Does Your Child Get a Good Night Sleep?

December 8, 2007 | Leave a Comment

Does Your Child Sleep Well?

A surprisingly large number of children suffer from true sleep problems, which are more complicated than just the “bad habits” or frustrating schedules that many families complain about. In the young toddler and school age child, these sleep disturbances can lead to a myriad of school-related problems, and many children who get labeled with behavior disorders or learning differences may simply need a better night sleep. Sleep problems can range from bad dreams, to night terrors, sleepwalking and breathing problems. Please consult your child’s doctor if you are concerned that your child is not sleeping well.

Sleep is much more work than we realize and occurs in stages throughout the night. There are two major types of sleep states, known as REM and NON-REM sleep. REM stands for rapid eye movement and REM sleep occurs approximately every 90 minutes in the course of our sleep time and is the period when we dream. Non-REM sleep is broken down into stages 1 through 4, with stages 3 and 4 often referred to as “deep sleep.” It is the non-REM sleep that provides the rest and restoration, when hormones are released which help the body recharge itself.

Different sleep disorders may occur during different stages of sleep. For example, sleepwalking and night terrors, common problems in children, usually occur in non-REM sleep.

Night Terrors

A night terror is very different from a nightmare. Nightmares occur during REM sleep and the child wakes up frightened by a vivid image. Night terrors, in contrast, occur during non-REM sleep, usually stage 3 or 4, and may last up to an hour. Most importantly, the child remains asleep although her eyes may be open and when she does wake up, she will feel scared but not remember why. Unfortunately for parents, about 2 to 3% of all children will experience episodes of night terrors, usually in toddlers. Fortunately most of these children outgrow them, and they are rarely dangerous.

Sometimes night terrors run in families but exhaustion and sleep deprivation can exacerbate the problem. Talk to your Doctor who may suggest alternative schedules for your child’s sleep or even waking your child up briefly just prior to when the night terror usually occurs. Most doctors recommend that parents gently supervise the child during a night terror to prevent her from moving about the house but that the child should be essentially left undisturbed.

Obstructive Sleep Apnea (OSA)

A common breathing problem during sleep is called obstructive sleep apnea, which occurs in approximately 2 percent of all children, especially in preschool-age children. These toddlers are loud snorers, with restless sleep. They usually breathe through their mouths and often appear to stop breathing momentarily. Usually they are hard to wake up in the morning because they really didn’t sleep effectively. Occasionally they wet the bed and are treated for that condition instead of the underlying sleep disturbance.

Diagnosis is based in part on a high index of suspicion. If your child sleeps restlessly, thrashing about, snoring, and appears exhausted in the morning, ask your doctor about OSA. If your child is overweight, has big tonsils or a nasally voice that reflects large adenoids, she may be at risk. Often times the problem resolves if the child loses weight, but some children require that the tonsils and adenoids be removed. Ask your doctor what steps can be taken to evaluate the problem further.

Posted by Dr. Natalie Geary MD | Filed Under Dr Geary 

Another Reason Not to Smoke

December 8, 2007 | Leave a Comment

In the August issue of PEDIATRICS, Drs. Linnet et al. investigated the association between women who smoked during their pregnancy, and their children developing ADHD. The study was conducted using a large population based on Danish longitudinal registers done by researchers from hospitals in Aarhus and Copenhagen, Denmark.

Using records of all children born between 1991 and 1994, 170 children diagnosed with ADHD or hyperactivity were compared to 3,765 kids of the same age and gender who didn’t have ADHD. The mothers of the children in the study reported whether they were non-smokers or had smoked during that pregnancy.

Mothers who had smoked during pregnancy had a three-fold increased risk for giving birth to a child with ADHD or hyperactivity, compared with nonsmokers. The researchers found that smoking during pregnancy increased the risk of ADHD even when they took into consideration other newborn problems, perinatal problems, socioeconomic factors and family history of mental health problems.

What the results mean: This study may reflect a true biological effect of cigarette smoke on the developing fetal brain. The study did consider whether smokers have different personality traits or may themselves have ADHD, such that the child is both genetically more susceptible and is parented differently. However, their research suggests that, even taking other variables into account, exposure in utero to cigarette smoke is a risk factor for ADHD.

Lesson learned: another reason to quit smoking or better yet never start. If you do smoke, please contact your doctor and learn about ways to quit.

Karen Markussen Linnet, MD, PhD; Kirsten Wisborg, MD, DMSc; Carsten Obel, MD, PHD; Niels Jorgen Secher, MD; Per Hove Thomsen, MD, DMSc; Esben Agerbo, MSc; Tine Brink Henriksen, MD, PhD; Pediatrics, August 2005

Posted by natalie | Filed Under Dr Geary 

A Reminder About Skin Cancer

December 8, 2007 | Leave a Comment

SKIN CANCER IN CHILDREN IS ON THE RISE: According to the National Cancer Institute, melanomas are extremely rare in patients under 20, yet the rate is rising. Some dermatologists doubt that the rise is due to increased sun exposure alone. Be careful what you put on your child’s skin. A child’s skin is not only more sensitive, it is more absorptive and therefore more vulnerable. Read the labels carefully. Remember that Methyl Parabens used as preservatives are just one of several chemicals found to be ubiquitous in products claiming to be all natural. Other potent chemicals include steroids such as hydrocortisone and fragrances which are chemical derivatives, not natural scents. See “news” at www.vedababy.com for further information.

Posted by natalie | Filed Under Dr Geary 

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