Four childhood sleep scenarios, and what you can do to rest easy
Problem: Your child snores. It’s keeping you or a sibling who shares the room awake.
Why it Happens: About 80 percent of all children snore at some point, says Nina Shapiro, M.D., an associate professor of pediatric otolaryngology at UCLA’s School of Medicine. Most grow out of snoring by about age six as their facial shape and airways mature. However, Shapiro says, allergies can also cause a child to snore. He’ll mouth-breathe (loudly, usually) if his nose is stuffy, so allergy medicine might be worth considering (talk to a pediatrician first). Heavy snoring shouldn’t be ignored, though, since it can disrupt a child’s sleep and may be the first sign of obstructive sleep apnea (see the following item), a serious health condition.
How to Rest Easy: If your child snores loudly and regularly, talk to your pediatrician. Your child may have extra-large tonsils or adenoids, and your doctor will probably recommend that they be removed. Tonsillectomies and adenoidectomies are usually done on an outpatient basis, and your child will most likely be up and about within a week. You should also ask the surgeon about Coblation tonsillectomy and adenoidectomy, an advanced procedure that reduces damage to surrounding tissue and has a faster recovery time. Another cause of snoring in kids that is increasing is obesity. The extra tissue that gathers around the neck presses on a child’s airways. If weight is an issue, talk with your doctor about safe ways for your child to drop the pounds.
Problem: Beyond snoring, your child gasps for breath or even seems to stop breathing for a few seconds to a minute at night.
Why it Happens: These are classic symptoms of obstructive sleep apnea, a condition that affects about 3 percent of children, according to Lynn D’Andrea, M.D., director of the Pediatric Sleep Disorders Center at the Children’s Hospital of Wisconsin, in Wauwatosa. And they’re very scary when witnessed by wide-awake parents. Sleep apnea definitely requires intervention. “Your child won’t sleep well if he’s not breathing well. Plus, the condition causes his oxygen levels to plummet, can lead to high blood pressure, and may contribute to bed-wetting,” says D’Andrea. Because they’re sleep-deprived, kids with sleep apnea may be so overactive and inattentive during the day that teachers or parents mistakenly think they have attention-deficit/hyperactivity disorder (ADHD), says D’Andrea. As a result, savvy pediatricians now screen kids for sleep disorders as part of ADHD evaluations.
How to Rest Easy: As with snoring, the most common remedy for sleep apnea in children is a tonsillectomy or an adenoidectomy. In rare cases, a child will still have trouble breathing even after the surgery (this is more common in overweight children), and for some children a doctor may recommend a continuous positive airway pressure (CPAP) device. The CPAP apparatus forces compressed air through your child’s airways, eliminating both snoring and apnea.
Problem: Your child grinds his teeth.
Why it Happens: Experts aren’t quite sure, but one theory is that children’s upper and lower teeth aren’t yet aligned. Some kids may do it when they’re anxious. Whatever the reason, it’s quite common. “About 20 percent of kids grind their teeth intermittently. Usually it is short-lived and nothing to worry about,” says Judith Owens, M.D., director of the Pediatric Sleep Disorders Clinic at the Hasbro Children’s Hospital, in Providence, and a coauthor of Take Charge of Your Child’s Sleep (Marlowe & Company, $16, amazon.com).
How to Rest Easy: Owens says you probably don’t need to do anything, unless your child complains of an aching jaw or tooth or a headache in the morning. In that case, talk to your child’s dentist. If she decides your child is suffering from temporomandibular joint (TMJ) syndrome or that the grinding is wearing down the tooth enamel, she may prescribe a special nighttime mouth guard. Similar to the mouthpieces worn by athletes, they protect your child’s teeth from further wear and tear.
Problem: Your child tosses and turns.
Why it Happens: Some kids are just “active” sleepers, so if your child seems well rested, don’t worry about it. However, obstructive sleep apnea can cause children to move around at night, since they often reposition themselves every time they wake up. A child could also have restless legs syndrome (RLS) or a related condition known as periodic limb movement disorder (PLMD). “Kids with RLS have an urge to move their legs that is worse at bedtime, worse at rest, and is usually accompanied by an uncomfortable sensation. I had a patient describe it as ‘soda in my veins’ or ‘bugs crawling on my legs,’ ” says Owens. Kids may also just say their legs hurt, so parents assume they’re having growing pains. Kids with PLMD kick rhythmically in their sleep and also tend to be very restless sleepers.
How to Rest Easy: Children with RLS are often deficient in iron, which is easily addressed with a supplement. Have your pediatrician do a simple blood test to determine if your child has low iron. In rare cases, your child may need RLS-specific medication. Follow a similar course of treatment for PLMD.