Tag Archive for: Children and sleep

Night Terrors in Children

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Night Terrors in Children

Night terrors are a common sleep disorder that can affect children, causing them to experience intense fear and confusion during their sleep. As a parent or caregiver, it can be distressing to witness your child going through night terrors.

What are Night Terrors?

Night terrors, also known as sleep terrors, are episodes of intense fear or terror that occur during sleep. They usually occur within few hours after bedtime. Unlike nightmares, after a night terror a child is not able to remember the dream when he or she awakens in the morning.

Night terrors are more common in children aged 3 to 8 years but can occur at any age. Sometimes, recurring sleep terrors are a symptom of other sleep disorders like obstructive sleep apnea. They affect 2% to 7%of children and usually peak between ages 4 and 7. Most children outgrow them before their teens.

Causes:

The exact causes of night terrors are not fully understood, but several factors can contribute to their occurrence including:

  • Overstimulation: Overtiredness, exhaustion, or disrupted sleep patterns can trigger night terrors.
  • Genetics: A family history of night terrors or other sleep disorders may increase the likelihood of a child experiencing them.
  • Stress or Anxiety: Emotional stress, anxiety, or significant life changes can contribute to night terrors in some children.
  • Fever or Illness: High fevers or certain illnesses may be associated with an increased risk of night terrors.
  • Obstructive Sleep Apnea (OSA) –untreated OSA increases the amount of arousals children have overnight and can increase the risk of night terrors occurring, This should particularly be considered if they are having multiple night terrors a week or in the same night as that would be an abnormal frequency for night terrors alone.

Symptoms:

Recognizing the signs of night terrors can help you differentiate them from other sleep disturbances. Common symptoms include:

  • Sudden awakening from sleep with a look of intense fear
  • Loud screaming or crying that is difficult to console
  • Rapid breathing and increased heart rate
  • Sweating and physical agitation
  • Difficulty recognizing or interacting with others during the episode
  • Limited or no memory of the even upon awakening

Managing Your Child’s Night Terrors:

While they can be distressing, there are several steps you can employ to help your child through a night terror

  1. Maintain a Consistent Sleep Schedule: Establish a regular sleep routine to ensure your child gets enough restful sleep each night. Consistency can help prevent overstimulation and reduce the occurrence of night terrors.
  2. Create a Soothing Bedtime Routine: Implement calming activities before bedtime, such as reading a book or taking a warm bath. This can help your child relax and transition into sleep more easily.
  3. Create a Safe Sleep Environment: Make sure your child’s bedroom is safe and free from any potential hazards. Use a night light if your child feels more comfortable with some light in the room.
  4. Minimize Stress and Anxiety: Encourage open communication with your child and provide reassurance and support during the day. If your child is experiencing stress or anxiety, consider incorporating relaxation techniques, such as deep breathing exercises or visualization, into their daily routine.
  5. Avoid Triggers: Identify and minimize potential triggers for night terrors, such as certain foods, drinks, or activities close to bedtime. Additionally, limit exposure to stimulating media before sleep.
  6. Ensure Safety During Episodes: If your child experiences a night terror, make sure they are safe by gently guiding them back to bed without waking them fully. Attempting to wake or restrain them may prolong the episode or increase distress.
  7. Seek Professional Advice: If night terrors persist or significantly affect your child’s well-being or daily functioning, consider consulting your pediatrician or a sleep medicine professional for further evaluation and guidance.

Night terrors can be unsettling for both children and parents, but with understanding and effective strategies, they can be managed. By creating a consistent sleep routine, providing a supportive environment, and minimizing potential triggers, you can help your child navigate through night terrors and ensure they have a restful night’s sleep.

Our sleep medicine specialists at Comprehensive Sleep Care Center can determine whether these events are night terrors or whether they are symptoms of a more serious sleep disorder like sleep apnea. Our doctors will combine the information they learn from your child’s sleep history, physical exam, and other test, like a sleep study, to make the diagnosis.

Sleep and Time Change

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How to sleep well during time changes

A time change can take a toll on your sleep. Adjusting to changes in your sleep patterns can be hard on your body. You can take steps to avoid disruption to your sleep by learning a few simple strategies.

What are the negative effects of the time change?

The annual change from standard time to daylight saving time is associated with increased risk of heart attacks and stroke. There are increased hospital admissions due to atrial fibrillation. There also is an increase in emergency room visits and missed medical appointments. Traffic accidents increase in the first few days after the change from standard time to daylight saving time. The spring and fall time changes have also been associated with mood disturbances and suicide.

The American Academy of Sleep Medicine supports the elimination of daylight-saving time. A change to permanent standard time is best aligned with human circadian biology and has the potential to produce beneficial effects for public health and safety.

How does daylight saving time change affect your sleep?

We are most vulnerable to sleep deprivation in early March, as they transition from Standard Time to DST. One study found that the average person receives 40 minutes less sleep on the Monday after “Springing Forward” compared to other nights of the year.

During daylight saving time, we tend to go to bed and fall asleep later at night, resulting in sleep loss. The spring and fall time changes can also disrupt our sleep schedule and have a negative effect on the quality of our sleep. The changes to daylight saving time can be especially problematic for any populations that already experiences chronically insufficient sleep or other sleep difficulties. Those at greatest risk include teenagers, who tend to experience chronic sleep restriction during the school week, and night shift workers, who often struggle to sleep well during daytime hours.

Adjusting the time by one hour may not seem like a drastic change, but sleep experts have noted troubling trends that occur during the transition between Standard Time and DST, particularly in March. These issues include  increases in heart problems, mood disorders, and motor vehicle collisions. Some people also experience insomnia symptoms due to springtime changes.

During time change, you can take steps to help avoid disruption to your sleep. Getting the recommended seven to eight hours of sleep a night provides tremendous health benefits and helps you perform at your best.

Daylight Saving Time Sleep Tips

  • Practice Good Sleep Hygiene: Sleep hygiene refers to practices that can influence sleep for better or worse. In order to ease the transition of the time change, you should refrain from consuming alcohol before bed. While drinking can cause you to feel sleepy initially, alcohol also causes sleep disruptions and leads to poor sleep quality. Heavy meals before bedtime can also negatively affect how well you sleep that night.
  • Establish a Consistent Sleep Routine: Going to bed and waking up at the same time each day – including the weekends – is a healthy sleep hygiene practice that can also prepare you for time changes.
  • Gradually Alter Your Bedtime: Two to three days before the time change we recommend waking up 15-20 minutes earlier than usual. Then, on the Saturday before the time change, set your alarm clock back by an additional 15-20 minutes. Adjusting your wake-up time can help the body make a smoother transition when the time change occurs.
  • Spend Time Outdoors: Since natural light is a driving force behind our circadian rhythms, exposure to sunlight can alleviate feelings of tiredness during the day that often accompany time changes.
  • Nap in Moderation: People who experience sleep debt as a result of DST may find some relief by taking short naps during the day. These naps should never exceed 20 minutes in length; otherwise, you may wake up feeling groggy.
  • Don’t Consume Caffeine Too Close to Bedtime: Studies have found caffeine consumed within six hours of bedtime can disrupt your sleep cycle.

If you are experiencing sleep problems visit one of our sleep medicine providers at Comprehensive Sleep Care Center. Our doctors treat over 80 types of sleep disorders such as Sleep Apnea, Insomnia, and Narcolepsy. Give us a call and Say Hello to Sleep Again…

Doomscrolling it’s Affecting your Sleep Health

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Doomscrolling it’s affecting your Sleep Health

 Doomscrolling is a new term referring to the habit of scrolling through bad news, even though that news is saddening, disheartening, or depressing. Large numbers of people are finding themselves reading continuously bad news. The Covid-19 pandemic has exacerbated this habit with people stranded in their homes increasing  the ever scrolling of Google news, Twitter, Instagram, and Facebook.  The news cycle has gotten more intense and the constant stream of bad news and social media never ends. And so, unfortunately, so does our morbid curiosity or fear of missing out on something important. This self-destructive behavior of Doomscrolling can seriously disrupt your sleep and your overall health.

This constant barrage of bad news can lead to difficulty falling asleep and eventually insomnia. Poor sleep can provoke symptoms of depression in some individuals. Chronic sleep problems can exacerbate depression, leading to a negative cycle between depression and sleep that can be challenging to break.

Doomscrolling can increase levels of cortisol and adrenaline, which are stress hormones. Research has shown that chronic levels of elevated stress hormones are associated with many physical health issues, including heart disease, diabetes, and obesity.

So, what can you do to scroll without so much doom?

It is important to our overall health and wellbeing that we practice self-care and find balance in our lives. One good solution is by logging off. Start by cutting back and creating boundaries for your social media and news scrolling use. Do your best to not scroll the 2 hours before bedtime. It is not only the doom and gloom of the media, but using tablets, smartphones, laptops, or other electronic devices before bed delays your body’s internal clock (circadian rhythm), which suppresses the release of the sleep-inducing hormone melatonin, making it even more difficult to fall asleep.

10 Tips to Better Sleep

Swap out the doom and gloom with happier things

Whether it’s connecting with family or sending funny memes to friends, these are the things we should try and spend more time doing. This will help to build up more positive emotions in our lives. And who couldn’t use more of those?

If you feel you may have a sleep problem. Call our office and make an appointment with one of our sleep medicine professionals. We currently have Tele Medicine Virtual visits as well as in-office appointments. Let us help you to Say Hello to Sleep Again.

Comprehensive Sleep Care Center has 9 locations in Virginia and Maryland (Alexandria, Arlington, Bethesda, Chantilly, Dumfries, Germantown, Lansdowne, Manassas, Woodbridge).

Tips for Your Child’s Sleep Study

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Tips for Your Child’s Sleep Study

By Amanda Jones RPSGT- A Sleep Technician Mommy

An in-lab sleep study can be stressful for the adult patient. But bringing your child in for a sleep study can be nerve-wracking for the both of you. Our Sleep Technician Manager (and mommy of 2) is here to help give you some tips for your child’s sleep study and what to expect.

Pediatric Sleep Study Tips

  • To best prepare your child, keep napping to a minimum on the day of the study. Keeping your child from napping may help them fall asleep easier in the lab. Of course, it may be difficult to prevent your child from falling asleep, but do your best to minimize napping the day of the study.
  • You and your child will be greeted by a friendly, experienced licensed sleep technologist. You both will be shown to your private room for the night. Our rooms have a queen size bed, TV, and an overstuffed recliner for your comfort.
  • The sleep technologist will go over any questions you may have prior to starting the study. Your child will be asked to sit in a computer chair while the wires are applied. The hook up can take up to 30 minutes, so if your child has an iPad, book, or toy they like, feel free to bring it!
  • During the hook up, the sleep tech will politely explain why the wires are being applied. This, in turn, will make your child feel more comfortable. As an example: For some younger children, some techs will say the wires will test for superpowers! This set-up includes the following equipment:
    • A bandage-like sensor that measures your child’s oxygen will be placed on the toe or finger
    • Small plastic prongs at the nose will measure your child’s exhaled air
    • Elastic or cloth belts will be placed on your child’s chest and stomach, usually over their pajamas
    • Stick-on electrodes will be placed on your child’s face and chest to measure eye movements, heart rate, and muscle tone during sleep.
      • A few additional electrodes are applied with a washable paste on your child’s scalp to measure stages of sleep
  • We do recommend and ask that the parent sleep in the recliner and not in the bed with the child. This is so we get a clear recording of your child’s movements and sleep patterns. If the parent were to sleep in the bed with a child and simply just change positions, it could cause the child to wake up or make it look like the child was moving their leg.
    • We understand that this can be stressful and at times scary for your little one, and they may need your comfort while laying in bed. This is OK. We only ask that once the child is asleep, you exit the bed quietly and move to the recliner to sleep.
  • If your child has any comfort items (blanket, stuffed animal, etc.), we recommend and welcome them to come to the sleep over as well!
  • If your child likes to have a bedtime snack or a specific nighttime drink (ex: milk), make sure to bring those as well. The lab does have a refrigerator, a water cooler with hot and cold water and a microwave, if needed.
  • No need to worry if your child is a restless sleeper. The sleep technologist will be monitoring your child and the leads throughout the night. They might have to come into the room a few times to adjust or reattach wires that come loose.
  • If your child has a hard time tolerating the study, don’t worry. The sleep technologist is experienced working with children and will work hard to get the proper data for the doctors. The doctors are great and are equipped to read the data collected, even if its not perfect.
  • If your child has bed-wetting accidents at night, that is not a problem! Kindly let the tech know so they can lay down extra protection.
  • The wires are pain-free to attach, as well as remove. We have adhesive remover on hand for an easy removal in the morning with little irritation! There will be some paste residue on the face and head once the wires are removed. This residue is water soluble and will wash out with warm water. Using conditioner can help make the paste removal easier, as well as micellar water or rubbing alcohol.

Pediatric Sleep Disorders

Up to 50% of children will experience a sleep problem. Early identification of sleep problems may prevent negative consequences, such as daytime sleepiness, irritability, behavioral problems, learning difficulties, motor vehicle crashes in teenagers, and poor academic performance.

Our goal at Comprehensive Sleep Care Center is to make you and your child’s experience as comfortable and beneficial as possible.

Kids, Sleep and COVID-19

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Kids, Sleep and COVID-19
Boost your child’s immune system during COVID-19 Pandemic with quality sleep

Research shows that quality sleep is essential when it comes to health for both children and adults. Ensuring that your child gets an adequate amount of quality sleep can help boost their immune system and keep families healthy. This is a high priority during COVID-19, but also vital for health year-round.

Many kids today are struggling because of schooling issues, not being able to see their friends or play sports. They are not expending the same levels of energy as before COVID-19. Everyone’s routine has changed. Children may feel our stress or be anxious from listening to the news. All this can lead to poor sleep resulting in more meltdowns and unwanted behaviors.

A child’s poor sleep can be due to many issues like:

  • Lack of stimulation (physically and mentally)
  • Increased screen time with TV, computers, video games
  • Increased feelings of stress and anxiety

If your child is consistently not getting enough sleep,
they are three times more likely to get sick.

Sleep helps your body (adults and kids) produce immune-boosting cells to protect us.

That’s why, when we get sick, we also get tired. Your body is telling you that you need sleep to heal.
While more sleep won’t necessarily prevent you from getting sick, skimping on it could adversely affect your child’s immune system, leaving them more susceptible.

The National Sleep Foundation has these recommendations for children:

Under 1 year of age: 12 to 16 hours a day
1 to 2 years: 11 to 14 hours a day
3 to 5 years: 10 to 13 hours a day
6 to 12 years: 9 to 12 hours a day
13 to 18 years: 8 to 10 hours a day

5 TIPS TO PROTECT YOUR CHILD’S SLEEP

  1. Make a schedule for sleep and daily activities (for both you and your children) – and do your best to keep consistent.
  2. Stop screen time 60 minutes before bedtime- Intense, close-up light exposure in the evening will delay sleep by not allowing the body to produce melatonin, the good sleep hormone. This is especially important since our kids are using more screen time during the day.
  3. Get sunlight- Try and get outside. Open up your blinds, take a walk, or play outside. The sun controls our internal 24-hour clock that tells our body when to be awake and when to be asleep. If your child’s body doesn’t get enough sunlight, it will mix up their days and nights.
  4. Your child needs physical activity – Kids days have likely gone from active to sedentary. The harder they play, the more their body will need to recover, and the better they’ll sleep.
  5. Create a calming routine – This routine should be at least 30 minutes before bedtime. Things like a warm bath, a good book, (no screen time), do a puzzle or something quiet. The best sleep results come from a routine that’s calm and technology-free.

Of course, there’s more to boosting your immunity and guarding against illness than just getting ample sleep. It’s also important to practice stay-healthy strategies too.

Steps to Keep Children and Others Healthy

  1. Clean hands often using soap and water or alcohol-based hand sanitizer.
  2. Avoid people who are sick (coughing and sneezing).
  3. Put distance between your children and other people outside of your home. Keep children at least 6 feet from other people.Consider postponing visits or trips to see older family members and grandparents. Connect virtually or by writing letters.
  4. Children 2 years and older should wear a cloth face covering over their nose and mouth when in public settings where it’s difficult to practice social distancing. This is an additional public health measure people should take to reduce the spread of COVID-19 in addition to (not instead of) the other everyday preventive actions listed above.
  5. Clean and disinfect high-touch surfaces daily in household common areas (like tables, doorknobs, light switches, remotes, desks, toilets, and sinks).
  6. Launder items including washable plush toys, as needed. Follow the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting and dry items completely.
    Make sure your children are up to date on well-child visits and immunizations.

Following guidelines to prevent the spread of the COVID-19 virus can be particularly difficult for children. Stay patient. Be a good role model and your child will be more likely to follow your lead. And remember, you children will be able to bounce back faster if they get sick if their body is well rested.

If your child continues to have sleep issues, or if you are concerned that your child may have a sleep disorder, the pediatric sleep medicine physicians at Comprehensive Sleep Care Center are here to help. Give us a call today. We are offering in-office as well as virtual office visits.

Pediatric Sleep Disorders

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PEDIATRIC SLEEP DISORDERS

Up to 30% of children today have some type of sleep disorder. Pediatric sleep disorders can lead to tired and cranky children, but also to a number of behavioral problems at home, in school, and in their social lives as well.

SYMPTOMS

Signs and symptoms of sleep disorders in children might include:

  • Impulsiveness
  • Irritability
  • Difficulty focusing/concentrating
  • Hyperactivity
  • Snoring /gasping, pauses in breathing
  • Restless sleep
  • Nightmares / night terrors
  • Sleepwalking
  • Snorting, coughing or choking
  • Mouth breathing
  • Bed wetting (over the age of 5)
  • Unexplained decrease in daytime performance
  • Obesity
  • Grinding teeth during sleep
  • Trouble falling asleep due to leg discomfort

Infants and young children with obstructive sleep apnea don’t always snore. They might just have disturbed sleep.

Children who have sleep disorders may often exhibit symptoms (inattentiveness, over-activity, restlessness) similar to ADHD. Studies have suggested that as many as 25 percent of children diagnosed with attention-deficit hyperactivity disorder (ADHD) may actually have symptoms of obstructive sleep apnea and that much of their learning difficulty and behavior problems can be the consequence of chronic fragmented sleep. Bed-wetting, sleep-walking, retarded growth, other hormonal and metabolic problems, even failure to thrive can be related to a sleep disorder. Several recent studies show a strong association between pediatric sleep disorders and childhood obesity. Children exhibiting these symptoms or other behavioral problems should be carefully assessed by a pediatric sleep medicine specialist to assess their sleep problems.

American Acedemy of Pediatrics Guidelines

The American Academy of Pediatrics (AAP) guideline recommends that children who frequently snore should be tested for obstructive sleep apnea.  The clinical practice guideline “Diagnosis and Management of Childhood Obstructive Sleep Apnea” was published in the September 2012 issue of Pediatrics. The guideline recommends in-lab polysomnography for children with daytime learning problems, labored breathing during sleep and disturbed sleep with frequent gasps, snorts or pauses. The guidelines also call for children and adolescents to be screened for snoring as part of routine physician visits. The AAP recommends adenotonsillectomy as the first-line treatment for children with sleep apnea. Pediatricians may also recommend weight loss in obese patients or CPAP if surgery is ineffective or not conducted. 

Causes 

There are differences between pediatric obstructive sleep apnea and adult sleep apnea. While adults usually have daytime sleepiness, children are more likely to have behavioral problems. The underlying cause in adults is often obesity, while in children the most common underlying condition is enlargement of the adenoids and tonsils. However, obesity also plays a role in children. Other underlying factors can be craniofacial anomalies and neuromuscular disorders. Early diagnosis and treatment are important to prevent complications that can affect children’s growth, cognitive development and behavior.

DURING THE DAY, CHILDREN WITH SLEEP DISORDERS MIGHT:

  • Perform poorly in school
  • Have difficulty paying attention
  • Have learning problems
  • Have behavioral problems
  • Have poor weight gain
  • Be hyperactive

 MAKING A DIAGNOSIS

As in adults, a polysomnography (sleep study) is the only tool for a definitive diagnosis and assessment of the severity of pediatric obstructive sleep apnea. It needs to be conducted during an overnight stay in a sleep lab, with the test conducted by technologists experienced in working with children and the data interpreted by a sleep medicine physician with pediatric experience. In addition, since children’s sleep apnea is frequently most pronounced during REM sleep late in the sleep cycle, home sleep studies and daytime nap studies are not useful and can be misleading.

FINDING A SPECIALIST

Comprehensive Sleep Care Center offers expert diagnosis, treatment, and care for pediatric sleep disorders for children from the age of 2 months and up with the goal of providing a better night’s sleep and a better day ahead for the entire family.

If you suspect your child might have a sleep disorder, contact our physicians at Comprehensive Sleep Care Center. We have a team of pediatric sleep medicine specialists on staff and ready to help.