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Areas of Care

DREAMS (Disorders Relating to the Airway and Mouth in Sleep) Clinic

About us

The DREAMS Clinic is a specialized clinic for the assessment and treatment of children and adolescents with complex sleep-disordered breathing. The experienced team includes respirologists/sleep physicians, otolaryngologists (head and neck surgeons), neurosurgeons, plastic surgeons, paediatric orthodontists, neuroradiologists, MRI technicians, anesthesiologists, a nurse practitioner and a respiratory therapist. We provide a multidisciplinary approach to managing complex obstructive sleep apnea, which may include surgical and non-surgical options.

Contact us

If you cannot come to your scheduled clinic appointment or have a question about your appointment, please call the sleep coordinator at 416-813-6338. We will try our best to schedule another appointment as soon as possible, based on availability.

Clinic/registration location

The DREAMS Clinic is located in Room 6109, on the 6th floor of the Burton Wing.

When you register, a SickKids identification (ID) band will be placed on your child. The band must be worn on your child's arm or ankle at all times. Check your child's ID band to make sure the information is correct. If your child is not wearing a band or has the wrong one, it can lead to errors that can result in the wrong care for your child. Staff must always check the band before providing care to your child. Your child must keep the band on at all times while at SickKids.

If you or your child are sick before your appointment

Call the clinic if you or your child have had a cold, cough, diarrhea, fever or rash within two days of your appointment, or have been sick with or exposed to chicken pox in the last three weeks. Your appointment may need to be rescheduled. 

Tell the clerk, nurse or doctor if your child has been in a hospital outside of Canada within the last 12 months. 

If you cannot come to your child’s appointment, it is important that you call the clinic as soon as possible to cancel and reschedule.

Be on time

Please arrive at the clinic 15 minutes before your scheduled appointment time.

If you are late, you may have to wait for other patients to be seen first. Allow lots of time to get to the hospital. It can take some time to get used to finding your way around and it is important to be on time for your child’s appointment. Staff will try to see your child as close to your appointment time as possible. Please understand that some patients being seen ahead of you may need more time than expected, and this can cause delay for others.

Bring the following

  • You must show valid health-care coverage at every visit. If you do not, you will be required to pay a fee for the visit, unless coverage or insurance can be verified.

Proof of health-care coverage must be valid at the time of visit (not expired).

    • If you live in Ontario, show your child’s valid Ontario Health Insurance Plan (OHIP) card.
    • If you live in another province, show your child’s provincial health-care card.
    • If you are a refugee claimant, show your child’s Interim Federal Health Program (IFHP) certificate.
    • If you have private health insurance, show the appropriate information or documentation.
    • If you are receiving support from a Community Health Centre (CHC), show a letter from the CHC.
  • Your appointment card or letter
  • Toys, books, nut-free snacks, diapers and formula to keep your child comfortable and occupied in case there is a wait
  • Any medical information, such as referral letters, test results, information about current therapies, X-rays, MRIs, ultrasounds or CT scans
  • All medications your child is currently taking (in original packaging), including alternative and complementary treatments
  • If your child is on a BiPAP or CPAP machine, it is important that you bring the machine and mask to the appointment. We may want to download the information stored on the machine.

Try not to bring other children to the appointment

If other children must come, please consider taking them to the Play Park during your visit. The Play Park is a free, fun and safe place for brothers and sisters of patients to play. It is open Monday to Friday from 8:30 a.m. to 4 p.m. and weekends from 11:30 a.m. to 3:15 p.m. It is located on the Main Floor of the Atrium, next to the parking elevators. All children over 2 ½ years of age are welcome. Trained staff and volunteers will watch your children carefully. You do not need to book in advance to use the Play Park. The Play Park number is 416-813-8884.

Latex allergy

Call the clinic before coming to the hospital if your child or anyone coming with them has a known or suspected allergy to latex.

Accessibility

All visitor entrances on the Main Floor are wheelchair accessible. SickKids has several wheelchair-accessible washrooms on the Main Floor. Both male and female washrooms in the Atrium have large change tables where children and teens can have diapers changed. There is another private wheelchair-accessible washroom with a large change table on the Service Floor of the Black Wing in Room S213, across the hall from Rehabilitation Services. Wheelchairs are available near the Atrium and University Avenue entrances.

Assistance dogs for children or parents with disabilities are allowed at SickKids. Please make sure they are clean and have up-to-date immunizations.

Interpreter Services

If you need an interpreter, please call the clinic before your appointment so we can arrange for an interpreter. There is no charge for an interpreter. Please give us at least 24 to 48 hours' notice to make it easier for us to find an interpreter for you.

What to expect during your visit

You will meet with members of the DREAMS Clinic team during your appointment. The core team includes an otolaryngologist, a respirologist/sleep physician and a nurse practitioner. If required, you may also meet with a respiratory therapist and/or an Otolaryngology Clinic nurse. Depending on your child’s specific condition, there may be other members of the team present.

The initial appointment in the DREAMS Clinic will involve a review of the patient’s medical history, which may include sleep history, past surgical interventions and previous and/or current treatments for obstructive sleep apnea.  The otolaryngologist will complete a thorough examination of your child’s ears, nose, mouth and throat.  In most cases, we will then bring you to another room where the otolaryngologist will perform a nasal endoscopy. This involves placing a very small flexible camera down your child’s nose to look at the back of the throat and voice box.  This allows the DREAMS Clinic team to see parts of the upper airway that would otherwise not be visible and provides us with valuable information which helps the team decide about appropriate treatment options for obstructive sleep apnea. During the nasal endoscopy, the patient is awake and the parent is present throughout the whole procedure. A member of the DREAMS Clinic team may help hold the patient during the nasal endoscopy. The nasal endoscopy may feel uncomfortable during the procedure itself, but the discomfort will resolve once the scope is removed. If the patient is tolerating the nasal endoscopy, the otolaryngologist may ask the patient to lie down during the nasal endoscopy. Once the nasal endoscopy is complete, the DREAMS Clinic team will review the findings of the nasal endoscopy with the patient and parents and discuss recommended management options, which may include introduction of medications, imaging such as an MRI or a Sleep MRI, positive airway pressure therapy (CPAP/BiPAP) and/or surgical interventions.

You will have lots of time to ask questions and give feedback on your child’s management plan. At the end of the appointment, if surgical intervention is recommended, you will meet with the Otolaryngology Clinic nurse to complete pre-operative paperwork.

Because we want to give each patient as much time as they need to be thoroughly examined and to have all of their questions answered, please expect to be at the hospital for approximately 3 hours. Your child may be required to do extra testing, to see other members of the Sleep Disorders Team and/or you may be waiting for your appointment due to circumstances beyond our control.

More information:

Department of Otolaryngology - Head and Neck Surgery