Is your child exhibiting behavioral issues or chronic infections? Have you considered that poor sleep could be the cause?
Children don’t function well without good sleep. However, spotting sleep problems in children isn’t always easy. Instead of sleepiness, for example, a sleep-deprived child might exhibit hyperactivity.
If you suspect your child has a sleep problem, it’s imperative to turn to an expert in pediatric sleep medicine. We asked Mohsin Maqbool, MD, a pediatric neurologist and Medical Director of the Pediatric Sleep Institute in Plano, to talk about sleep problems in children. Here are excerpts:
Q. What are the most common sleep-related symptoms or signs that lead parents to contact a physician or a sleep clinic?
Mohsin Maqbool, MD: Many patients come to our clinic during the summertime. That’s because the family has been on vacation and family members slept together in one hotel room. That’s the first time the parents realized their child snores or is not sleeping soundly at night.
Other common sleep-related problems include difficulty waking up in the morning or falling asleep at night, daytime sleepiness, snoring, frequent waking at night, or restless, painful legs at bedtime.
Many parents worry about “parasomnias”—nightmares, night terrors, sleep eating or sleep walking. These may signal a problem if they occur frequently.
Q. We expect babies to keep us up at night. When does nighttime wakefulness signal a problem?
MM: Pediatricians rely on a few developmental milestones: At 6 months of age only about 50% of babies sleep through the night; by 9 months of age, this number grows to about 80-90%; by the age of 1 year, almost every child will be sleeping through the night and not requiring night-time feedings. Keep in mind, however, that when a child is not sleeping through the night by age 1, that doesn’t necessarily mean there’s a medical problem. It could be a sleep training problem. Parents may unknowingly develop habits that lead baby to think it’s normal to wake up in the middle of the night for feeding or socializing. Often, my job is to educate parents to adjust habits that may promote night-time wakefulness.
Q. Are there signs of sleep problems that parents tend to overlook?
MM: Yes. Many parents don’t consider snoring abnormal and ignore it. Don’t take snoring lightly. It could be a sign of sleep apnea.
If a child gets up for multiple bathroom breaks during the night, that could be a sign of diabetes, sleep apnea or other sleep disturbance. When a child is sleep-deprived, the body makes more urine. The child may start wetting the bed again, sometimes years after having been potty-trained. New onset bedwetting is always something that needs to be looked into.
Behavioral issues aren’t usually overlooked, but parents and doctors often don’t connect them with sleep disturbances. If a child was doing great in school and suddenly starts getting failing grades, or starts acting out or exhibits worrisome behavioral changes, the possibility of sleep problems should be explored.
Q. Are there some sleep issues that pediatricians aren’t typically attuned to?
MM: Yes. One common misdiagnosis: A child complains that their legs hurt or feel restless at bedtime; the pediatrician dismisses that as “growing pains” and treats with pain medication. In reality, the child may have restless leg syndrome. With iron supplements, we can treat the problem and not just the symptoms.
Q. What kind of training does a sleep specialist typically have?
MM: Sleep physicians always come from another discipline because, before 2011, there were no training programs for sleep medicine. Physicians would “grandfather” into sleep medicine. In 2011, the American Academy of Sleep Medicine made fellowship training mandatory for anyone practicing sleep medicine or serving as a sleep lab director. In my case, I’m a pediatric neurologist, and I’ve also completed a fellowship in sleep medicine.
Q. What advice do you offer parents for helping children get good sleep?
MM: I see many teenagers in my clinic in the first two or three months of school. They’re having insomnia at bedtime and difficulty waking at 7am because, over the summer, they were going to bed at 4am or 5am and waking up at noon or 1pm. When school starts, it’s very hard time to get their bodies’ circadian rhythms re-aligned again with the school schedule.
My advice to parents: Don’t let your child stay up beyond 1am during the summer. Even that’s a little generous, but you’ve got to let children have some fun, right?
Q. Talk about good sleep hygiene. What does that mean?
MM: Basically, sleep hygiene means following a regular sleep schedule—going to bed and waking at the same time each day; avoiding bright lights, computer or TV screens, heavy meals and vigorous exercise three hours before bedtime. Sleep hygiene is so important. I’m surprised it’s not taught in schools!
Promoted content provided by Pediatric Sleep Institute at Texas Health Center for Diagnostics and Surgery.