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On March 21, visitors to www.Turnto10.com chatted online about kids and sleep disorders with Judith Owens, MD, director of the pediatric sleep disorders clinic at Hasbro Children's Hospital. Below are excerpts from the chat. Moderator: Good afternoon, everyone, and welcome to today's Doc Chat. Our guest today will be Dr. Judith Owens, who will answer your questions on "Bedtime Battles." moody: I have a 9 year-old who sleeps with a blanky, teddy bear and leaves his small light on and also a radio. He has a lot of nightmares and I am at my wits' end as to what to do to make him feel comfortable at nighttime. He also wakes up in the middle of the night and calls out to me but will often go back to sleep if I don't answer him. He is a perfectionist and seems to have a lot of stress. Any suggestions? Dr. Owens: It sounds as though your son might have some more generalized anxiety, which might be manifesting itself as sleep problems. This might be worth exploring further with a counselor if he also has daytime anxiety. Some things that might help at night include a fish tank in his room (or even another pet if that works for your family) and a relaxation tape at bedtime which he could listen to as he falls asleep. You also might try a "carrot" approach; reward him if sleeps through the night without disturbing the rest of the family. moody: We have a cat but the glowing eyes scare him at night. We have tried rewards and punishments which work for awhile. We went to a counselor who suggested not answering him which at times has worked. I, as a mother, just want him to feel safe and to get a good night's sleep. What do you think of relaxation or yoga classes? If I could find one. kaykay: Our 9 year-old granddaughter has trouble getting to sleep and trouble staying asleep. Any suggestions? Dr. Owens: I am always in favor of learning relaxation techniques, especially to help deal with sleep onset problems or night wakings. Another technique we have tried for kids who worry a lot at bedtime is to have a "worry" time an hour or so before bed, when he can talk about anything that is bothering him well before it's time to fall asleep. Make sure that you limit TV viewing, especially around bedtime, as that can adversely affect suggestible children as well. kaykay: Do children suffer from sleep disorders such as sleep apnea? If so, would there be any daytime clues to look for? Susan: Are the possible treatments for childhood sleep apnea the same ones that are used for adults? What are the dangers of a child having sleep apnea that remains undiagnosed and untreated? Dr. Owens: Sleep apnea in children can cause serious behavioral problems, mood disturbances and school problems. Because the child is not getting good, quality sleep, he is often sleepy, inattentive, irritable and easily frustrated. Because the main cause of sleep apnea in children is big tonsils and adenoids, usually removing them takes care of the problem. Some children, like adults with sleep apnea, need to lose weight. We sometimes use a special machine called CPAP to treat sleep apnea in children. mollyferg: Is it normal for a child to wake up groggy and take an hour or so to become fully functional, or does this indicate too little sleep? Dr. Owens: Mollyferg, some people have what's called "sleep inertia," which means they have a hard time becoming alert in the a.m. Some children are naturally "night owls" and thus are ready to fall asleep later and also wake up later than what may be ideal for their lifestyle. Morning grogginess can be a sign of inadequate sleep, especially if she is also sleepy during the day. Susan: Are there any sources for pediatricians on how to determine which children should be referred to a sleep specialist to rule out sleep apnea? Dr. Owens: There are two texts
on pediatric sleep in print by Drs. Stephen Sheldon and Richard Ferber.
A new, combined edition will probably be coming out this fall. We are in
the process of developing guidelines for such referrals through the
American Academy of Sleep Medicine as well. If you want to call me at the
Lifespan Sleep Disorders Center (401-444-1614), I can get you references
of some articles that might also be helpful in the meantime! leelee: My son just turned 3 in January and he does not take a nap during the day any more. Is this normal? Dr. Owens: In general, children give up naps around 4 to 5 years old, but some earlier. Your 3 year-old should be getting about 12 to 13 hours of sleep in 24. If he is not cranky or sleepy during the day, he is probably fine! Dr. Owens: Help celebrate National Sleep Awareness Week (3/26-4/1) by getting a good night's sleep! Most school-age children need about 10 hours per night and most adults need 8. Make sleep a priority in your household, and you will have happier and healthier children! Find out more:For more information about sleep problems and their treatment call the Lifespan Sleep Disorders Center at 401-444-1614 (for children) or 401-444-4269 (for adults). |
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