Sleep Disorders

A good night’s sleep is essential for a child’s growth and development. But sometimes, breathing problems, behavioral disorders and other conditions can interrupt normal sleep patterns

In those cases, proper diagnosis and treatment of sleep disorders is vital to help kids get back on track to restful sleep.

A calm and alert state is a sign of sleeping well. Upon awakening, well-rested children are in good cheer and can play by themselves. A constant small deficit in sleep produces a cumulative reduction in daytime alertness. Not all sleep periods are created equal! Long naps do not compensate for late bedtimes. Sleep quality, not just sleep duration, is an essential component of healthy sleep. A regular bedtime may vary by some minutes per night but not hours per night. Even if the bedtime is too late, a regular bedtime is better than an irregular bedtime.

Sleeping is not a completely automatically regulated process, like the control of body temperature. Sleeping is more like feeding. We do not expect children to grow well if all they eat is junk food. Children need a well-balanced diet. The same is true for sleep. Healthy sleep benefits the child socially, emotionally, medically, physically, athletically, and cognitively. Moreover, the benefits of sleeping well in early childhood carry over into adolescence and even beyond.

Two of the world’s leading sleep researchers, Dr. Christian Guilleminault and Dr. William C. Dement, published a landmark paper in 1976 that was the first careful study of how impaired breathing during sleep destroys good-quality sleep in children. They studied eight children ages 5 to 14 years, all of whom snored. All eight children snored loudly every night, and snoring had been present for several years. Snoring started in one child at 6 months, and while the snoring in most of the children was originally intermittent, it eventually became continuous. Here’s how their symptoms were described:

Daytime drowsiness: The report noted that “the children, particularly at school, tried desperately to fight it off, usually with success. To avoid falling asleep, the children tended to move about and gave the appearance of hyperactivity.”

Bed-wetting: All the children had been completely toilet trained, but seven started to wet their beds again.

Decreased school performance: The teachers reported lack of attention, hyperactivity, and a general decrease in intellectual performance, particularly in the older children.

Morning headaches: Headaches occurred only when they awoke in the morning; the headaches lessened or disappeared completely by late morning.

Mood and personality changes: Half the children had received professional counseling or family psychotherapy for “emotional” problems. The report noted that “three children were particularly disturbed at bedtime; they consistently avoided going to bed, fighting desperately against sleepiness. They refused to be left alone in their rooms while falling asleep and, if allowed, would go to sleep on the floor in the living room.”

Weight problems: Five of the children were underweight, and two were overweight.

Not all children who snore have all the problems described above, and these differences may be explained by differences in the severity and duration of the underlying problem. But overall we have a picture here of impaired mood and school performance, which deteriorated as the children grew older or as the snoring became more continuous or severe. Sleep is definitely not bliss for these children!

Why, then, has kids’ snoring particularly been ignored?

In part, this is another example of a medical concern that has taken a long time to be recognized by physicians and parents as a real problem.

But also, it could be that there are more snorers around today.

Although surgical removal of tonsils and adenoids is much less common today, it was for many years in the past a very popular procedure for recurrent throat infections; it also happened to “cure” snoring in children. As, because the air we breathe is increasingly polluted and our processed foods increasingly allergenic; this may cause reactive enlargement of adenoids or tonsils in more children.

Reference:

1. Price AMH, Brown JE, Bittman M, et al Children’s sleep patterns from 0 to 9 years: Australian population longitudinal study Archives of Disease in Childhood 2014;99:119-125

2. Healthy Sleep Habits, Happy Child by Marc Weissbluth