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By Carol Pearson
Washington
18 September 2007 

kid sleeping
A lot of studies have examined adult sleep problems, such as sleep apnea, a condition that can lead to heart attack or stroke.  But now researchers are looking at problems that children, even infants, can have in getting a good night's sleep.  VOA's Carol Pearson has more.

Six-year-old Timmy Vale is an energetic little boy, but his mother, Kris, was concerned about his sleep. "I noticed his really heavy breathing and snoring.  And I noticed every now and then when I'd wake up in the middle of the night, I'd hear him just go, 'gasp, gasp'."

Dr. Sumit Bhargava, examines Timmy, saying, "Stick your tongue out and say 'ahh' as loudly as you can."

Dr. Sumit Bhargava
Dr. Sumit Bhargava
Dr. Bhargava, at Yale University, found in addition to the snoring, Timmy's tonsils were enlarged. "Children who have obstructive sleep apnea, and they go to sleep, they tend to either partially close or completely close their airway off," he explains.

With sleep apnea people literally stop breathing during their sleep.  Extra tissue, tonsils or a large tongue, can close their airways.  Sleep apnea can lead to heart problems and diabetes.

During the day, children with sleep apnea can be groggy and unable to concentrate or they can be hyperactive. They may have difficulty learning and score lower on intelligence tests. 

So early diagnosis is critical.  Timmy went to a sleep center at Yale-New Haven Children's Hospital in the eastern state of Connecticut. A nurse attaches electrodes to Timmy's body to measure his brain activity. 

Dr. Bhargava comments, "We also look at how they breathe, how fast they breathe, whether they stop breathing, whether the oxygen level goes down, whether their limbs move excessively at night."

Once Timmy falls asleep, a computer starts recording the data. 

Dr. Bhargava found the loud snores contributed to restlessness, and Timmy woke up more often than most children his age. He also determined that Timmy's sleep apnea is mild, so he decided not to remove his tonsils.  But the doctors says he will continue to monitor the boy's sleep.

Babies are diagnosed differently.  Even infants can have sleep problems, but specialists say detecting them is tricky.

"They don't have the adult sleep stages so you need more visual cues to help determine stage of sleep," says Samantha Kasven. She is the sleep laboratory coordinator at a hospital in Denver, Colorado. The lab uses a camera to focus on the baby's eyes to see how deeply the baby is sleeping. 

Dr. Robert Ballard says it is important to document every movement of a baby's sleep. "Until you actually monitor it and record it, and sit down and record it on a computer screen, you might not have a very accurate idea as to what is actually going on."

Infants diagnosed with an adult sleep disorder may have corrective surgery.  Dr. Ballard finds that oxygen treatment eliminates the need for most surgeries on infants.  Dr. Bhargava adds that if an infant has some physical obstruction, surgery may still be needed. 

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