40 winks for kids

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OBSTRUCTIVE SLEEP APNOEA (OSA)

This occurs when your child's airways are blocked during sleep. He stops breathing frequently - as often as once every minute, cutting off oxygen supply. The disorder affects about a fifth of obese kids, who are at a higher risk of getting it because they have more fatty tissue in the throat and neck, which narrows the airways, explained Dr Theodric Lee from the division of paediatric pulmonary and sleep at National University Hospital (NUH).

But most children who suffer from OSA get it because they have enlarged tonsils and adenoids (the patch of tissue sitting at the back of the nasal passage), which is hereditary, says ear, nose, and throat (ENT) surgeon and sleep specialist Kenny Pang, medical director of Asia Sleep Centre.

 

WATCH FOR: Loud snoring, accompanied by signs of choking, grunting sounds and gasping for air during sleep. Your child might wake frequently at night, and toss and turn in his sleep, said Dr Pang.

Even with sufficient hours of sleep, he appears tired because he does not get enough oxygen.

GET BETTER REST: Get help from a sleep specialist. Your child might be required to undergo an overnight sleep study, or polysomnography, said Dr Lee.

Surgery to remove the adenoids and tonsils is typically the first-line treatment, he said. Other non-invasive methods include using a continuous positive airway pressure machine or oral mouthpiece to keep the airway open during sleep.

NASAL ALLERGIES

This condition occurs when your child breathes in particles in the air that he is allergic to. They irritate the nasal passages, causing symptoms such as sneezing, itchy eyes and a blocked nose. In Singapore, the most common allergens are house dust mites, pet dander and grass.

"Kids who have allergic rhinitis, especially the more severe forms, have problems breathing properly when they sleep," said Dr Pang.

WATCH FOR: Runny, congested noses. Other telltale signs are itchy, watery eyes, persistent phlegm, cough or a sore throat. They may breathe through, or open, their mouth during sleep, said Dr Pang.

GET BETTER REST: About 70 per cent of kids outgrow their nasal allergies by the time they turn 17, said Dr Pang. In the meantime, go for an allergy test to find his triggers. This will help parents to know what a child should avoid, and relieve uncomfortable symptoms.

Treatments include medication, such as antihistamines or nasal sprays, but check with a doctor instead of self-medicating.

TOO MUCH ARTIFICIAL LIGHT IN THE EVENING

Being exposed to bright lights from a TV and electronic gadgets delays the body's circadian rhythm, said Dr Ignatius Mark Hon Wah, an ENT surgeon at Ascent Ear Nose Throat Specialist Group. The circadian rhythm is your body's 24-hour internal clock, which tells you when you need sleep.

Research has found that artificial light from electronic devices in the late afternoon and evening is particularly disruptive to sleep, as it makes the brain think it is still daytime. It can delay sleep cycles by as much as six to eight hours.

WATCH FOR: Difficulty in waking up your child. During the day, he might be irritable, hyperactive and have difficulty focusing on tasks, said Dr Pang.

GET BETTER REST: Unplug and keep gadgets out of the bedroom. Focus on doing quiet activities at least two hours before bedtime, he suggested.

PARASOMNIAS

Parasomnias, like sleepwalking and night terrors, which run in the family, are relatively common among kids, said Dr Lee. About 15 per cent of them are estimated to sleepwalk, while up to 6 per cent are thought to experience sleep terrors. But most kids outgrow them by the time they reach their teens.

WATCH FOR: Potential danger hot spots around your home. "Prevent injuries by modifying your home, such as installing gates at the top of the stairway, and locking doors and windows," advised Dr Lee.

GET BETTER REST: Stress and changes in sleep schedules, such as during a holiday, can trigger an episode. Having regular bedtimes and getting enough sleep can help.

Signs your child is sleep-deprived

He becomes hyperactive and you cannot control him

He might also be prone to temper tantrums. "During the day, he goes through an adrenaline surge and end up running everywhere, touching everything," said Dr Kenny Pang of Asia Sleep Centre.

A study by researchers at the University of Helsinki in Finland on seven- to eight-year-olds suggests that insufficient sleep in kids might be linked to attention-deficit hyperactivity disorder behaviour.

His memory worsens and he cannot focus on tasks

Your child forgets that he has homework, and he cannot remember what the teacher said. He might doze off in class.

Without proper sleep, your child's memory, concentration and focus will be diminished, affecting the way he learns in school, said Dr Pang.

He struggles to put on weight

A long-term sleep deficit can stunt your child's development.

"A large proportion of growth hormone is secreted during sleep, with most of it during deep sleep. If your child's sleep is disrupted, his physical growth might be affected," said Dr Ignatius Mark Hon Wah of the Ascent Ear Nose Throat Specialist Group.

 
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