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Books, teachers, backpacks…alarm clocks. A new school year means transitioning from a laissez-faire summer schedule to a bright-eyed school-year regimen. But that’s not the only challenge kids – and parents – face. “The biggest myth out there is that sleep disorders are not very common among children. But 25 to 30 percent, if not more, of all children have some kind of sleep disorder,” says Cleveland Clinic Children’s Hospital sleep specialist Jyoti Krishna, MD, Head of the Pediatric Sleep Disorders Program.
Children spend one-third to one-half of their lives asleep, yet sleep issues are rarely brought up at the doctor’s office.
“What goes on at night is just as important as what happens in the daytime,” says Dr. Krishna. So be sure to bring any of the following problems up with your child’s physician:
1. Behavioral issues. You may think your hyperactive or inattentive 5-year-old has attention deficit-hyperactivity disorder (ADHD). But sleep disorders such as sleep apnea can masquerade as ADHD.
“Some kids on ADHD medications may actually have sleep problems,” says Dr. Krishna. Talk to your child’s doctor; a full battery of testing can sort things out.
2. Snoring. Between 10 and 30 percent of kids snore, which is harmless except in the 2 percent of children with sleep apnea (abnormal pauses in breathing during sleep). Enlarged adenoids and tonsils can contribute to sleep apnea by partially blocking the airway.
“Usually the first course of therapy is to get the tonsils and adenoids taken out,” says Dr. Krishna. “This may be appropriate for some children, but not all. The clinical exam alone may be misleading.”
If your child snores, gasps or snorts during sleep, he recommends sleep testing to confirm apnea before going through with surgery.
3. Sleep deprivation. Few parents realize that experts recommend 10 to 11 hours of sleep per night for kids 6 to 12, and nine hours per night for kids 12 to 18. Very few children get that much sleep due to poor sleep habits, caffeine use and electronic distractions — TV, texting, tweeting — in the bedroom, says Dr. Krishna.
A 2006 National Sleep Foundation poll found that in the hour before bedtime, three out of four 11-to-17-year-olds were watching TV and about two out of five were talking on the phone or texting. “It is a fair guess that those numbers are higher today,” he says. “Parents should make some rules surrounding bedtime because these habits are eating their way into nighttime sleep.”
4. Insomnia. Insomnia — the inability to fall or stay asleep — doesn’t plague just adults. One in seven kids of elementary school age also reports difficulty falling asleep, often due to anxiety, bedtime fears or other emotional challenges. For persistent cases of insomnia, consult your child’s pediatrician, says Dr. Krishna.
He or she may refer your child to a pediatric psychologist or sleep specialist. Most cases of childhood insomnia can be successfully treated with behavioral modification or cognitive therapy.
5. Needing naps. Beyond age 5 or 6, most kids should be able to function all day without napping, Dr. Krishna says. For kids who are excessively sleepy, taking a “sleep history” can be invaluable.
For example, asking teens about difficulty falling asleep and about difficulty waking up can point to insufficient sleep, to hypersomnia (the overpowering urge to sleep throughout the day) or to delayed sleep phase syndrome (in which the biological clock is set later than usual). Getting the right diagnosis means avoiding the wrong medications, says Dr. Krishna.
When sleep studies are recommended, they are conducted overnight in a comfortable bedroom-like “lab,” and a parent can be present.