If early bedtimes and a conducive sleep environment are still not making a difference to your child’s quality of sleep, the problem might be health related…
We’ve had our fair share of sleep woes thanks to fussy kids, as former HoneyKids writer Tracy can tell you. We also know how grumpy kids can be without a nap – and how grumpy we are without our coffee. But not getting your required 10 to 12 hours of sleep (yes, that’s how much a kid should be sleeping in a day!), can also cause problems that go beyond the occasional ‘off day’.
Lack of sleep isn’t just a result of poor sleep habits; it can also be due to sleep disorders, say doctors that we spoke to. Sleep disorders occur when a child’s sleep pattern is disrupted, and it affects everyday functioning and well-being. Yup, way more serious than a case of the grumps.
So, when should parents chalk up their child’s bad sleep to a disorder? And what signs and symptoms should they be looking out for? We ask experts Dr Jenny Tang and Dr Dawn Teo, a Medical Director and Consultant ENT (Ears, Nose & Throat) Surgeon at The Children’s Eye & ENT Centre at Mt Alvernia Hospital.
Bad sleep or sleep disorder? Here’s what the experts have to say:
Common sleep disorders in children
Sleep disorders are different from poor sleep habits, as there’s no way to outgrow them completely, and they’ll continue to impair sleep and daytime function until they’re fixed. The most common sleep disorders that plague little ones are…
- Behavioural insomnia in children (BIC): where kids have difficulty falling asleep.
- Chronic sleep insufficiency: common in school-going kids who lack sleep due to school pressures and family schedules.
- Parasomnias: which includes night terrors and sleepwalking.
- Obstructive sleep apnoea (OSA): where children are unable to breathe during sleep because of partial or complete obstruction of the upper airway.
- Rhythmic movement disorders: which include head banging and body rocking.
How do sleep orders affect children?
Sleep disorders can lead to insufficient sleep or poor quality sleep, as well as disorder-specific consequences. “For example, with regards to OSA, interrupted breathing during sleep results in choking episodes and lack of oxygen reaching the brain,” notes Dr Dawn Teo.
This, in turn, results in interrupted sleep which, in the short term, may cause daytime sleepiness, poor school performance, and behavioural problems. In the long term, it predisposes your child to chronic problems like heart problems and hypertension.
Some parents may choose to wait for their kids to grow out of their disorder. And some, like parasomnias, do become less frequent with age. “But there’s also a chance it may evolve into something else,” notes Dr Tang. A toddler who experiences night terrors may outgrow it, but it might manifest into another parasomnia sleep disorder, such as sleepwalking later on. However, other sleep disorders, like OSA, are unlikely to be cured without treatment.
OSA: Signs, symptoms and available treatments
When it comes to OSA, Dr Tang says parents should be on the lookout for daytime and nighttime symptoms. Daytime symptoms include irritability and the inability to focus at school, while nighttime symptoms include persistent snoring, frequent wake-ups, and difficulty falling asleep or waking up.
Selina Altomonte, former Honeycombers Editor and mum of two, shares how her youngest son was diagnosed with OSA under some unique circumstances, “As a baby, my little boy would sleep in short bursts and make loud snoring sounds even while he was awake. It was only during a hospital stay that we found out his oxygen levels would dip quite frequently (and severely) during his sleep.”
Selina’s son underwent a sleep study, which revealed he had moderate to severe OSA and was waking up almost 40 times during the night! He was put on Continuous Positive Airway Pressure (CPAP) therapy, which makes use of a machine to deliver a stream of pressurised air through a mask. This mask is worn during sleep to keep upper airways open and allows children to have uninterrupted sleep.
Needless to say, such a treatment is a lifestyle change for a family. Beyond your child needing to get used to sleeping with a mask, you also need to monitor and maintain the CPAP equipment and deal with alarms going off whenever the mask shifts during sleep. “My advice? Seek a diagnosis as soon as you think there could be an issue, and look at all therapy options available to you,” adds Selina.
Treatments available in Singapore
If you believe your child is getting insufficient sleep or poor quality sleep, speak to your doctor at once. If they agree your child might indeed have a sleep disorder, a sleep study will be carried out to confirm their suspicions.
A sleep study is a painless and non-invasive overnight examination that monitors your child while they sleep to see what’s happening in the brain and body. Sensors and electrodes are placed on the head and body to monitor junior throughout the night. The data will then be evaluated by the doctor, who will recommend the right treatment.
Treatments for sleep disorders vary. The standard treatment available for OSA is CPAP therapy, as mentioned above. Luckily, more sophisticated machines and interfaces have been developed to make CPAP therapy more comfortable and portable.
Should you decide to opt out of CPAP therapy or choose not to undergo surgical intervention, know that there are other alternative treatments being developed. Myofunctional Therapy has shown promising results – it’s painless and involves facial exercises to strengthen the muscles in the face.
For more information on childhood sleep apnea or (OSA), visit sleepfoundation.org. This foundation is working hard to create more awareness around the topic of sleep disorders.