Sleep Disorders in Children

What are the signs and symptoms of sleep disorders?

Excessive daytime tiredness, inability to focus, hyperactivity and irritability can be signs of poor sleep in children. Other signs and symptoms of sleep disorders include:

• Snoring (the most common) followed by pauses or gasping
• Labored breathing while sleeping
• Very restless sleep and sleeping in unusual positions
• Daytime sleepiness or behavioral problems
• Bed wetting
• Unusual or abnormal behaviors while falling asleep, sleeping or waking up
• Failure to thrive or not gaining weight appropriately

What tests are used to diagnose sleep disorders?

There are dozens of causes for excessive sleepiness, sleep-disordered breathing, insomnia and movement problems during sleep. To diagnose a sleep disorder, your child's doctor will perform a physical exam and ask about your child's sleeping patterns, medical history and symptoms. Your child's doctor may ask you to keep a sleep diary or sleep log to help diagnose sleep phase problems and insomnia. Based on this information, your child's doctor may order further testing or consult with our team of multidisciplinary experts in sleep, breathing and behavior.

We may also order a sleep study, which is called a polysomnogram. It is an overnight test that we perform in the Breathing Institute's Sleep Program here at Children's Hospital Colorado. It records different sleep stages to see if there are problems in your child’s sleep or breathing.

The polysomnogram will monitor your child's brain waves, heart rate, breathing and muscle activity using sensors. We place these sensors on your child's head, chin, legs, chest and near the eyes. The sensors are painlessly secured to the skin with gel, tape or special mesh netting.

The hook-up process can take 1 to 1.5 hours. During the process, you may read bedtime stories or watch a video. "Lights out" designates bedtime when all entertainment ends and the sleep recording begins. When your child is scheduled for a sleep study, we will send you a packet of information about two weeks before the study.

How are sleep disorders treated?

The treatment for your child's sleep disorder depends on the type of disorder and the cause. Breathing disorders may require medical therapy, oxygen or surgery to improve breathing during sleep. Other disorders benefit from cognitive behavioral strategies to improve sleep.

Occasionally, children need machines to help with breathing during sleep. One machine that is commonly used is called continuous positive airway pressure (CPAP). A CPAP machine is used to treat obstructive sleep apnea by providing a flow of positive-pressure air through a mask to open the upper airway while the child is asleep. The goal of CPAP is to enable the child to have regular or normal breathing, eliminate snoring and restore normal sleep patterns. Some children may need help feeling comfortable with PAP treatment. We have a desensitization program called STARS (Steps Towards Achieving Restful Sleep) for these children at the Anschutz Campus.

STARS Program Steps Toward Achieving Restful Sleep (STARS) teaches children to feel comfortable with PAP masks and air pressure, oxygen cannulas and overnight sleep studies. STARS/desensitization training is usually completed in 2 to 3 visits:

• First visit: Parents/guardians will attend this 90-minute class to learn about STARS/desensitization. Parents/guardians must complete this class before the follow-up visit(s) can be scheduled. Free childcare may be available. Please call 720-777-6489 before your appointment.
• Second visit: This 25-minute visit will be for the patient and parent/guardian. We usually work on the mask, cannula or sleep study sensations during this visit. Check in on the 4th floor in the Sleep Lab.
• Third visit: If needed, this visit is also for the patient and parent/guardian. We usually work on air pressure, oxygen flow or more sleep study sensations during this visit. Check in on the 4th floor in the Sleep Lab.

For STARS/desensitization questions, please call 720-777-1805. For scheduling questions, please call 720-777-6181.

Why choose us for treatment of your child's sleep disorder?

Children's Colorado's Sleep Center provides comprehensive clinics to evaluate children’s sleep and to make appropriate treatment recommendations so the entire family can return to a normal night of sleep. Our team includes experts such as pulmonologists, neurologists, sleep psychologists, nurse practitioners and physician assistants with extensive experience diagnosing and treating infants, children and adolescents with sleep problems.

Children with sleep problems often have other medical problems. That is why the multidisciplinary approach to care at Children's Colorado is so important when successfully solving sleep problems. The Sleep Center team works closely with other teams within the hospital, including pulmonary medicine, otolaryngology (ear, nose, throat/ENT), neurology and adolescent medicine specialists to form a comprehensive treatment plant that addresses every aspect of the sleep disorder.

• The National Sleep Foundation provides information on healthy sleep as well as sleep disorders.
• The American Academy of Sleep Medicine (AASM) is the only professional society dedicated exclusively to the medical subspecialty of sleep medicine.
• The Society for Behavioral Sleep Medicine is an organization focused on behavioral and psychological approaches to the prevention and treatment of sleep disorders.
• The Pediatric Sleep Council offers expert information and advice on baby and toddler sleep.