows that children who have problems breathing while they sleep are more likely to experience behavioral problems such as hyperactivity and aggressiveness when they get older. They’re also more likely to have emotional issues such as difficult peer relationships.

Researchers from the University of Michigan and the Albert Einstein College of Medicine at Yeshiva University followed the sleeping patterns of more than 11,000 children for six years. They found that kids who snored, breathed heavily through their mouths and experienced apnea—long pauses between breaths during sleep—were at risk.

Collectively known as sleep-disordered breathing (SDB), the problem peaks when children are between 2 and 6 years old, but can occur when they are younger. Approximately 1 in 10 children snores regularly and 2 to 4 in 100 have sleep apnea, according to the American Academy of Otolaryngology–Health and Neck Surgery (AAO-HNS). Common causes of SDB are enlarged tonsils or adenoids, but be wary of the “quick-fix” of tonsillectomy—as we have reported, that surgical procedure is often unnecessary, and to conclude that tonsils contribute to sleep disorders requires careful diagnosis.

Quite simply, the study’s authors said, “Parents and pediatricians alike should be paying closer attention to sleep-disordered breathing in young children, perhaps as early as the first year of life.”

Although earlier studies indicated sleep problems could signal later difficulties, they involved only small numbers of patients, short follow-up of a single symptom or limited control of individual traits such as low birth weight that could be responsible for some symptoms.

In the new, more substantial study, children whose symptoms peaked between the ages of six and 18 months were much more likely to experience behavioral problems when they were 7 compared with children who breathe normally during sleep. Children whose SDB symptoms persisted throughout the evaluation period, and were most severe at 30 months, expressed the most severe behavioral problems.

Researchers theorize that SDB might be responsible for behavioral problems because of its effect on the brain. Decreased oxygen levels and increased carbon dioxide interrupts the restorative process of sleep and disrupts various chemical systems. Such malfunctions can impair one’s ability to pay attention, plan ahead and organize. They also impede one’s ability to regulate emotions.

To learn more about SDB and treatment options, consult the AAO-HNS fact sheet.

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