May 23, 2002
Checking child’s sleep pattern
It’s a parent’s nightmare: a child who is not doing well in school, not thinking clearly and not behaving. Parents may blame a thousand different causes, but pass over a cause that’s right in front of them: their child’s sleep patterns.
“Sleep disorders affect children, behaviorally and cognitively, in day-to-day behavior and in school performance. It’s not just that the child cannot sit still or falls asleep – it affects their ability to solve problems, or to pay attention, sometimes in subtle ways,” says Kristen Archbold, a senior research fellow at the UW School of Nursing. She has co-authored papers on the effects of sleep disorders in children, including an article in the March edition of Pediatrics. The Pediatrics paper concerned children who demonstrated symptoms of attention deficit hyperactivity disorder, but Archbold says children do not need to have ADHD to suffer from the results of poor sleep.
As many as 11 percent of children may have sleep disorders that rob their brains of oxygen, according to Archbold’s research. There are a variety of sleep disorders. Some are very obvious, because the child snores as a result. Snoring can seem amusing, but it can result from obstructions in the airway that rob the body of oxygen.
There are other sleeping problems that are difficult to detect unless the child goes to a sleep lab for evaluation. Children appear to be more vulnerable than adults to upper airway resistance syndrome, or UARS. This can be caused in children when some parts of the body, like the head, air passages and nostrils, grow at a different pace than other parts of the body. During sleep, muscles relax, taking up more space in the airway than they do during waking hours. The result can be an obstructed airway. There can be many likely causes: some children may have naturally narrower airways than normal, or unusually large tonsils and/or adenoids can block air passages.
Some children, particularly those whose parents describe them as “hyperactive,” have periodic leg movement disorder – the so-called restless leg syndrome. In this situation, the child’s leg moves involuntarily in bed, waking the child or even making it difficult to sleep at all. Archbold encourages parents to observe their children occasionally during the first half of the night to see if their legs have a tic – an involuntary movement every 20 seconds or so. Another symptom: children who complain of leg cramps or ‘growing pains’ in the legs. Or perhaps in the morning the parent discovers the child’s bed sheets are folded and rearranged like a plate of spaghetti, indicating considerable movement at night.
Whatever the cause of the sleep disorder, the effect is the same. Oxygen saturation drops in the blood, causing a condition called hypoxia. Hypoxia typically awakens the sleeper so they can breathe normally, thus interrupting the sleep pattern.
“Some parents, often with sleep problems themselves, think it’s normal to be a bad sleeper, but it’s not. The first thing a parent can do about this is say ‘I really should talk to my pediatrician about this,’” Archbold says. “It may be that the child is someone who snores naturally, with no harm at all. But it’s something that should be evaluated.”
The pediatrician or other health care provider may suggest that the parent and child visit a sleep lab for evaluation. At a sleep lab, the child is monitored during sleep. To find one in your state, check the National Sleep Foundation site at http://sleepfoundation.org. Archbold also recommends the book “Solve Your Child’s Sleep Problems,” by Dr. Richard Ferber
There are a variety of potential treatments, from the removal of tonsils and/or adenoids to medication for the underlying condition.
“Children have developing brains that need a lot of oxygen. If a brain is being starved for oxygen at night, that’s not good,” Archbold says. “It’s not even good for an adult – and it’s especially bad for a developing brain.”
