Rates of sleep apnea and other sleep troubles skyrocket for children with special needs.
Many children with special needs also face significant
sleep challenges, a draining double-whammy that leaves millions of parents and
children exhausted.
The National Association of School Psychologists reports
that as many as 30 percent of children may have a sleep disorder, but rates are
much higher among children with special needs.
Recent studies published in Pediatrics link childhood snoring and sleep apnea, or “sleep
disordered breathing,” to behavioral problems and an increased need for special
education. In fact, SBD is strongly associated with conditions like Down
syndrome and cerebral palsy.
What’s more, sleep problems can be especially devastating
to children with special needs, because the resulting sleep deprivation can
worsen the symptoms of their existing medical or behavioral problems, says
Carole L. Marcus, M.D., director CHOP Sleep Center in Philadelphia.
Snoring and sleep
apnea
Most children snore once in a while, and 10 percent snore
most nights. But these nighttime noises shouldn’t be dismissed as “normal.”
Researchers now believe that snoring is on the same
spectrum as sleep apnea, a disorder characterized by pauses in breathing that
cause brief awakenings. Left untreated, sleep apnea can contribute to
behavioral problems and learning difficulties, even hyperactivity.
A study by the American College of Chest Physicians found
that children who snored loudly were twice as likely to have learning
impairment. The potential impact is so severe that the American Academy of Pediatrics recommends that all children who snore be screened for sleep apnea,
says Dr. Robert Heinle, of the Nemours/Alfred I. duPont Hospital for Children Sleep Lab in Wilmington, DE.
Other SDB warning signs include sleeping in strange
positions, experiencing night terrors, bedwetting, or perspiring during sleep,
says Dr. Renee Turchi, board-certified pediatrician with St. Christopher's Hospital for Children in Philadelphia.
How to help
The good news: nearly all otherwise-healthy children with
sleep apnea respond well to having the tonsils removed, says Marcus.
Back-sleeping can exacerbate snoring; regular snorers or those with sleep apnea
should choose another position (“back to sleep” is still best for babies,
though).
READ MORE: Create a bedtime routine for your child
Beyond snoring:
sleep and special needs
Rates of sleep apnea and other sleep troubles skyrocket
for children with special needs. About two-thirds of children with Down
syndrome have sleep apnea, says Marcus; a larger tongue, a small mid-face, and
lower muscle tone make these children more prone to SDB and apnea.
Children with cerebral palsy, spina bifida, and other
conditions associated with low muscle tone also have higher rates of sleep
apnea. According to multiple studies, over half of children with Down syndrome
ages 7 to 11 wake during the night, and nearly 40 percent wet the bed.
Children with autism can have difficulties with the
circadian rhythm, the sleep-wake cycle that governs wakefulness and sleep,
driving them to stay up too late, says Marcus. “Our brains regulate sleep, so
if the brain is abnormal for any reason, sleep is going to be impacted, too.”
How to help
Though some special-needs sleep problems are
physiological in nature, such as those related to low muscle tone, many are
behavioral, such as habitual night wakings, waking too early in the morning, or
fighting bedtime.
“Often, parents may not set the same bedtime limits for
children with special needs that they set for other children,” says Marcus.
Defining clear parameters for sleep —including when bedtime occurs, where a
child sleeps, and what is an acceptable hour to wake in the morning — and
gently yet firmly enforcing these household rules, night after night, can help
get sleep on track for children with special needs.
Malia Jacobson is a nationally published health
journalist and mom. Her latest book is “Sleep Tight, Every Night: Helping
Toddlers and Preschoolers Sleep Well Without Tears, Tricks, or Tirades.”