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Sleep Medicine Specialists

What is Sleep Medicine?

Sleep is very important for the health of children, but what if they're struggling to rest through the night? Conditions ranging from sleep apnea to night terrors raise a lot of questions, and East Tennessee Children's Hospital is working to find answers as the only pediatric sleep center in the region designed just for children. A sleep study is known as a polysomnogram, a painless process involves an overnight stay at East Tennessee Children's Hospital's Sleep Medicine Center. The sleep study can help determine whether lifestyle, a health complication or a clinical disorder is responsible for lack of sleep.

Frequently Asked Questions About Sleep Studies

Sleep Medicine specialists at Children's Hospital offer answers to some frequently asked questions about sleep problems in children.

How much sleep does my child need?
Infants sleep 12-14 hours total. But by six months, most children sleep only 11-12 hours total, and this number changes only slowly as children grow. Even by mid-childhood the number usually has not dropped below 10 hours. How those hours are distributed may vary. In the first few months, a third or more may still occur in the day. But after three months, most should occur at night. Still, a child needing 12 hours may distribute it between the night and day as seven and five, eight and four, or nine and three. As the child gets to five months or so, he probably should be getting at least nine hours of sleep at night.

Are some children just better sleepers than others?
Some children are naturally good and long sleepers, others are not. But basically all healthy. Normal babies have the ability to sleep well. If they're not, then a thorough assessment of the problem and implementation of corrective behavioral and schedule-related measures should normalize their sleep within a few days. Sleep medication is rarely ever necessary. The sleep drive is very powerful in children, and if it's understood and controlled properly, just about all children should be able to sleep pretty well.

What are the most important factors in getting babies to sleep well?
Self soothing & training your kid to fall asleep on his own beside being sure that nighttime feedings are not excessive are two key factors after the first few months. A third factor that's very important (and often least recognized) is the schedule. All of our body's systems (including those that control sleep) function best when on a regular and appropriate schedule. If we're on an irregular sleep schedule, sleep can suffer. If a child's bedtime, wake time, and nap times differ day to day, one cannot know on any given night or day when that child is even capable of sleep. Or a schedule may be regular but inappropriate. Thus, children may be unable to sleep well at night because they sleep too much during the day, or they can't nap well during the day because they sleep too much at night.

How does lack of sleep impact a child's ability to do their schoolwork/pay attention in class?
Is there any correlation between sleep deprivation and doing poorly in school?
All of us gather information during the day while we are awake; then, we consolidate that information into memories at night while we sleep. Therefore, children who do not get a good night's sleep have trouble remembering what they learned during the day, and their schoolwork suffers.

What can you teach your children about why it's important to get enough sleep?
How do you make sleep a priority?
The best way is often the most difficult for parents: lead by example! It is important for not only your child, but also for the parent, to get enough sleep.

How important is a routine bedtime?
What should those bedtime routines be?
A bedtime routine, including a consistent bedtime, is very important and helps the child prepare to go to sleep each evening. The routine might begin by bathing, brushing teeth and putting on night clothes, then end with the parent reading a story and having that special "one-on-one" time with the child – which is valuable in so many ways.

How long should it take to establish a new sleep routine with your child?
In as little as one week, an expectation can be established. Rules, limits and boundaries for a sleep routine should be set for children, and they should be expected to operate within those limits. As the child learns that the parent is serious about these expectations, the routine begins to be established. A good pattern and routine can usually be set in about a month.

Could sleep deprivation make my toddler a more "terrible two"?
Absolutely. Lack of sleep can create a "terrible two" at any age, including during the teenage years. Adults also can become irritable and short tempered when they are sleep deprived. Growing children, and even teenagers, have no inhibitions about letting others know when they are unhappy!

What's the best way to diagnose the cause of a sleep problem?
To diagnose sleep problems, physician must take a good, careful history from the parents. Diagnosis requires an in-depth understanding of normal and abnormal sleep patterns and behavior. A sleep study might or might not be needed. Parents are often able to identify these problems themselves after reading proper educational materials.

People seem to be more aware today of sleep problems with adults. What about sleep problems in children?
Sleep problems in children are quite common, and awareness is increasing. There have been studies completed showing that sleep problems in children impact all aspects of their lives: school work, social interaction, as well as general happiness and well-being.

Are there any visual warning signs for sleep problems in children that parents should be aware of?
Yes, snoring is a common indicator that a child may have obstructive sleep apnea. In addition, a sleep-deprived child will have difficulty focusing during the day. He/she may be easily upset, irritable or overly emotional.

It seems like many children now have sleep problems or are identified as having sleep problems. Is it as common as it seems, or are we just hearing more about it?
About one in four children have a sleep disorder of some type. Diagnoses range from nightmares and night terrors to snoring, obstructive sleep apnea or sleep walking.

Should I tell my child's primary care doctor if my child isn't sleeping well?
What can they do about it?
Your child's primary care physician needs to know about any trouble your child has sleeping. He/she will examine your child with this problem in mind and may refer your child to the Children's Sleep Medicine Center for further evaluation. There is probably a reason for the child's difficulty sleeping. If the cause can be identified and corrected, the result may be a happier, more productive child.

I've heard that a child who is sleep deprived might behave similarly to a child with ADHD. Can you tell us more about that?
Yes, it is true. Symptoms of ADHD such as poor focus, impulsivity and hyperactivity are also very common in children who simply don't get the sleep they need. ADHD patients have higher prevalence of sleep apnea, restless leg syndrome and insomnia. Improving sleep usually makes them restful and help with daytime symptoms.

My child was diagnosed with autism; his sleep is poor & difficult, what can I do?
Sleep problems are very common, reportedly as high as 80% in children with Autism spectrum disorders (ASD). The most common sleep problems in children with ASD are difficulty falling asleep and repeated awakenings during the night. It is important to address medical or psychiatric issues that potentially interfere with sleep. Your child's medications might need adjustment if they affect his sleep. If your child suffers from a sleep disorder such as sleep apnea or restless legs syndrome, more specific treatment will be needed. Cognitive behavioral therapy can often help with their sleep problems. Better sleep for children with ASD can potentially improve their daytime functioning as well as the sleep of family members.