Pediatric Sleep Medicine

Ang Li, M.D.

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Sleep is essential for physical health and emotional wellbeing. Everyone experiences occasional sleeping problems, but if your child experiences problems sleeping repeatedly, it could indicate an underlying health problem. Sleep disorders are problems associated with sleeping, including difficulty falling or staying asleep through the night, feeling sleepy during the day, or waking up feeling exhausted. Because of lack of sleep you may find it difficult to concentrate and perform activities of daily living. This lack of sleep can lead to depression, mood swings, or other health problems.

According to the International Classification of Sleep Disorders (third edition), there are over 80 different recognized sleep disorders. They are divided into the following 6 categories. Our pediatric sleep medicine providers treat many of the conditions that can be found in each of the categories:

 

Hypersomnolence

Like narcolepsy, hypersomnolence (also known as idiopathic hypersomnia) is a condition characterized by excessive sleepiness. Patients experience difficulty in waking (either in the morning or at the end of nap periods during the day). Idiopathic simply means 'of unknown cause'. Typically, the diagnosis is made after demonstrating excessive sleepiness on a daytime nap study called an MSLT. Unlike narcolepsy, idiopathic hypersomnia does not have rapid occurrence of dream sleep during daytime napping.

Narcolepsy

Narcolepsy is a sleep disorder that causes excessive daytime drowsiness and sudden onset of sleep.

Idiopathic Hypersomnia

Idiopathic hypersomnia is an uncommon disorder causing excessive sleepiness during the day even after a good night's sleep. The need to sleep can arise at inconvenient times like when driving or working, making it potentially dangerous. Other more common disorders must be ruled out before idiopathic hypersomnia diagnosis.

 

Treatments

Sleep disorder treatment can be classified into two main categories: pharmacological treatment and non-pharmacological treatment.

Pharmacological treatment includes any prescription or non-prescription medications to help prevent the onset of the symptoms or treat the developed symptoms. Depending on the type of disorder, treatment could include sedatives (in case the condition is related to insomnia), or stimulants (in case the condition is related to narcolepsy or sleep apnea).

Non-pharmacological sleep treatment refers to those options that do not require the use of prescription or non-prescription drugs. These may include behavioral therapy, medical equipment, surgery, and other options. Surgery may be needed to correct the anatomic abnormalities of the upper airway which can lead to the onset of obstructive sleep apnea. Behavioral treatments for sleep problems may include relaxation training, cognitive therapy, stimulus control (SC), sleep restriction therapy (SRT), and sleep hygiene. Behavioral therapy can be used to treat people with insomnia, parasomnias, bedwetting, and other sleep problems. Another option is the use of different types of medical equipment such as “continuous positive airway pressure" (CPAP) and bilevel "” or BiPAP for the treatment of sleep apnea. CPAP is a device that prevents narrowing of the airway during inspiration and expiration by providing a persistent increased pressure. Another similar option is “bilevel" in which the face mask allows for two different alternating pressures: one with inhalation and one with exhalation. Other non-pharmacological treatment options for sleep disorders include mandibular advancement devices, nasal strips, positional therapy, and playing didgeridoo (a wind instrument) to strengthen the upper airway.

Lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of caffeine may also be helpful.

Dr. Li's Pediatric Sleep Medicine Practice Location

1400 S. Potomac St.
Suite #250
Aurora, CO 80012