Are your kids getting enough sleep?

In New York City, sleep is a commodity that can be hard to come by. With busy schedules extending into late hours, loud street noises, and high academic demands, making sure your kids get enough sleep can be a challenge. There is much debate over the exact number of hours a child should sleep every night, yet of equal importance is determining whether or not your child is getting good quality sleep. The consequences of untreated poor sleep in children affect many different parts of the body, and can include heart failure, developmental or behavioral issues, poor school performance, poor growth, obesity, reflux, and significantly increased risks of complications from surgery.

Risk factors for poor sleep include a history of prematurity (early birth), obesity, sinus disease, having a family member with poor sleep, large tonsils or adenoids, and persistent wheezing. Your pediatrician should be screening your child for symptoms of sleep disorders, so understanding what to look for can help your pediatrician make a diagnosis and refer your child to treatment.

Snoring is one of the most common complaints parents have concerning their child’s sleep quality. Snoring is caused by an obstruction or narrowed airway (breathing tube) and can sometimes lead to apnea, or pauses in breathing. Most children with sleep apnea will have some degree of snoring, but not all children who snore have sleep apnea. It is normal for children to have noisy breathing during a cold or sinus infection, but if you notice snoring during times of wellness, pay close attention. Other nighttime symptoms of poor sleep include night terrors, sleep walking, restless sleep, or return of bed-wetting issues.

Daytime symptoms of poor sleep in children can be easy to miss but do exist. Many children will be difficult to wake in the morning or complain of a headache. Older children can have daytime sleepiness with excessive napping or falling asleep at inappropriate times. Younger children can also have increased sleepiness but may also show hyperactivity.

Talk with your child’s teacher about his academic performance and behavior during school hours. Inability to concentrate, focus, or pay attention during school can be a sign of poor sleep. Your child’s teacher is a valuable resource, as she is likely to be spending more daytime hours observing your child and noticing changes in his performance. These symptoms are easily reversible once sleep patterns return to normal.

Adults with severe sleep apnea or sleep disorders tend to put on pounds, but young children are more likely to lose weight or have difficulty achieving normal expected weight and height gains. It is important to note, however, that obesity is a common cause of sleep apnea in children.

It may be helpful to observe your child sleeping, and look for pauses in breathing, though due to some variations in breathing patterns being normal at certain ages, sleep apnea in children can usually only be diagnosed by a pediatric sleep specialist with an overnight sleep study. Talk to your pediatrician about a referral if you suspect your child has a sleep disorder. The longer treatment is delayed, the more difficult it is to reverse the negative effects of poor sleep.

Joe Ciavarro is a pediatric physician assistant in New York City.

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