Identifying and Treating Pediatric Sleep Disorders

sleeping child

One-third of U.S. adults say they usually get less than the recommended amount of rest. But how do you know if your child is getting optimal sleep?

David Gozal, MD, a pediatric sleep specialist at University of Missouri Health Care, says parents should pay special attention to their children’s sleep habits. In this Q&A, he describes symptoms that could indicate a sleep disorder and explains how chronic insufficient sleep could result in long-term consequences.

What are some common warning signs of a pediatric sleep disorder?

One common symptom of a sleep disorder is when a child is very sleepy and difficult to arouse in the morning. All children should be able to wake up on their own. They shouldn’t need to be dragged out of bed, kicking and screaming.

Other common signs of sleep issues include changes in mood, behaviors and a deterioration in school performance. If your child’s behavior and grades start going downhill — for example, being more impulsive, lacking attention or becoming disruptive in class — you might want to investigate whether poor quality or insufficient sleep is to blame.

Snoring, headaches, unexplained weight gain, frequent night terrors and bed-wetting are also areas that should worry you as a parent.

You have conducted extensive research into the effects of a lack of sleep on children. Describe some of your findings.

I've been researching sleep for more than 35 years, and it's been a fascinating adventure.

Our brains and all the cells of our bodies are dependent on sleep. Sleep allows us to recover and function well when we are awake. If sleep was not an essential life-sustaining function, the fact that we need to do it every night would really be a very expensive evolutionary mistake, because why waste so much time sleeping if it is not really important?

Poor sleep can produce two major effects in children. One is on a child’s brain, which obviously is very important. We want our children to not only be the most intelligent that they can be, but also the most accomplished in their schooling and in their futures.

The second effect is on a child’s overall health. Children who do not sleep enough are at risk of developing cardiovascular consequences, behavioral consequences and also metabolic consequences, such as obesity and diabetes. They are also at risk of having more serious infections and not responding properly to immunizations. Many of these resulting health issues may not become apparent until the child is much older, so it’s important to address the sleep debt we accumulate when we are young.

Can you catch up on sleep if you don’t get enough?

It’s tricky, because itʼs a matter of mathematics. If you donʼt sleep enough — for example, two hours less than what you should every night — at the end of the school week, you will have accumulated 10 hours of debt. When you catch up, even if you sleep two extra hours per weekend day, you will only have recovered four hours. Now you owe yourself six hours.

If you do this every week, the amount of sleep that you owe yourself is virtually impossible to fix. 

In the end, your credit report for sleep will be destroyed, and essentially, you go bankrupt on your health.

If parents have concerns, where should they start?

Normally, we recommend approaching your primary care physician to seek a referral to a pediatric sleep specialist. Then we can really evaluate the child in a much more thorough fashion using our laboratory and programs.

At your first appointment, we take an extensive medical history of your child and have an in-depth conversation about your child’s personality, behavior and sleep habits. We want to understand not just what is happening during the night but also what happens during the day.  

We would also perform a physical examination of your child, and — depending on his or her symptoms — we might order a few blood tests. We also might ask you to bring your child in for an overnight sleep study. During that study, we would monitor him or her throughout the night to identify abnormalities that help us form a specific diagnosis. Once we pinpoint the diagnosis, we can explore a tailored treatment plan based upon your child’s specific needs.

MU Health Care’s pediatric sleep medicine program is one of the leading programs in the world. We have a group of very experienced sleep physicians and sleep researchers that work together to innovate and foster new developments in the field. We train a large number of extraordinary new physicians that will go and disseminate that knowledge elsewhere, so our impact is really felt all over the world.

We are very proud of all these accomplishments and the fact that we've been innovators for many, many years now. It's a privilege to work with children in Missouri while also helping the rest of the world understand the vast importance of sleep.

To schedule an appointment with Dr. Gozal, please call 573-882-6921