Children's Health

Quality Sleep May be Hindered by Sleep Disorder

Seven-year-old Rebekah Ross of Eaton Rapids was doing everything right. She was sleeping in a dark room set at a comfortable 70 degrees. She often enjoyed a light snack before bedtime and avoided TV before turning in for the night. Despite the best laid plans, Rebekah still wasn’t getting a good night’s sleep. She was snoring and suffering from what her dad thought might be sleep apnea.

“Snoring isn’t a typical sound most parents expect to hear coming for their children’s bedroom,” said Brian Ross, Rebekah’s father. “When it became a frequent occurrence, I knew we needed help. We learned that there was a sleep medicine physician at Helen DeVos Children’s Hospital and sought help there.”

Sleep medicine physicians can help children with sleeping issues in a variety of ways. For some children, it may be establishing better sleep hygiene. Good sleep hygiene includes establishing a bedtime routine and sticking to it, sleeping in a dark and comfortable room and turning to soft music if falling asleep is an issue. For others, a more thorough sleep evaluation may be necessary through a sleep study.

A children’s sleep study is a multifaceted test in which electrodes are applied to the child’s scalp, sides of the head, chin, chest and legs. This enables physicians to measure brain waves, heart rate and eye movement. A sensor is placed near the nose and mouth for measurement of airflow. Belts are placed around the rib cage and abdomen for measurement of breathing movements. A clip is placed on a finger for measurement of blood oxygen levels. Children may also be videotaped while asleep in the sleep lab. A sleep study involves no needles and isn’t painful.’ After the study, a pediatric specialist interprets the information collected and reports the findings to the child’s primary care physician.

Rebekah’s sleep study revealed she suffered from obstructive sleep apnea. She was prescribed a device that enabled her to sleep through the night without constantly waking up from her troubled breathing.

“Obstructive sleep apnea can be treated in a variety of ways,” said John Schuen, M.D., division chief, pulmonology and sleep medicine. “Usually, in children, the tonsils and adenoids may cause the problem.’ If that is the case, an adenotonsillectomy is preferred treatment as it frequently eliminates the problem.”

Physicians needed to use another approach with Rebekah.

“Another way to treat sleep apnea is through a breathing therapy device called BiPAP,” added Schuen. “While a child sleeps, the device blows two levels of air pressure into the airway through tubing and a mask that the child wears over their nose or nose and mouth. BiPAP creates an ‘air stent’, which keeps the airway open for uninterrupted breathing. BiPAP is suited for children because the two levels are more gentle, which makes the device easier to tolerate during sleep.”

Snoring is not a symptom of a sleep problem for everyone so it may be difficult for parents to rely on that alone as a clue. An acronym developed by the National Sleep Foundation- BEARS – is designed to help parents determine if a trip to the pediatrician is necessary. Parents should consider the following questions to help identify potential sleep issues.

B = Bedtime
Does your child have difficulty going to bed? Falling asleep?

E = Excessive daytime sleepiness
Is your child always difficult to wake up in the morning?
Does your child seem sleepy or groggy during the day?
Does he or she often seem moody, ‘hyper,’ or ‘out of it’ as well as sleepy?

A = Awakenings during the night
Does your child wake up at night? Have trouble falling back to sleep?
Does anything else seem to interrupt his or her sleep?

R = Regularity and duration of sleep
What time does your child go to bed and get up on weekdays? Weekends?
How much sleep does he or she get? Need?

S = Snoring
Does your child snore? Every night?
Does he or she ever stop breathing, choke or gasp during sleep?

Parents should contact their pediatrician if they notice anything out of the ordinary in their child’s sleeping habits or patterns. A pediatrician will determine if a referral to a sleep medicine specialist is necessary.

Helen DeVos Children’s Hospital, a member of Spectrum Health, is West Michigan’s largest children’s hospital, serving children and families throughout a 37-county region. The team includes more than 100 specialists uniquely skilled in providing medical care to children, in over 40 outpatient clinical settings. Helen DeVos Children’s Hospital is committed to caring for children and families with compassion, excellence and innovation.