Children with Sleep Issues Can Demonstrate Raucous Behavior
I've said it before and I'll say it again, fall is my favorite time of year. Thank God it finally seems to be settling in on us, well, at least as fall-like as it gets in Augusta, Ga. Our mean temperature now is between 70-80 degrees which is about 20 degrees cooler than we have been accustomed to. Some of us have even donned our cool weather outerwear. You may laugh, but I am serious.
I read with interest the article "Pediatric OSA Screening" in ADVANCE this morning. It was accompanied by an online feature about this one child, Jake, who had extremely bad behavior and his mom's struggle to find out what was wrong with him. I applaud her determination in pursuing doctor after doctor until the cause was found.
Sleep apnea in children can directly affect their behavior at a very early age. Our sleep lab is the only lab in the area that treats this difficult patient population. We see children like this on an almost weekly basis. I wrote last month about the child who was swinging around his dad's neck and repelling off of him while I was trying to perform a hook up. You may have thought I was exaggerating. But these kids' behaviors can be uncontrollable: running and screaming, crawling under beds and tables to get away, exhibiting aggression at times, biting, kicking, hitting. The behaviors are very worrisome and upsetting. As Jake's mom stated, she was sure she had a serial killer on her hands.
But if you can manage to get them through the diagnostic sleep process, what a change!
They have the sleep study which reveals the problem, generally tonsils are interfering with their breathing during sleep. I did wonder why, with such huge tonsils, (it was reported they were four times the normal size), the pediatrician was not able to diagnose Jake properly or recommend a sleep study.
At any rate, after a tonsillectomy we bring the children back for a postop evaluation. The data is remarkable. You would not believe you were looking at the same patient study. But what makes it all worthwhile is when the parents say they have a totally different child. And we see it too. When back for the follow-up study the children are usually all smiles, cooperative and sleep through the night.
I clipped this from Science Daily (Feb. 14, 2008): "For children who suffer from obstructive sleep apnea (OSA), a tonsillectomy and adenoidectomy can provide dramatic relief and is successful in solving sleep problems for 80 to 90 percent of children, a Saint Louis University study found."
And I believe it was the Academy of ENT physicians that came out this summer as recommending sleep studies prior to surgery for all pediatric patients as standard of care.
Jake is a lucky boy to have such a diligent mom.
Read all about Jake in "One Parent's Nightmare: A Child Who Couldn't Sleep."