Does this sound familiar? The doctor has told you he doesn’t need to eat at night anymore.
You’ve been working through the Sleep Shuffle.
You’ve avoided all the typical sleep coaching mistakes.
And yet he STILL is waking up multiple times at night.
You feel hopeless.
Is that Heather?! Standing at the bottom of the Exhaustion Abyss with a glimmering shimmer of Hope’s Candlelight?
Yes, my friend. It’s your candle in the wind.
Elton John, Dr. Lewis Kaas, and I are holding it for you.
According to Dr. Kaas, there is an emerging awareness that childhood and baby sleep apnea has been grossly under-diagnosed.
Researchers are discovering that Obstructive Sleep Apnea (OSA) in children is a whole lot more common than doctors ever thought before.
This study says it’s as high as 10% of all children. (That’s 1% higher than the number of kids with asthma.)
Sleep apnea is simple to understand.
The body values air over sleep.
(It’s smart like that.)
In OSA, something (usually tonsils or adenoids) is partly blocking the airways of the nose and throat.
This means that your child is having a hard time breathing properly through the nose while sleeping.
So the body, realizing this current position isn’t air-friendly, wakes up, finds a new body position, and then tries to sleep again.
It’s a vicious cycle.
How can you tell whether your baby is caught in one of these sleep apnea cycles?
Let’s go over the symptoms.
As a reminder, I’m not a doctor. I don’t diagnose or prescribe. This article is meant to give you information that you can go back and share with your doctor. Don’t forget! When in doubt, give Doc a shout!
A child doesn’t have to have ALL these symptoms to have OSA. (For example, he may not snore.)
But these are the ones your doctor will need to know about in order to request further testing.
Childhood sleep apnea is most common in 2 – 6 years old, but Dr. Kaas has diagnosed it as young as 3 months.
“Pink Flag” Signs to Talk Over with the Doc
There are a few medical conditions that sometimes like to “pair up” with sleep apnea in kids.
If your baby or child has any of these, and also some of the symptoms above, you should give your pediatrician, an ENT, or a pediatric sleep specialist a call.
I named them “pink flags” because they’re not a slam dunk for OSA. They’re more like up a layup assisting the slam dunk.
- Asthma that isn’t being well-controlled
- Recurrent ear infections – large adenoids can prevent the ear canal from draining properly, leading to infections
- Recurrent tonsillitis
- Acid Reflux – the reflux can inflame the tonsils and adenoids and make them swell
- Chronic illness – “my kids is always sick!”
- Failure to Thrive – we secrete growth hormones when we sleep. No sleep = fewer growth hormones
Treating Baby Sleep Apnea
Once you’ve shared your concerns with your pediatrician and he’s asked about these symptoms, he’ll need to look at your child’s tonsils and adenoids.
Tonsils are a piece of cake. Open wide….there they are.
Adenoids, though. Those are a bit tougher.
To get a good shot of those, he’s going to either need to do an X-ray, or use a special telescope to look down the nose.
The only way to make SURE there’s sleep apnea affecting your child’s sleep is to conduct a sleep study at a Pediatric Sleep Center.
BTW, there is a huge difference between Pediatric (for kids) Sleep Center and an Adult Sleep Center. The process is very different for kids, and the results have to be interpreted developmentally, in different ways. So always choose a Pediatric Sleep Center for your child’s assessment.
You go in around 7pm, and get all cozy. They cover your baby with harmless little stickers, you go through your routine, and everyone goes to sleep.
No needles. No tubes. Just some harmless stickers.
The next morning you go home, and in a few days the Pediatrician calls you with the results.
Once baby sleep apnea is diagnosed, the treatment is to remove the tonsils and adenoids that are obstructing the breathing.
Waiting for a diagnosis? Dr. Kaas recommends getting an air purifier for the nursery. It will remove any air allergens that can cause swelling in the tonsils and adenoids and make the apnea worse.
If your health insurance refuses to cover a sleep study, or if you’re struggling getting a doctor’s referral, Dr. Kaas recommends going straight to an ENT to discuss getting the tonsils and adenoids removed without the sleep study diagnosis.
Treating Sleep Apnea Helps, but Doesn’t Cure Sleeping Problems
My Elena was a mouth-breathing, snoring, restless sleeper.
Knowing what I know now, I’m glad we got her tonsils and adenoids removed.
She was five at the time. After the surgery, I noticed she seemed to be more rested in the morning, and much of the “Fuss Fits” we were struggling with started to go away. (It’s hard to have self-control when you’re so tired all the time!)
If she hadn’t already had a good foundation of sleeping habits already, I’m not sure I would have noticed such a huge difference in her sleeping afterwards.
If your child doesn’t know how to put himself back to sleep on his own, you may not notice a big change after the apnea is taken care of.
Because sleeping is like hopscotch.
We jump around in the different stages of sleep (cycle? whatever! It’s chaos!), and everytime our brain decides to go to another stage of sleep (whether that’s forwards toward REM dream sleep, or backwards towards a lighter true sleep), we partially wake up.
We roll over.
Or we steal the blanket from our spouse.
Or we pick up the pillow that fell to the ground and go the bathroom.
Then we climb back into bed and fall asleep.
“Falling to sleep” is a brain skill that we’ve learned.
If your baby relies on you to help him fall asleep, then he will continue to need you to help him fall asleep even after the surgery. Through each partial awakening period.
The good news is there is no sleeping crutch that cannot be re-wired.
We can gently start to help our babies and children get the good brain-rest they need to release the growth hormones their body is waiting for.
If you’re struggling with this process of sleep coaching, I’d love to help.
And if you really get stuck, and just need someone to help you figure out what to do next, drop me an email at email@example.com. I’d love to work with you one-on-one.
See? There’s hope!
Where did I get all this information?
In the process of my Sleep Coaching Certification studies, I took a class on medical sleep disturbances by Dr. Lewis Kass, MD, FAAP, Board Certified Pediatric Pulmonologist & Sleep Medicine Specialists. These are from the notes he presented in class.