Conditions we Treat
- noisy breathing
- sleeping with open mouth
- obstructive sleep apnea (difficulty breathing while asleep, blockage of airflow)
- resisting bedtime
- problems getting to sleep
- frequent nighttime waking
- irregular sleep patterns
- trouble with naps
Sleep schedule abnormalities
- difficulty falling asleep or waking at the desired time
- reversal of sleep-wake timings (long naps, short nighttime sleep)
- shifts in sleep rhythms
- difficulty falling asleep or waking at the desired hour
- remaining awake for long hours at night and sleeping until late hours in the morning/afternoon on weekends.
- feeling sleepy during the daytime, taking frequent naps and dozing off in class
- insufficient sleep or inconsistent sleep schedule
Excessive daytime sleepiness
- overt daytime sleepiness
- difficulty focusing or learning
- poor memory
- narcolepsy and other medical disorders
- sleeping too long (12-14 hours)
Parasomnias and nocturnal events
- confusion arousals and sleep terrors (incomplete waking, crying or screaming, thrashing, looking upset or frightened)
- sleepwalking and sleep talking (while only partly awake)
- teeth grinding (bruxism)
- bedwetting (nocturnal enuresis)
- periodic limb movements in sleep (leg or arm jerks every 20 to 60 seconds while asleep)
Restless leg syndrome (RLS)
- restlessness/unpleasant feelings in legs during the evening or at bedtime
- relieved by activity
- worsened with resting
- family history of parents or other relatives having similar symptoms
If your child is suffering from any of these sleep problems, speak with your primary care physician. You may also want to consider contacting us for an appointment.
Treating and managing sleep disorders
In most situations, we can help you normalize your child’s sleep by using behavioral interventions. We will work with you and your child and suggest strategies to normalize her sleep—for example, by helping you teach your child more appropriate sleep-related habits, correcting problematic sleep schedules and adjusting nighttime feeding schedules.
If your child has certain sleep-related medical disorders, we may prescribe medications that promote sleep and wakefulness. We may suggest adjustments in other medications your child is taking, as well.
In obstructive sleep apnea, your child’s breathing is partially blocked during sleep. The most frequent cause in children is enlargement of the adenoids and tonsils, and we may seek the opinion of one of our surgical colleagues in Otolaryngology (ear, nose, and throat) for possible removal of the enlarged tissue (adenotonsillectomy). Because deposits of fat in the airway are a common cause of breathing troubles in obese children, weight loss may be an important part of treatment; we may refer your child to Boston Children’s Optimal Weight for Life (OWL) Program.
For obstructive sleep apnea we sometimes prescribe continuous positive airway pressure (CPAP), in which your child wears a mask at night. Air blows through the mask to keep his airway open while he sleeps.
In some cases, we may prescribe specific medications to manage excessive daytime sleepiness.
In special circumstances, we may refer your child to other physicians for help in managing sleep problems associated with other respiratory disorders or neuromuscular disease, developmental disorders, abnormalities in facial structure and seizures.