Treating Pediatric Sleep Disorders in Children
The Pediatric Sleep Medicine Center at Cohen Children's Medical Center provides a comprehensive, multidisciplinary approach to the diagnosis and management of respiratory and non-respiratory pediatric sleep disorders. Our center diagnoses and provides treatment for many different types of sleep disorders, such as:
- Obstructive sleep apnea
- Central apnea
- Apnea of infancy / prematurity
- Nocturnal hypoventilation
- Breathing disorders secondary to cardiac, neurologic, and / or gastric disorders
- Circadian rhythm and sleep-wake schedule disorders
- Periodic limb movement disorders
- Rhythmic movement disorders
Obstructive Sleep Apnea and Snoring:
Possibly the most common sleep problem in children, obstructive sleep apnea, characterized by a reduction or pause of breathing during sleep, is often overlooked by health care professionals. Snoring occurs in about seven out of every 100 children between the ages of one and nine years old. While one in five children who snore will have obstructive sleep apnea, this problem can occur in children who do not snore as well. The typical daytime fatigue that is seen in adults with obstructive sleep apnea is often absent in children, replaced by behavioral problems, inattention and learning difficulties. Long-term obstructive sleep apnea can lead to heart and other respiratory difficulties, making pediatric obstructive sleep apnea a challenging diagnosis to establish and treat in a timely fashion.
Sleep walking, sleep talking, nocturnal enuresis (nighttime bed wetting), night terrors, and night mares make up the largest proportion of the pediatric parasomnias. Although reassurance of the normality of these sleep problems is needed, safety issues are of particular importance. In addition, in rare circumstances, these problems can be related to obstructive sleep apnea and neurologic conditions such as epilepsy.
Apnea of Prematurity & Apnea of Infancy:
Apnea of prematurity is seen in infants born before 37 weeks gestational age and most commonly in infants born before 31 weeks gestational age. Apnea of prematurity is thought to be caused by immaturity of the breathing centers of the brain. While most infants “outgrow” this problem, some require ongoing monitoring.
The diagnosis of apnea of infancy is reserved for infants older than 37 weeks gestational age and for whom no specific cause of apnea could be identified. Although about a thrid of these infants will never have another episode of apnea, half of them will, usually within seven days of the first event. One in five infants with apnea of infancy will continue to demonstrate respiratory difficulties throughout the first year of life and beyond. Many of these children require medication therapy and home monitoring, as well as special training for their parents and care providers.
Behavioral Sleep Problems:
Bedtime behavioral issues account for many parents concerns. From struggles to transition an infant to sleep through the night, to difficulties keeping teenagers on a regular routine, our bedtime behaviors and rituals dictate many of our sleep patterns and habits.
For infants, transitional objects and consistent bedtime patterns provide for the greatest structure in developing healthy sleep habits. Likewise, for older children and teenagers, limiting late night television and activities can be of particular importance to keeping wake and sleep rhythms as regular as possible.