Kids Sleep Doctor: App That Improves Your Kid’s Sleep Better Than A Doctor

By Nida I Zamir on April 6, 2015

So parents are about to sigh with relief as a free app to improve children’s sleep has been launched by doctors at the Evelina Children’s Hospital in London. The app, Kids Sleep Doctor, gives parents custom advice, based on the sleeping patterns of their children, like night terrors or teens staying up all night long.

Paul Gringras, a professor of children’s sleep medicine at the hospital, said that the doctors only skim through a patient, seeing “only the tip of the iceberg” due to the “massive” waiting lists. That is why the hospital decided to develop an app which could focus on the patients more closely and give advice along the way as different problems would pop up during the life cycle of the children aged 0 – 16.

The app initially requires details about the children, like bedtimes, where the child falls asleep, how much screen time they have, and consumption of caffeinated drinks.

After five days of collecting the data on the child’s sleep habits, like night-waking and bedtimes, the actual tailored service of advice begins.

“Hopefully they are sleeping in the normal range, but if they’re outside that then it advises parents,” Prof Gringras said.

“Take a five-year-old who suddenly is waking up every night screaming, doesn’t recognize parents and pushes them away. The app would say it is like a night terror and will happen in 10% of children in this age range and they will grow out of it, but they can also try a technique called scheduled waking half an hour after they have gone to bed.”

For teenagers who are unable to sleep until really late into the night, the app would advise parents that the child needs exercise in the afternoon as it promotes healthy sleep.

“These are not annoying daily tips, it’s tailored advice,” he added.

Considering how the doctors are actually letting their waiting lists shorten for an app, it points at the hospital’s ethical responsibility which is to reduce pressure on the overburdened service, and does not focus on making a few extra dollars.

“I think there’s a lot of people it could prevent needing to see a GP. Parents can do a brilliant job,” added Prof Gringras.

However, the 200,000 children diagnosed with serious sleep disorders such as narcolepsy or obstructive sleep apnoea would still require proper doctor consultation.

Moreover, the app has a dark and orange palette to minimize the amount of blue light emission, which is the wavelength of light that disrupts sleep.

Psychologist and child therapist Professor Tanya Byron commented:

“Many children are affected by sleep problems which can have a major effect on the whole family. Getting a good night’s sleep is so important for a child’s physical and mental development, behaviour and concentration – to name but a few. We know parents know their children better than anyone, and I’m confident that the ‘Kids Sleep Dr’ app will help parents to understand and better manage their child’s sleep problems.”

Kids Sleep Doctor is currently available free on iOS. Android and Windows versions are in the pipeline.

Obesity In Children Linked to Lack of Sleep and Breathing Problems

March 7, 2015

A child’s difficulty to sleep and breathing problems can influence the risk of your child from getting obese. The recent research study published in The Journal of Pediatrics revealed that these two conditions may double the risk for obesity of a child as he reaches the age of 15. The lead researcher, Prof. Karen Bonuck, indicated that sleep and breathing problems are correctable conditions, but when not treated accordingly can increase the risk of the child to become obese.

Sleep disordered breathing

Sleep disordered breathing is considered to be a risk factor to child obesity. The condition includes sleep apnea and snoring. Parents of children in the study were asked to provide information involving their child’s sleep duration and sleep disordered breathing symptoms since birth until the child reaches the age of 6 years. Data on body mass index(BMI) were also obtained. The study showed that those with a higher BMI and with severe sleep disordered breathing symptoms are at the greatest risk of getting obese. Their chance to become obese as they reach the age of 7 to 15 years old is twice as much as those who are symptomatic with sleep disordered breathing condition. A study made in Hong Kong revealed that children with an excess weight tend to have a breathing problem because it causes the narrowing or congestion of the child’s airway while sleeping. Children with sleep disorders also tend to have enlarged tissues at the back of their throat, increasing their chance to getting obese later on.

Sleep duration symptoms

Children with a shorter sleep duration at the age of five or six have about 60 to 100 percent of getting obese upon reaching the age of 15. This finding, however, is interestingly not consistent among children of other age group. Short sleep duration in children refers to sleep that is less than 90% than the other children of their age. Parents are advised to help their children get enough sleep at an ideal duration, considering that about 25 to 50 percent of preschoolers suffer from lack of sufficient sleep.

In a research study published in Pediatrics that was conducted by the University of Chicago researchers, the sleeping patterns of about 308 children between the age of 4 and 10 were tracked down using a special wrist device. These children were categorized with normal, overweight and obese according to their respective body mass index. The study revealed that obese children in the group have variable sleep patterns and they tend to have short duration sleep as the other children. They were also identified to have the unhealthiest blood profile during blood extraction.

Additional findings of the researchers show that those children having the tendency to become obese are more protected when they get adequate sleep. Additional observation was added by Dr. Phyllis Zee, a sleep researcher, where he agreed there is a correlating link between sleep and obesity, but also signifies that the variability of sleep-wake timing in children can also be a contributing factor in regulating weight.

Other researches were also focusing on the resulting interrupted or disordered activity of the body’s metabolism and endocrine system caused by the lack of sleep. This is especially significant among children whose body are still growing. Another relation to sleep and obesity are the changes in the levels  of two hormones named leptin and gherlin, which are responsible for appetite and hunger regulation. The body often misinterprets sleep cravings as a hunger that causes an increase in the activities of these hormones that makes a child overeat.

Neck-to-waist ratio can help predict pediatric obstructive sleep apnea

Sharon M. O'Brien, MPAS, PA-C
January 19, 2015

Research from Canada demonstrated that a neck-to-waist ratio of >0.41 has sufficient sensitivity and specificity to be considered a predictor of obstructive sleep apnea.

Neck-to-waist ratio can help predict pediatric OSA

Adults are not the only ones who develop sleep apnea. The condition occurs frequently in children as well. The statistics are quite staggering -- up to 66% of obese children are diagnosed with apnea compared with 5.7% of non-obese children. This is another reason to keep children active and help them make better food choices.

Just as with adults, the consequences of sleep apnea can lead to other health issues. In children, learning and behavioral problems can be the first symptoms that suggest there is something happening in their sleep.

In adults, obstructive sleep apnea is the collapse of the pharyngeal tissue which causes obstruction of breathing during sleep. Children often develop sleep apnea because of large tonsils and adenoids. When a child is not sleeping well, ask his or her parents about snoring or if they can hear their child breathing from across the room. These are indications that tonsils and adenoids are hypertrophic.

As a provider, keep a measuring tape in your drawer can be helpful in determining whether your pediatric patient has obstructive sleep apnea. Research from Canada suggests that a neck-to-waist ratio of >0.41 has sufficient sensitivity and specificity to be considered a predictor of obstructive sleep apnea. The neck circumference is measured at the most prominent part of the thyroid cartilage and the waist circumference equidistant between the iliac crest and the lowest rib.

Of course, if you believe a child has obstructive sleep apnea it is important to order a polysomnogram to confirm the diagnosis. As it is often a concern, assure your patient that sleep labs have rooms set up for parents to stay with their child. Treatment may be as simple as removal of tonsils and adenoids, however, some children may need continuous positive airway pressure (CPAP) therapy. 

Children are not able to always put into words what they are feeling physically. As adults, we can say we are tired or fatigued, while children might not be able to do so. Ask parents how the child is interacting with other children or siblings. Are they falling asleep if not active? How are they doing in school? How is their behavior at home?

On your pediatric patient's next visit, remember to measure their neck and waist to see if they might need to a sleep study to assess for obstructive sleep apnea.

Poor sleep tied to inflammation in teens

Notes from Dr. Norman Blumenstock:

Teens who don’t get enough sleep may be at risk for chronic problems later in life from increased inflammation throughout the body, according to a new study.

BY KATHRYN DOYLE

Thu Nov 20, 2014 3:29pm EST

(Reuters Health) – Teens who don’t get enough sleep may be at risk for chronic problems later in life from increased inflammation throughout the body, according to a new study.

Those who didn’t get enough sleep during the week and especially those who slept longer on weekends had higher inflammation levels tied to heart disease and diabetes, researchers report in Sleep Medicine.

Investigators used blood tests to measure kids’ C-reactive protein (CRP) levels. High levels indicate that the body is in “inflammation mode,” said lead author Martica Hall of the psychiatry department at the University of Pittsburgh in Pennsylvania.

“Frankly, high CRP over a long period of time is bad for everything,” Hall said. “We say it increases the risk of ‘all things bad.’”

This study only measured CRP levels at one point in time, but “folks that have chronically high CRP are at risk for heart disease and diabetes,” Hall told Reuters Health by phone. “For adults we know that short sleep is associated with CRP levels.”

The researchers also had the 244 healthy high school students wear wrist monitors that recorded how much they slept.

Most kids had CRP levels in the low to moderate risk range, below 3 milligrams per liter, but 33 students qualified as “high risk” by scoring above that threshold.

On average, the kids got less than six hours of sleep per night during weekdays and between seven and eight hours on the weekends.

Teens who slept the least during the week were most likely to be in the high-risk group. Additionally, those who slept at least two hours longer on the weekends were more than twice as likely to be in the high-risk group, compared to those who had more consistent sleep times throughout the week.

Kids in the high-risk group also tended to have a higher body mass index, which is a measure of weight in relation to height.

Sleep duration was still linked to CRP levels even when the authors accounted for depression, sex, race, parental education and body mass index, which is usually an important predictor of CRP levels, Hall said.

“The kids who have a big discrepancy between the amount of sleep they get between weekdays and weekends, as well as those who have short sleep during the school day, that’s associated with higher level of CRP,” Hall said.

Similar results have been seen in adults and the elderly, but these studies that look at one moment in time can’t prove cause and effect, Dr. Francesco Cappuccio told Reuters Health in an email.

“In other words, is sleep deprivation causing an activation of inflammation or is an underlying reason for raised inflammatory markers the cause of reduced sleep?” said Cappuccio, a cardiovascular physician at the University of Warwick in Coventry, U.K. who was not involved with the new study.

Caution is always a good approach for results like these, but there are plenty of reasons for believing that sleep deprivation could be harmful, he said.

CRP levels can be lowered, but it would take a separate experiment to determine if changing sleep patterns would effect that change, Hall said.

“The cool thing about sleep is that it’s changeable,” she added.

Hall said kids and parents should focus on lengthening sleep times during the school week and not worry so much about the weekend. Other studies have found that highly variable sleep lengths are associated with health risks, so standardizing and lengthening sleep for five of the seven days of the week is a good start, she said.

“One of the reasons why there is such a move for trying to change high school start times is this is a population which is biologically predisposed to be awake at night,” Hall said.

In August, the American Academy of Pediatrics recommended schools delay start times to at least 8:30 a.m. to improve the physical and mental health of students (see Reuters Health story of August 25, 2014 here: reut.rs/1F7MWwc).

“They are predisposed to be awake at night then have really early start times, and that may increase the risk for way downstream disease,” she said.

Notes from Dr. Norman Blumenstock

A five year study is a wake-up call to a child snoring problem

Obese boys are more prone to habitual snoring than other children and they sleep less hours.

This would have been a better study if they all had sleep studies to see how many children had undiagnosed sleep apnea.

Elizabeth Cheung elizabeth.cheung@scmp.comPUBLISHED : Tuesday, 11 November, 2014, 4:49am        UPDATED : Tuesday, 11 November, 2014, 4:49am

Obese boys are more prone to habitual snoring than other children, a five-year study reveals. Photo: Reuters

Obese boys are more prone to habitual snoring than other children, a five-year study reveals.

The paediatric department of Kwong Wah Hospital in Yau Ma Tei conducted a phone survey with parents of 3,047 children in 2002 to understand the prevalence of sleep symptoms among local primary school pupils.

A similar follow-up survey was conducted five years later when the students had reached puberty. In 2007, researchers managed to interview 2,005 of the students involved in the first survey.

They found that 12.7 per cent of respondents, or 254 teenagers, were habitual snorers, meaning they snored on at least six nights a week.

About 40.6 per cent of pupils suffered from habitual snoring in both studies, while 7.1 per cent of children became habitual snorers when they moved to secondary school.

Dr Daniel Ng Kwok-keung, head of paediatrics at Kwong Wah Hospital, said male gender and a body mass index over 30 were factors leading to persistent and incidental habitual snoring.

Allergic rhinitis, inflammation of the nasal airways, is associated with persistent habitual snoring, while asthma is linked with incidental habitual snoring, meaning non-snorers started to snore in the second stage of study.

Habitual snoring affected the quality of teenagers' sleep. Pupils who showed excessive daytime tiredness slept for 7.1 hours on average every day, which is half an hour less than those who did not show any tiredness during the day, the study found.

The study pointed out that as many as 90 per cent of respondents did not reach the international recommended sleeping range of at least 91/2 hours a day. Hong Kong teenagers sleep for an average of 7.6 hours a day.

To prevent habitual snoring, Ng suggests that children exercise for one hour every day to prevent obesity, treat allergic rhinitis with nasal wash or topical steroid, and avoid sleep deprivation.

He also advised children to maintain proper sleep hygiene, such as avoiding exposure to a computer monitor two hours before bedtime and by exercising in the afternoon.

The result of the research was published in the Journal of Paediatrics and Child Health in June.

Sleeping nightmare: How snoring meant my child was naughty and only surgery could help

Notes from Dr. Norman Blumenstock

My advice to parents is if you have a child who snores and whose behaviour is out-of-control, have a sleep test.

Katrina Creer with her son Mitchel, 4, battled sleep aponea for years.

WE used to think it was a blessing our youngest child was a terrible snorer. Exhausted after a morning of meltdowns it was never a problem putting him down for his nap. And his snoring was so loud I didn’t even have to walk down the corridor to check on him.

But when he was awake, things were different. While most two-year-olds have tantrums our toddler’s were in the extreme. While other children amused themselves at the local playgroup, my son was trying to escape out the door.

SIGNS OF SLEEP APONEA

• Snoring in children with sleep aponea normally starts around two years

• It can also occur in seven to nine year olds, usually as a result of allergy or obesity

• Children tend to sleep with their neck and head stretched back

• They are fussy eaters preferring soft foods like cheese and yoghurts over hard to swallow foods

• They are often restless and sweaty sleepers

• They can be cranky during the start and end of the day, but will often appear hyperactive

• Take a video of your child sleeping and see your GP

• Other signs are blocked nose, dry lips and dark rings around eyes. They can also have a cross bite

Whenever possible, I needed someone to help me put him in his car seat as he would lie down on the floor kicking and waving his arms. This went on for two years.

Not surprisingly, there were very few offers to babysit. Friends and family didn’t always see the same loving and cuddly little boy we knew, which always reassured us there was probably nothing seriously wrong.

But by his third birthday, Mitchell barely slept through the night and his behaviour was wearing thin. Dinnertime was a struggle but by chance, one day I noticed a huge set of tonsils.

I sounded desperate but luckily our GP agreed and sent us to an Ear, Nose and Throat specialist.

While we had sought medical help before for his behaviour, we were told he would most likely outgrow it. In our sleep-deprived fog, we don’t remember anyone asking us “does your son snore?”

The specialist immediately suspected sleep aponea.

The condition causes a loss of airflow during rest often due to enlarged tonsils or adenoids.

It can also make young children naughty, despite being very tired they appear hyped-up. According to doctors, it mimics the symptoms ADHD.

The only way to make a definite diagnosis was a sleep study. The cost was covered by our private health insurance. Mitchell was wired up and eventually dosed off during our overnight stay in hospital.

Katrina Creer with her son Mitchel, 4, now enjoy a more soothing night’s sleep.

As I lay in the same room, I could hear him noisily sucking in the air. Occasionally it would go quiet and then restart. He never fully woke and if we were at home, we would have thought it was a good night.

The test showed Mitchell had a moderate sleep aponea waking on average 26 times every hour with his oxygen levels dipping to 80 per cent. It is likely he had never been in a deep enough sleep to ever dream.

I felt relief when told the results. Over the years I’d been given plenty of parenting advice, but deep down I always felt like he just couldn’t help it.

Three months after surgery and a much calmer little boy had emerged. And now, almost a year after surgery, he has become an absolute joy.

My advice to parents is if you have a child who snores and whose behaviour is out-of-control, have their sleep checked.

For further information contact the Woolcock Institute on (02) 9114 0000 or www. woolcock.org.au

Crowdsourcing Campaign Launched for Urine Test to Determine Whether Child Has Sleep Apnea or ADHD

Published on September 17, 2014

For millions of kids, a urine test could mean better, healthier sleep and possibly avoiding a mistaken diagnosis of ADHD.  The East Peezy Pee Test is a new diagnostic test in development at NuSomnea that has been found to be 96.5% accurate in determining if a child has pediatric obstructive sleep apnea (OSA), according to NuSomnea.  This condition is associated with symptoms often mistaken for attention deficit/hyperactivity disorder (ADHD).

This week, NuSomnea launched an Indiegogo fundraising campaign to help complete the development of the urinalysis test and to conduct another validation study in children, to confirm the results found in initial studies.

The Indiegogo campaign offers contributors perks including fun t-shirts and backpacks featuring "The Peezies," the characters from the Easy Peezy video, as well as the Easy Peezy Pee Test when it becomes available.

The test identifies the urinary concentrations of four proteins that are predictive of pediatric OSA. "Diagnosing OSA usually requires an expensive stay at a sleep lab.  It's inconvenient for parents and uncomfortable for kids,"  says Michael Thomas, co-founder of NuSomnea, in a release.  "We're changing that with a simple urine test that's more accessible, more accurate and costs about 75% less."

In children, common indicators of OSA are behavioral problems, learning disabilities, hyperactivity and attention problems, which may frequently be diagnosed as ADHD or ADD.  Nearly 7 million children between 4 and 17 years old are currently diagnosed with ADHD, but research has reported that up to 50% might actually have pediatric OSA.  Further, a large percentage of kids with ADHD respond to standard treatment for OSA-tonsil and adenoid surgery-reinforcing the conclusion that many have OSA in addition to or instead of ADHD.  If a child has OSA, treating only for ADHD with stimulant drugs may not resolve the issue.

Because the Easy Peezy Pee Test is so convenient to administer, the manufacturer says it has the potential to be used as both a diagnostic tool and a disease management tool to more closely monitor therapy effectiveness and improve patient outcomes.

The Easy Peezy Pee Test by NuSomnea is still in clinical development and should be available to doctors in 2016.

Doctors want schools to start later so kids can sleep

MICHELLE HEALY @BYMICHELLEHEALY USA TODAY

America’s pediatricians have a message for school administrators: Let the kids sleep.

The nation’s largest pediatrician group issued a policy statement this past week, just as millions of children are returning to school, calling for high school and middle school classes to begin at 8:30 a.m. or later. The move would be “an effective countermeasure to chronic sleep loss” and the “epidemic” of delayed, insufficient and erratic sleep patterns among the nation’s teens, the group noted.

Many factors, “including biological changes in sleep associated with puberty, lifestyle choices and academic demands,” negatively impact teens’ ability to get enough sleep. Pushing back school start times is key to helping them achieve optimal levels of sleep — 8½ to 9½ hours a night, says the American Academy of Pediatrics statement, which was published online in Pediatrics.

“As adolescents go up in grade, they’re less likely with each passing year to get anything resembling sufficient sleep,” says Judith Owens, director of sleep medicine at Children National Medical Center in Washington, D.C., and lead author of the AAP statement.

Chronic sleep loss in children and adolescents “can, without hyperbole, really be called a public health crisis,” Owens says.

Among the consequences of insufficient sleep for teens, according to the statement:

Increased risk for obesity, stroke and type 2 diabetes; higher rates of automobile accidents; lower levels of physical activity; increased risk for anxiety and depression; lower academic achievement, poor school attendance; increased dropout rates; and impairments in attention, memory, organization and time management.

According to U.S. Department of Education statistics, approximately 43% of the over 18,000 public high schools in the U.S. have a start time before 8 a.m.; 15% started at 8:30 a.m. or later.


1 in 5

Adolescents getting nine hours of sleep on school nights

45%

Percentage of adolescents sleeping less than eight hours

Source: 2006 National Sleep Foundation poll

Untreated snoring in kids may lead to heart disease: expert

Notes from Dr. Norman Blumenstock
Is your child's snoring a sign of sleep disordered breathing

TNN | Aug 26, 2014, 10.51PM IST

Kanpur: Does your kid snore while sleeping at night? If the answer is `yes', you should immediately consult a doctor, as it can be a symptom of sleep breathing disorder, a more serious underlying problem that can affect your child's physical and mental well-being, an expert revealed during the third day of IMA CGP.

Dr JC Suri from New Delhi, said that sleep breathing disorder is most common among kids between 2-18 years of age. "This problem is seen in about 5% of children between this age group. The biggest reason being excessive growth of tonsils and adenoid in the back of the throat. Major symptoms of the disease include snoring, irregular sleep, increased aggressiveness, change in attitude etc.

Children who are chronically sleep deprived may be prone to problems with attention behavior, learning and mood. If not treated on time the disorder can take shape of chronic heart disease. With the advancement of science today we have developed ways to cure the disease without operating the child," the doctor said.

In Kids, a Urine Test for Sleep Apnea May Be Viable Alternative to PSG

Notes from Dr. Norman Blumenstock
Early diagnosis of obstructive sleep apnea in children has benefits especially if can be done as simply as a urine test.

Published on August 4, 2014
A sleep apnea test being referred to as “less stressful” for children was presented at the 2014 American Association for Clinical Chemistry (AACC) Annual Meeting & Clinical Lab Expo. The meeting was held July 27 to 31 in Chicago.

Obstructive sleep apnea in children can lead to behavioral difficulties, learning disabilities, pulmonary/systemic hypertension, and decreased growth. However, the current gold standard for diagnosing sleep apnea—the overnight sleep study—is labor intensive, expensive, and limited by availability, in addition to being a potentially traumatic experience for children, says Trevor Pitcher, PhD. At the AACC annual meeting, Pitcher, a clinical chemistry fellow at the University of Louisville in Kentucky, reported the results of research showing that an immunoassay can effectively detect in urine the stress-coping peptide urocortin 3, which is significantly increased in children with sleep apnea. This urine test could serve as a psychologically easier alternative to a child spending a night in a strange bed in a sleep clinic, he says.

What to Know About Snoring in Children

POSTED 7:36 AM, JUNE 11, 2014, BY ESSE HEALTH PEDIATRICS, UPDATED AT 07:37AM, JUNE 11, 2014

Snoring in children is a common event, with estimates placing it at about 12 to 15 percent. Most of these children are healthy, show no symptoms and have primary snoring. Snoring happens during sleep due to a blockage of air when breathing as it passes through the back of the mouth. The loudness is affected by how much air passes through and how fast the throat tissue is vibrating. Snoring can be due to an upper respiratory infection, allergies, or it can be a sign of obstructive sleep apnea (OSA).

Infants and toddlers spend over half of their lives sleeping and, by adolescence, greater than on third of our lives are spent sleeping. Quality sleep is essential for proper development and daily functioning. Proper sleep helps with learning, consolidating memories, physical growth, recharging the body and helping our bodies fight infections.

Approximately 2 to 3 percent of children have OSA, which occurs when the posterior air collapses and blocks the throat. Frequent pauses in breathing, lasting from several seconds to a minute, often lead to the brain briefly waking up and causing us to breathe. This leads to gasping or snorting, waking us up and re-breathing. This can occur all through out the night.

Interrupted sleep can lead to behavioral issues, problems with social function, poor school performance and poor growth. These children are also more likely to be hyperactive and have trouble paying attention in school, mimicking signs of attention-deficit hyperactivity disorder (ADHD).

Studies also show that children with OSA are at risk of developing heart and lung problems which can lead to serious consequences later in life if it goes undetected. Untreated OSA, in the short term, often leads to daytime sleepiness, morning headaches, irritability, bed wetting and mouth breathing. The risk of apnea is higher in overweight children.

Other signs might include large tonsils and/or adenoids with frequent mouth breathing, restless sleep or sleep in abnormal positions, sleep in elevated position or with neck extended, excessive sweating during sleep, nasal speech, poor weight gain or being overweight, and high blood pressure. Even primary snoring (i.e. snoring without breathing pauses, frequent arousals, or drips in oxygen levels), which was once thought to be normal, still can lead to problems in school performance or behavior issues.

If you suspect your child may have symptoms of OSA don’t assume his or her snoring will go away on its own. Talk to your child’s doctor. The American Academy of Pediatrics has recognized this as a serious problem and has published recent guidelines for screening of obstructive sleep apnea, which will help doctors recognize, diagnose, and treat children with OSA.

Testing can be done if your child is suspected of having OSA, including an overnight sleep study. You may also videotape your child’s sleep to bring to the doctor for review. Night-time pulse oximetry to measure oxygen levels is also a useful tool. Your doctor may refer your child to a sleep specialist as well, as sometimes these tests are normal even when your child may still have OSA.

Once your child has been found to have obstructive sleep apnea syndrome, referral to doctors who specialize in treating OSA include pediatric otolaryngologists (ENT), pulmonologists and neurologists. Treatment options usually include removing enlarged tonsils and adenoids (T&A). Often removing the tonsils and adenoids stops the snoring and helps with improved appetite and growth in young children. It also improves academic performance and behavior in school-aged children as they get more uninterrupted, quality sleep. Other options include treating allergies or helping children lose weight. A night-time treatment called continuous positive airway pressure (CPAP) therapy is another option for children who can’t have surgery or have persistent OSA even after a T&A has been performed.

Remember to be suspicious that your child may have OSA if he or she regularly snores and has apnea, daytime sleepiness or school/behavior problems. If detected early, treatment of this problem may be reversible.

Dr. Michael E. Danter, Esse Health

How to get your kid to sleep

Notes from Dr. Norman Blumenstock:

Kids can also have obstructive sleep apnea.

PIPPA GARDNER FOR 7NEWS INVESTIGATIONSMarch 19, 2014, 7:39 pm

Up to 30 per cent of children under the age of three will suffer some form of sleep disorder.

Youngsters who do not get enough sleep can suffer from behavioural problems such mood swings and even depression.

Tresillian is sleep bootcamp for tired parents and their kids.

"Sleep is so important for a child's brain development for growth, and to have good behaviour,” a sleep expert from Tresillian said.

A common complaint from parents with kids who can’t sleep properly is ‘night walking’, a pattern which experts at Tresillian say kids can form.

Tresillian's tips to fix night walking

A consistent bedtime routine.
A calm quiet environment to sleep.
Being persistent and patient when resettling.

“Being consistent and persistent with their routine is really important and it takes six weeks once people have come into Tresillian to continue this to have the routine set, so it's not a quick fix,” the expert said.

Many parents also battle with short day sleeps.

Tresillian's tips to help getting kids to sleep

Set up a bedtime routine and stick to it.
Read your child's cues by putting them to bed before they're exhausted.
Try playing music.

“It’s just important they have that consistency of you coming back and reassuring them, eventually that will develop into a good routine and eventually they will sleep."

Tired parents will try anything to get their child to fall sleep, but Tresillian says parents should not fall into the trap of patting, rocking or driving your baby to sleep to create sleep associations that can become hard to break.

However, for the small percentage of children who have sleep problems that require medical treatment, experts say it is important parents do not ignore warning signs, such as snoring.

“Ninety per cent of children do not snore, so when a child snores parents should not assume it is just ‘cute’ or it is just the child and that it's normal to snore, [because] it's not,” the expert said.

Four-year-old Abby was a terrible sleeper and also snored, until her mother took action.

"Every morning she was in a bad mood and crying when she would wake up and really loud snoring every night,” Abby’s mum Laura said.

Enlarged tonsils blocking her airways triggered Abby’s snoring, a condition known as sleep apnoea.

Her tonsils have since been removed.

“Since the surgery, it's been amazing, she wakes up happy, she's got more concentration, we don't hear her snoring and she doesn't wake up in the middle of the night,” Laura said.

Connected clothing can tell how soundly your baby is sleeping

Notes from Dr. Norman Blumenstock
Here is a device for parents to monitor their sleeping infants.

Nick Barber                                                                                           February 4, 2014
@nickjb

Singing along to the Disney movie playing in the background, Dulcie Madden helped hand-package thousands of high-tech baby clothes from her start up in Boston’s Leather District. Madden is the CEO and co-founder of Rest Devices, which just last weekend started shipping its Mimo connected “onesie” to stores across the US. The $200 system aims to help anxious parents by monitoring a baby’s movement, respiration, position and skin temperature and delivering the information with audio to smartphones.

See TechHive’s profile of Mimo from CES 2014

 “The green stripes on the front of the onesie are the respiration sensors, which pick up the baby’s breathing throughout the night or as they’re playing,” Madden said. The green plastic turtle that attaches to the onesie has a temperature sensor, accelerometer and Bluetooth low-energy chip to deliver the information to the “lily pad,” which acts as a bridge between the onesie and the home’s WiFi network.

“We basically designed it because we had parents coming to us saying ‘I wake up over and over in the middle of the night because I’m wondering if everything is okay with my baby,’” Madden said. “It’s really there to be an extra tool for parents.”

Along with co-founder Thomas Lipoma, Madden leads a group of seven young employees, all but one of whom hail from The Massachusetts Institute of Technology. In a loft style office that Rest Devices shared with a custom tailoring company, the group developed, prototyped and began manufacturing Mimo.

“Since we started working on the baby monitor, we had three competitors pop up,” said Madden, citing the ability to rapidly prototype as an advantage. Rest Devices has a Makerbot Replicator 2 3D printer and a desktop injection molder on site. Lipoma uses a suite of software from Autodesk to design the 3D models, which are then sent to the 3D printer.

“If we have a first concept, we’re going to immediately CAD it,” said Lipoma. “Within half and hour we can have something up. We can print it. We can feel it.”

In December Intel invited Rest Devices to join the chip maker on stage at its CES keynote in January 2014. The Mimo turtle will eventually use Edison, an Intel chip that is a computer the size of an SD card. Currently, the team uses a homemade version since Edison won’t be available until later this year.

http://www.pcworld.com/video/iframe/30442/iframe.html

With the exception of the onesie, which comes from India, all of the components of the system and the assembly is done in Massachusetts and New Hampshire. For durability testing, the team 3D-printed a contraption that used a small motor to restart a washer and dryer.

“If you think about washing a thousand onesies hundreds of times, that’s a lot of laundry. So we added servos to the washer and dryer so that they’ll automatically restart and run on self-cycled water.”

They also modified another 3D printer so the process of applying the silver paste, for use in the respiration sensor, can be automated.

The first few thousand units are being hand assembled by the team in the Boston office, after which manufacturing and assembly will move one state north to New Hampshire.

The company’s next project is a connected bottle warmer. The idea is that when a baby wakes up in the middle of the night, the Mimo onesie sends a signal to the bottle warmer to start warming the baby’s milk.

After that they’re looking to help parents with potty training.

Blood Pressure Rose in Kids with Sleep Apnea

Notes from Dr. Norman Blumenstock

We generally think about high blood pressure and adult obstructive sleep apnea.

January 16, 2014 / Author: Natalie San Luis / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(dailyRx News) In adults, sleep apnea is tied to higher blood pressure. Does sleep apnea produce the same result in children?

In a recent study, researchers found that more severe sleep apnea among children was tied to higher blood pressure after four years. Both overweight and normal weight children were at risk.

The authors of this study suggested that sleep apnea is a key factor in regulating blood pressure in children.

"Get proper treatment for your child's sleep apnea."

Albert Li, MD, of the Department of Pediatrics at the Prince of Wales and Shatin Hospital, led this study on childhood sleep apnea.

Sleep apnea occurs when there are pauses or gaps in breathing during sleep.

According to Dr. Li and colleagues, research has linked sleep apnea in adults to higher blood pressure. This study investigated whether the same relationship exists for children who have sleep apnea.

High blood pressure during childhood increases the risk of high blood pressure during adulthood, metabolism problems and other heart health issues, according to these researchers.

A total of 185 children with sleep apnea were recruited for this study. Data was collected at a four-year follow-up visit, during which their blood pressure was measured for 24 hours.

The researchers also measured the children's height, weight, sleep habits and daytime sleepiness.

These researchers analyzed the data from the 58 overweight participants and the 127 normal weight participants separately.

The group of normal weight children had not experienced significant changes in BMI or sleep apnea severity over the previous four years.

The overweight participants had significant reductions in BMI but no significant changes in sleep apnea severity.

The researchers found that, for both groups, a higher sleep apnea severity at the beginning of the study was linked with higher blood pressure at the four-year follow-up.

For the group of overweight participants, changes in sleep apnea severity were also tied to changes in blood pressure scores across the four-year period.

According to the authors of this study, sleep apnea remains an important factor in regulating blood pressure, regardless of one's body weight or BMI. They concluded that sleep apnea severity may be a driving factor of high blood pressure in young people.

These researchers acknowledged some limitations to the study, like the modest rate of follow-up and only one night of observing sleep patterns.

The study was published in Chest on January 2.
The researchers did not disclose any funding information or conflicts of interest.

Children who snore may be at an increased risk of learning problems

October 14, 2013
By Tele management

(TeleManagement) Snoring is common among children, with between 3 and 12% affected by the condition. Some of these children suffer from obstructive sleep apnea – a condition where the airways become obstructed, causing the child to briefly stop breathing several times throughout the night.

Experts have known for some time that obstructive sleep apnea increases the risk of learning problems and behavioral problems in children. However, it was unclear whether children who snored but did not suffer from obstructive sleep apnea were also at risk from learning problems.

Researchers from the University of Louisville, US, compared 87 children who snored but did not have obstructive sleep apnea with 31 children who did not snore. The children, all aged from five to seven years, were monitored in a lab while they slept and given a series of tests the next morning. The tests were designed to measure learning abilities, attention, and general intelligence. The children’s parents also answered questions about their child’s behavior.

The researchers found that children who snored performed significantly worse on the tests.

Children with obstructive sleep apnea can experience improvements in their learning if they have their adenoids and tonsils removed, the researchers say. They suggests that any children with learning or behavioral problems who frequently snore should be checked by a sleep specialist to see whether they suffer from obstructive sleep apnea.