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Pediatric Sleep Medicine

Sleep has very important effects on growth, healing, immune function, cardiopulmonary function and metabolic activities. Sleep in humans is a biologic function as important as breathing. Restricted sleep in adults may manifest as excessive daytime sleepiness; however, in children it often takes the form of mood and behavioral disturbances such as hyperactive behavior, poor impulse control, irritability, grouchiness, inattention, impaired memory and ability to reason, which results in significant social and learning problems. The effects of sleep and loss of sleep impact everyone significantly, particularly children. The latest guidelines from the American Academy of Sleep Medicine (AASM), endorsed by the American Academy of Pediatrics (AAP), recommend the following minimum and maximum hours of sleep per day for each age for optimal health:

  • Ages 4-12 months:12-16 hours (including naps)
  • Ages 1-2 years 11-14 hours (including naps)
  • Ages 3-5 years:10-13 hours (including naps)
  • Age 6-12 years9-12 hours
  • Age 13-18 years:8-10 hours

Keep in mind that sleep requirements can vary by individual. When comparing two children of the same age with the same bedtimes, one child may feel rested upon waking, while the other child may require more sleep in order to perform well in school and avoid the adverse effects of sleep deprivation such as behavior problems and daytime sleepiness.

Similarly, the effects of inadequate sleep in children can vary by individual and manifest in different ways, as no two children are the same.

Here are some statements about your child’s sleep that signify adequate, normal sleep in children. With regard to your child’s sleep, if you agree with all of the following statements, it is a good sign that your child’s sleep is on track. If your child’s sleep demonstrates disagreement with one or more of the following statements, a sleep study may be necessary to rule out a sleep disorder as the cause.

  • Your child falls asleep within 15-20 minutes of lying down to sleep at bedtime.
  • Your child regularly sleeps a total of hours according with the recommended hours for their age in a 24-hour period.
  • While in bed, your child’s sleep is continuous.
  • Your child wakes up feeling refreshed after a night of sleep.
  • Your child feels alert, energetic and content during the waking hours.
  • Your child does not have any disturbing or out of the ordinary behavior during sleep such as mouth breathing, snoring, breathing pauses, restlessness, gasping or increased work of breathing.

What can I do to promote healthy sleep in my child?

You need to practice good sleep hygiene to promote healthy sleep in your child. Sleep hygiene are the habits and practices that are conducive to sleeping well on a regular basis. The following are good sleep hygiene practices that promote a restorative sleep:

  • Keep regular bedtimes, even on weekends, that allow your child to sleep the recommended hours of sleep for their age.
  • Promote the habit in your child to use the bedroom just to sleep. Avoid using the bedroom as a playroom. Avoid use of electronics in the bedroom.
  • Limit the use of electronic devices one hour prior to bedtime as blue light from screens suppresses melatonin release. Melatonin is the hormone secreted by the pineal gland in the brain in response to darkness at the end of the day. Melatonin promotes sleep at the beginning of the night. Light of any kind can suppress the normal secretion of melatonin; however, the blue light from electronic devices does so more powerfully. As a result, your child will have a hard time falling asleep at night when they are permitted to use electronic devices late at night.
  • Avoid food and drinks that contains caffeine and sugar in the afternoon and evenings such as soda and energy drinks. Caffeine is a stimulant that acts on the central nervous system and keeps your child awake. Sugar intake before bedtime can have a stimulating effect, leading to restlessness and reduced deep sleep during the night.
  • Limit your child’s activity and exercise close to bedtime, as exercise stimulates the central nervous system and keeps your child awake.
  • Keep the same routines every night prior to bedtime.
  • Keep electronics out of your child’s bedroom, including video games, televisions, computers and cell phones.
  • Keep the bedroom comfortable, cool and dark at night.
  • Encourage your child to sleep independently.
  • Avoid unnecessary excitement at bedtime, such as scary movies or stories that may cause emotional distress in your child. Taking the time to relax and wind-down after the events of the day encourages restful sleep.

What are the signs of sleep problems in my child?

Signs of sleep problems in children include:

  • Snoring, particularly if it is associated with gasping, restlessness, mouth breathing, breathing pauses during sleep and bed-wetting may indicate obstructive sleep apnea.
  • Excessive daytime sleepiness. Taking naps in school-age children.
  • Poor school performance
  • Hyperactive behavior and decreased attention span
  • Falling asleep in class
  • Behavioral problems
  • Depression, which can be associated with insomnia and/or irregular sleep
  • Awakenings during the night
  • Headaches

If you are suffering from a sleep disorder, ask to be referred to UT Health East Texas by your physician or call 903-531-8079 to begin the referral process.

Providers For Pediatric Sleep Medicine

Rodolfo Amaro Galvez, MD
Pulmonology (Lung Disease) - Pediatric, Sleep Medicine

Ketan Patel, MBBS, MD, FCCP
Pulmonology (Lung Disease), Critical Care Medicine, Sleep Medicine

Carla Wang-Kocik, MD
Pulmonology (Lung Disease), Critical Care Medicine, Sleep Medicine