Ask The Expert: Sleep Health
The Sleep Health Clinic at Gillette Children’s Specialty Healthcare is dedicated to meeting the needs of children, teens, and young adults who have disabilities. Our clinic offers comprehensive, family-focused care in a facility that is specially designed for children with complex conditions. Sleep disorders disproportionately affect children who have cerebral palsy, craniofacial conditions, attention deficit hyperactivity disorder, epilepsy, and other neurologic conditions. Often, these children may already have health issues that can be further complicated by sleep problems. Our pediatric sleep physicians work closely with families to resolve sleep disorders and achieve a better night’s rest.
On our Facebook page, we asked you to submit your sleep health questions for Dr. John Garcia to answer. You can read the questions and answers below. As always, we recommend you consult with your health care provider.
Q.What kind of affects can sleep apnea and obstructive breathing have on a child if it has gone untreated for many years? This child is not trached yet but is finally being treated at the age of 11. Can it affect other organs in her body?
A. I address this problem by systems. Untreated OS can cause difficulties with attention and can also lead to daytime sleepiness. If there is a history of seizures, it can make the seizures harder to control. From a pulmonary point of view, I can see increased incidence of pneumonia. Acutely untreated OSA can lead to sedation associated respiratory compromise. OSA can cause reflux. Untreated OSA can lead to right heart strain though this is quite rare. Untreated OSA can lead to metabolic diseases including insulin resistance, obesity, and lipid abnormalities.
Q. Some parents have wondered what to do about night terrors. Can Dr. Garcia provide some tips?
A. Night terrors are a subcategory of parsomanias which including sleepwalking, confusional arousals, and bed wetting. People who sleep too deeply are at increased risk for parasomnias. Good sleep hygiene is key to preventing night terrors. This means regular wake and bed times, predictable nap opportunities and a controlled sleep environment. If these episodes are occurring more than three times a week or are associated with injury then a sleep consultation is an option. Safety precautions including bells or buzzers on a child’s door and outside doors are another option.
Q. I have a sleep question. My son was born with congenital cytomegalovirus and he use to sleep good. Well the doc just diagnosed him with autism. He can go all day w/o a nap and go to bed at 8:00 pm and be back up by 11:00pm ready to go and is non stop until 3:00 am when he falls asleep again until 12:00 pm. I need help and sleep. I have tried to switch his sleeping around but he still is on the go. Please help.
A. About 86% of children with Autism have a sleep disorder, often insomnia. A sleep doctor would be a great place to start, who may recommend a trial of melatonin.
Q. Possible sleep apnea in a 13 year old boy with Downs. We haven’t been able to do a successful sleep test to determine if it is indeed sleep apnea. Any suggestions?
A sleep consultation should help to sort out whether a sleep study is needed. If there are symptoms consistent with OSA but a polysomnogram is not feasible, then overnight oximetry may help determine whether there is an associated severe oxygen desaturation. There are non-CPAP treatments available as well such as high flow if a 13 year old will not tolerate a CPAP
A board-certified sleep specialist, John Garcia, M.D., works with Gillette patients who have disabilities and associated sleep disorders. Such disorders include obstructive sleep apnea, sleepwalking, circadian rhythm disorders, and restless legs syndrome. He uses a combination of behavior management, medications, surgery and other therapies in his practice.
Dr. Garcia is a graduate of the University of Iowa School of Medicine. He completed a residency in pediatrics and one year of fellowship training in behavioral/developmental pediatrics at Riley Hospital for Children in Indianapolis, Ind. He then completed a sleep fellowship equivalent at the Minnesota Regional Sleep Disorders Center in Minneapolis. Dr. Garcia holds clinics at Gillette’s main campus in St. Paul and at the Burnsville Clinic.
His professional associations include the American Board of Sleep Medicine and the American Board of Pediatrics.