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About Sickkids
About SickKids

March 29, 2011

SickKids expert offers wake-up call on childhood sleep disorders

TORONTO – They are often difficult to detect, may cause behavioural issues or affect a child’s performance in school, and if left untreated, could even cause long-term cardiovascular and metabolic problems. While it is sometimes the last thing a parent or doctor would expect, a sleep disorder could be at the root of all of these issues.

“Good sleep is important in children as it may affect their development and well-being,” says Dr. Indra Narang, Director of Sleep Medicine at The Hospital for Sick Children (SickKids), which has the only specialized paediatric sleep program in the GTA. “Sleep disorders can go undiagnosed for years and could have long-term consequences for both the child and family. Early recognition is important because treatment options are available.”
Childhood sleep respiratory disorders, which encompass problems such as sleep apnea, involve difficulty breathing at night and occur in about two to four per cent of children in North America and Europe. Sleep apnea involves snoring and pauses where the patient stops breathing intermittently while sleeping, which may be caused by a blocked airway due to large tonsils or adenoids. While they can sometimes affect otherwise healthy children, about 70 per cent of cases of sleep apnea occur in children with pre-existing medical conditions like Down syndrome and obesity. Sleep apnea in healthy children is sometimes the most difficult to diagnose because symptoms like snoring usually appear unimportant and as a result, are not typically identified as health concerns.

Another disorder is nocturnal hypoventilation in neuromuscular and genetic diseases, which occurs when the brain does not send enough nerve impulses to the breathing muscles and causes an inadequate amount of breathing. Over time, respiratory failure and sleep-related behavioural problems can occur in these children. Non-respiratory disorders, which include insomnia and frequent waking up at night, may affect up to one third of children in North America and Europe.

Sleep disorders present differently in children than in adults, which is why consultation with a paediatric team is integral to accurate assessment and effective treatment, Narang explains. In addition to snoring and pauses in breathing adults may have symptoms which may include chest pain, waking up with shortness of breath, high blood pressure and depression.  

Children’s symptoms, on the other hand, are usually subtler. Children may simply present with hyperactivity, change in behaviour or falling behind in school, which can result in a child being misdiagnosed with other conditions.
The Paediatric Sleep Disorders Clinic 
at SickKids provides assessment and treatment to over 1,000 children every year. The multidisciplinary team is comprised of two sleep physicians, a nurse practitioner, a psychiatrist, a neurologist and a developmental paediatrician. Following initial examinations, the child undergoes a sleep study, in which an overnight observation occurs. Findings are then used to determine a treatment plan. Sleep apnea disorder symptoms in children can be treated through the surgical removal of tonsils and/or adenoids, medication and/or overnight ventilation.  

Since sleep disorders are very treatable, awareness and education amongst health-care providers is key, explains Narang, who is also a Staff Pulmonologist and Associate Scientist at SickKids, as well as Assistant Professor of Paediatrics at the University of Toronto. “If paediatric health-care providers can identify sleep disorders without delay, children may receive the care they need months, or even years, sooner, which may prevent the onset of long-term complications.”

About The Hospital for Sick Children
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally.  Its mission is to provide the best in complex and specialized child and family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision for Healthier Children. A Better World. For more information, please visit www.sickkids.ca. Follow us on Twitter (@SickKidsNews) and Instagram (@SickKidsToronto).

For more information, please contact:

Suzanne Gold
The Hospital for Sick Children
Phone: 416-813-7654 ext. 2059
email: suzanne.gold@sickkids.ca

Matet Nebres
The Hospital for Sick Children
Phone: 416-813-6380
email: matet.nebres@sickkids.ca