Pediatric sleep problems are best treated by the multidisciplinary approach that is unique to our clinic.
In many cases, both medical and behavioral factors need to be addressed in order to treat the child's sleep problem. The Pediatric Sleep Program at Hasbro Children's Hospital is the only sleep program in Rhode Island that offers both behavioral sleep medicine and pediatric sleep medicine.
Services offered by the program include:
- Evaluation by both a physician who is a board-certified sleep specialist and a pediatric psychologist specializing in behavioral sleep medicine. The evaluation includes a physical examination and careful review of your child's medical and sleep history to determine whether physical problems and/or behavior might be causing the sleep disorder.
Diagnosis and treatment of the full range of pediatric sleep disorders, including:
Sleep apnea is a common problem in children that causes a child to suddenly wake up each time his or her breathing stops due to blocked airways. Deprived of the sleep they need, children with sleep apnea are often irritable, hyperactive and tired. Symptoms of sleep apnea may include snoring, mouth breathing, disrupted or restless sleep, excessive daytime sleepiness and cognitive or behavior problems. In children, a common treatment is removal of tonsils and adenoids, if they are enlarged. Another form of treatment is use of a continuous positive airway pressure (CPAP) machine, which gently blows air into the nose to keep the airway open during sleep.
Common parasomnias are nightmares, night terrors and sleepwalking:
Nightmares are vivid dreams that can cause feelings of fear, terror or anxiety that awaken the child and can be detrimental to getting sufficient sleep if they occur often.
Night terrors are similar to nightmares, but a child may seem active and terrified (crying, calling for parent, sweating) while still asleep. It can be difficult to fully awaken the child.
Sleepwalking occurs when a child seems to be awake and moving around but is actually asleep. Sleepwalking can be dangerous because the child is unaware of his or her surroundings and can fall or walk into objects.
Narcolepsy is a nervous system disorder. Common symptoms of narcolepsy include periods of extreme drowsiness several times throughout the day, sleep attacks (sudden brief naps), hallucinations, sleep paralysis and cataplexy (loss of muscle tone while awake).
Insomnia is the inability to sleep soundly throughout the night, whether the child has difficulty falling asleep or staying asleep, or is waking too early in the morning.
Cognitive-behavioral therapy for insomnia involves changing learned sleep-preventing associations, and has proven to be an effective treatment.
Behavioral Insomnia of Childhood
Behavioral insomnia of childhood refers to difficulty falling asleep without certain conditions present (such as parental presence at bedtime) or difficulty adhering to bedtime limits (such as staying in bed except for bathroom or emergency). Behavioral insomnia of childhood is most often treated by teaching parents different strategies for helping children go to sleep independently, managing bedtime behavior and responding to night awakenings.
Delayed Sleep-Phase Syndrome
Delayed Sleep-Phase Syndrome (DSPS) is a circadian rhythm disorder that becomes more common in adolescence. Your "body clock," which is based on a 24-hour cycle, is a common term for a person's circadian rhythm. Adolescents with DSPS generally fall asleep very late and have great difficulty waking up in the morning for school. Treatments for DSPS focus on resetting the body clock.