Sleep Disorders

Children who have disabilities often have sleeping problems, too. That can affect the health—and quality of life—of both children and their families. That’s why we offer one of the nation’s only sleep medicine programs designed specifically for people who have disabilities and complex conditions. Our sleep health specialists work closely with patients and families to diagnose and treat sleep disorders in patients who have cerebral palsy, craniofacial conditions, epilepsy, neuromuscular conditions, and other neurological disorders.

Why Choose Gillette?

  • Our sleep-health experts specialize in the unique needs of people who have disabilities and complex conditions.
  • Our providers collaborate to provide comprehensive treatment plans.
  • Our facilities and technology are designed specifically for your needs.
  • We are committed to helping our patients achieve their highest possible levels of comfort, health and wellness.

Definition

Sleep disorders alter sleeping habits and change regular sleep patterns. Many sleep disorders can harm physical health and emotional well-being. Children who have a disabilities or complex medical conditions are much more likely to experience sleep problems than typically developing children are.


Types, Symptoms and Causes

Sleep disorders typically fall into three categories in children and young adults:

  • Lack of sleep
  • Excessive sleep
  • Problematic behaviors—such as sleepwalking, snoring or seizures—that occur during sleep.

Sleep Apnea

Obstructive sleep apnea occurs during sleep. Throat muscles occasionally relax, blocking air flow in the nose and mouth (apnea), often causing snoring. To stop the apnea, a person briefly wakes up, which interferes with sleep. Sleep disturbances caused by sleep apnea can produce stress hormones and lead to daytime sleepiness, irritability, and changes in the ways the body uses energy.

Some of the most common symptoms and effects of sleep apnea include:

  • Drowsiness, morning lethargy or sleepiness during daytime hours
  • Snoring
  • Brief periods of not breathing during sleep
  • Sudden awakenings with shortness of breath
  • Waking up with a sore throat or dry mouth
  • Headaches
  • Depression, irritability, difficulty concentrating or mood swings
  • Difficulty falling asleep
  • High blood pressure
  • Seizures
  • Enuresis (bed-wetting)

 

Because children who have cerebral palsy and certain neuromuscular conditions typically have abnormal muscle tone and might be unable to reposition themselves during sleep, they are more likely to develop sleep apnea than other children are. Children with craniofacial conditions (such as cleft lip and palate, craniosynostosis or Apert syndrome) have a greater risk of developing sleep apnea because their airways, jaws, and openings at the back of the throat are often small. Enlarged tonsils and adenoids (tissues in the back of the nasal cavity) can also cause sleep apnea. Sometimes surgery to remove the tonsils or adenoids helps to open the airway.

Insomnia

Insomnia might involve difficulty in getting to sleep, trouble staying asleep or both. Some children have conditioned insomnia—they may, for example, need a parent to help them fall asleep. Our specialists might prescribe medicines that induce sleep. We also work with families to change behaviors so children learn to sleep without their parents’ help.

The most common symptoms of insomnia include:

  • Daytime sleepiness
  • Irritability, mood swings or depression
  • Hyperactivity
  • Frequent accidents or injuries
  • Poor attention span or poor memory

Insomnia is often caused by:

  • Stress or anxiety
  • Depression
  • Medications or other stimulants
  • Medical conditions or disorders
  • Changes in environment or schedule
  • Chronic pain

Hypersomnolence

Hypersomnolence occurs when a person sleeps too much or is sleepy much of the time. It is common in children and teens who have traumatic brain injuries or developmental disorders. Stimulant medication can help people with hypersomnolence stay awake.

Symptoms of hypersomnolence usually include:

  • Difficulty waking
  • Disorientation after waking
  • Daytime sleepiness
  • Increased irritation and anxiety
  • Decreased energy, slow thinking and slow speech
  • Loss of appetite
  • Restlessness
  • Poor memory

Common causes of hypersomnolence are:

  • Depression
  • Medications
  • Low thyroid function (hypothyroidism)
  • Traumatic brain injury
  • Other medical conditions or disorders

Circadian Rhythm Disorders

Circadian rhythm disorders cause people to sleep at times when other people are awake (sleeping days instead of nights, for example). Light therapy, medications or a combination of both can reprogram the biological clock, helping a patient create new sleeping and waking schedules.

Typical symptoms of circadian rhythm disorders include:

  • Daytime sleepiness
  • Difficulty waking

Circadian rhythm disorders are often caused by:

  • Changes in routine
  • Changes in time zones
  • Medications

Restless Leg Syndrome

Restless leg syndrome (RLS) is a movement disorder. It often causes an irresistible urge to move the legs and unpleasant feelings when the legs when at rest. The urge usually arises at bedtime, but it also can occur when the legs have been inactive (such as after sitting still for a long period of time).

Typical symptoms of restless leg syndrome include:

  • Difficulty falling asleep or staying asleep
  • Crawling, burning or tingling feeling in the legs
  • Daytime exhaustion, fatigue or sleepiness
  • Difficulty concentrating

Night Terrors

Night terrors usually occur about 90 minutes after a child falls asleep. They include repeated episodes of intense crying, screaming and fright during sleep. Children experiencing night terrors are difficult to wake. Once they awaken, they might not respond when caregivers attempt to provide comfort. Night terrors are not as common as nightmares, and children rarely remember the episodes in the morning. We provide families with education and safety tips concerning night terrors once we rule out other possibilities, such as seizures.

Some common symptoms of night terrors include:

  • Abrupt disturbances during sleep
  • Sweating and increased heart rate
  • Screaming
  • Difficulty waking
  • Confusion after waking
  • Inability to remember dreams or nightmares

The cause of night terrors is unknown, but they might be triggered by:

  • Fever
  • Lack of sleep
  • Periods of emotional tension, stress or conflict

Parasomnias

Parasomnias are a group of sleep disorders in which unusual or abnormal behavior occurs while a person is falling asleep or during sleep. Many are common in children, but children typically outgrow them by the time they reach adulthood.

Parasomnias include the following behaviors:

  • Talking or screaming
  • Confusion after waking
  • Hallucinations
  • Sleepwalking
  • Sleep-related eating
  • Teeth grinding (bruxism)

People often don’t remember these things when they awake.

Many of the symptoms related to parasomnias are mild, but sometimes they become bothersome enough to require medical attention. Because unusual movements and vocal sounds may actually be nighttime seizures, we might refer patients with such symptoms to a Gillette neurologist for testing.

Parasomnias might be related to:

  • Stress
  • Medications
  • Other disorders and medical conditions

Incidence and Risk Factors

Up to 30 percent of children and teens may have sleep disorders at some point. For children and teens who have disabilities and complex medical conditions, however, the rate might be even higher. For example, studies indicate that up to 50 percent of children who have cerebral palsy also have a diagnosable sleep disorder, and half of all children who have craniofacial conditions also have obstructive sleep apnea. In addition, children who are overweight are at an increased risk of obstructive sleep apnea because fat deposits around the throat and neck sometimes narrow the airway.


Tests and Treatments

Gillette is a leader in treating sleep disorders in children, teens and adults. Our specialists use the latest techniques and technology to diagnose and care for patients with a wide variety of conditions.

Some of the tests and treatments for sleep disorders that we offer include:

  • Sleep consultation
  • Sleep study (polysomnography)
  • Actigraphy—a test used to determine sleep patterns and circadian rhythms
  • Continuous positive air pressure (CPAP) mask—a mask over the nose releases a puff of air into the throat, relieving obstructions so the airway won’t collapse
  • Evaluations (in collaboration with Neurology) for epilepsy and seizures
  • Medical management of sleep disorders
  • Multiple sleep latency test

For more information about the tests and treatments we offer at Gillette, search Conditions and Care.


Services

Patients who have sleep disorders and disturbances often have many needs in addition to sleep health services. That’s why Gillette brings together the specialties our patients need—in a way that’s both comprehensive and convenient.

As part of Gillette’s Center for Pediatric Neurosciences, our sleep health specialists often collaborate with providers in the following areas:

For more information about the services we offer at Gillette, search Conditions and Care.

Why Gillette?

Because all children deserve a lifetime of amazing health care.

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