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TPR Lifeline: What If Your Child Doesn't Sleep Like A Baby?

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David Dubose, MD, is a pediatric sleep specialist with Baylor College of Medicine at the Children's Hospital of San Antonio.

We generally don’t think about children having any trouble sleeping. Consider the phrase “sleep like a baby.” In reality, though, three in ten children may have a sleep disorder at some point in their lives.

In today’s TPR Lifeline, Bioscience-Medicine reporter Wendy Rigby talks to pediatric sleep specialist David Dubose, MD, of the Children’s Hospital of San Antonio. He has some advice for parents and important information about treatment.

  

Rigby: Dr. Dubose, what are some of the symptoms of pediatric sleep problems parents my notice?

Dubose: It can be anything from snoring, waking up during the night, having pauses in the respirations during sleep, or gasping in sleep. They can also have problems with coming in to mom’s room or dad’s room that may indicate a sleep problem.

We think of sleep apnea and obstructions as being an adult problem, perhaps from people being overweight or their anatomy changing with age. How does a kid end up with this?

Obstructive sleep apnea in the pediatric/adolescent problem is not uncommon. The number one reason that they would have obstructive sleep apnea is because of enlarged tonsils or adenoids. The second reason is obesity. And then the third reason is just the anatomy that the inherited from their parents.

Can there be a surgical solution, then, for some of these children?

If it is caused by an anatomical problem such as enlarged tonsils or adenoids, certainly having an adenotonsillectomy would take care of most of these problems.

What is a sleep study and where is it usually conducted?

So a sleep study is pretty much exactly what it sounds like. We watch the child sleep. There are multiple monitors placed upon the child. And it is usually done in a sleep center. Our particular sleep center is at the Children’s Hospital of San Antonio. Our sleep center is a little bit different because we only do pediatric patients. So our patient population is under 18 years of age. Nothing we do during the sleep study actually hurts with that. It is a lot of stuff and monitors and leads that are pasted on to the child.

So when you get this data, what different kinds of physicians are sometimes called into action to deal with that child’s sleep issues?

So after the sleep study is done, the sleep physician will interpret the report. The sleep physician is looking at six to eight hours of sleep. And they will get an impression for this whether there is a problem with breathing, whether there are problems with the stages of sleep, or movements during sleep. Depending upon what this is, there would be referrals to other specialists such as an ear, nose and throat physician if there’s obstructive sleep apnea or narrowing or blocking of the airway. They may be referred to a bariatric physician who specializes in the nutrition, weight loss, and exercise programs. We also use psychologists and psychiatrists if there are behavioral problems causing sleep disturbances.

But children don’t take sleep medicines, do they?

Rarely do they take sleep medicines. There are no sleeping pills approved by the FDA for children.

What is your best advice for parents who may be struggling with this issue with their child?

Have a bedtime routine. And that starts an hour before the bedtime where we discontinue the electronics and we participate in quiet activities that sets the brain to the calming down mode. And then we have a sleep period. So the sleep period needs to be regular and consistent and repetitive for this. We also look at the sleep environment where they should be in a cool, dark, quiet environment. But the worse thing and the biggest thing I fight against is electronics…with people with a TV in the room, a computer in the room, using the phone. And all of this interferes with sleep, prolongs the sleep onset and then actually disturbs the sleep if it’s left on while they are trying to sleep.

It’s a modern problem, right Dr. Dubose?

You betcha.

So what do you like about working in this field? Why are you passionate about this?

It affects not only their ability to perform well in school and memory, but it also affects their immune system, their weight gain, activity, all of those things. So it’s a huge part that affects the whole life of the child with this.

So you must feel like you can really make a difference for these children.

I like to think so.

Dr. David Dubose, pediatric sleep specialist with the Children’s Hospital of San Antonio, thanks for sharing your expertise.

Thanks for having me.