This article originally appeared in Star Chronicle, a newsletter
published for the Children's Medical Center.
It is 8 pm and time for 13-year-old Brittany to go to bed. She brushes her
teeth, hops into bed and the lights go out. Unfortunately, her restless sleep
and snoring will prevent her from getting a good night's rest. Whether it is
sleep apnea, restless leg syndrome or snoring, sleep problems can have
significant consequences on the health and functioning of a child.
Children's Medical Center pulmonary and neurology specialists are working
together to help children and their families resolve sleep problems so that kids
can lead healthier lives. "We see children as young as two years old who have
sleep issues - some behavioral and some medical in nature," says Ted Kremer, MD,
a pediatric pulmonologist who is one of just a few board-certified pediatric
sleep medicine specialists in New England. "Diagnosing the problem and coming up
with solutions or treatments to help the child is our main goal."
Dr. Kremer is joined by Seema Adhami, MD, pediatric neurologist, in the UMass
Memorial Sleep Disorders Center. "Not all sleep issues are problems, but when
they start to interfere with daily living, the child should see a specialist,"
notes Dr. Adhami.
Sleep disorders can cause a variety of problems during childhood. For
example, growth and development are impacted by our sleep. Learning proves to be
more difficult as memories are stored while sleeping. In addition, children and
teens become unmotivated to learn or participate in activities when they are
tired. Younger kids can also become irritable and fussy.
"Infant sleep problems may be medically based or behavioral," says Dr.
Kremer. "Sleeping with parents, not learning to fall asleep independently and
lack of a bedtime routine can have a negative impact on sleep patterns." The
center's goal is to address each problem and change the issue causing it.
Sleep apnea can occur in children of any age. Frequent awakenings, fragmented
sleep, snoring, gasping arousals and breathing that stops for brief periods are
symptoms associated with this disorder. After a sleep study is performed,
treatment is determined based on the diagnosis.
"If sleep apnea is present, removal of tonsils and adenoids is considered for
some patients. Sometimes medications are prescribed to treat allergies that may
be causing nasal congestion and snoring. Continuous positive airway pressure is
occasionally needed for some children and adolescents," adds Dr. Kremer.
When poor sleep hygiene occurs in adolescents, grades and performance suffer.
"Getting nine hours of sleep is ideal due to the changes the body is going
through, however, this age group often only gets about seven hours since sleep
ends up being low on the priority list," notes Dr. Kremer.
Delayed sleep phase syndrome, a condition when the timing of the circadian
rhythm is off, is commonly seen in the adolescent population and can also be
evaluated and treated.
"When problems arise, patients can rely on expert care at our Sleep Disorders
Center," comments Dr. Adhami. "With both neurology and pulmonology staff
offering a multidisciplinary approach to sleep medicine, we are able to consult
on diagnoses and effective treatment plans that best suit our patients'
During an overnight study, electrodes monitor arousals, as well as muscle,
eye and temporal movements, while technicians check airflow and respirations and
track heart rhythms and oxygen levels. Once completed, the child is awakened and
The study is scored and the doctor then interprets the results. "The results
are compared with the patient's symptoms and a diagnosis is made," says Dr.
Kremer. "Then we can choose a treatment plan accordingly."
The center sees infants, children and adolescents in a family-centered,
comfortable environment. Since sleep problems are so common, trained specialists
at the Children's Medical Center are available to help families manage all types
of sleep disorders.