sleep issues

[Rose-Roget]

Ds is 6.  He has SPD and looks kind of ADHD at times.  He's learning well at school, although he acts impulsively and gets into trouble.  On another thread, someone posted that he could have sleep problems, since I commented that he sleeps for 12 hours a night and still wakes up tired or complains of being tired.  I said I'd always considered him to be just a kid who needs more sleep (2 naps until 2+, 1 nap until almost 5, 11-12 hours of sleep a night), but they pointed out that needing extra sleep and waking refreshed would be one thing, but still feeling tired is different.  Makes sense.  Furthermore, he often says he has nightmares or doesn't sleep well.  He has almost always woken once per night, but I always assumed it was just to go to the bathroom.

So I 'm looking into pursuing this.  Would I go to my regular ped. or should I talk to a Developmental Ped?  I've been hedging about an appointment with a Dev'l Ped because his needs aren't that extreme and I'm not sure what kind of information she could give me.  But if this is another piece to the puzzle that she might know more about than my general ped. then I'd go.

Also, are sleep disorders well-recognized and accepted/understood by mainstream medicine?  Or is it like SPD that is completely valid, but not widely accepted at this point by mainstreamers?  I hope that doesn't sound wrong.  I just would need to know what to prepare for, you know?

TIA!

[khaoskat]

Two of my children, so far, have sleep problems.

Eldest has Sleep Apnea (Obstructive).  Often times our Ped kept pushing us off.  When we first brought up the problem it was he needs to be in activity and go to bed an hour earlier.  After about 2-3 months still no help.  So, we went back..this time it was he just needs counseling.  4 months later, we called when he was having a total melt down over being told "No, we will not go pay $4+ for a hot dog at the street vendor", and he started kicking, screaming, flaying his arms.  (He was 4 1/2 - 5 at this time).  I called our Ped, and the nurse was like, you are just a bad parent, parent that child and you wouldn't have the problem.  I in no certain terms told the Nurse they were fired, that I would be filing a complaint with the state medical board.  Within 30 mins our Ped called.  Talked to us..and made referrals for neck x-ray (see how enlarged tonsils and adnoids were) as well as sleep study.

Second Son - we were referred to Dev. Ped due to some issues and also suggested starting him on Melatonin.  When we brought up the issues of sleeping with the Dev. Ped, she referred for a sleep study.  We had the sleep study and found out he has RLS/PLM.  He also has low serum iron.

I am just waiting to see if we will have to go through this with my other two children or not...

I find that they want to rule out so much more before going through a sleep study...but often times a sleep study is more revealing.  I don't think they push it off, but I don't think they want to look at sleep as the cause of a child's problems.  Lack of sleep can mimic so many things - ODD; ADHD; Hyperactivity; 

[Rose-Roget]

Thanks for that information.   Sounds like it can completely depend on who the doctor is.  It's true that sleep disorders can have overlapping symptoms with other disorders.  But since ADHD and the like are just based on a checklist of information for dx, then why don't docs go looking for root causes of the symptoms to rule out, and THEN have a better idea of ADHD/ODD/hyperactivity/etc. with unknown etiology.  Seems so silly that you or anyone would have to fight so hard to get the issues taken care of. 

Do you feel like the Dev'l Ped. was more receptive?  It sounds like she ordered the study sooner than the regular ped. 

Also, what does a child sleep study entail?  I've actually been wanting my husband to get one done, too.  Maybe we can schedule them for the same time. :)

[khaoskat]

Ours was an overnight stay in a pediatric sleep lab.

Basically you go in, they show you to a room in the sleep lab.  They then give the child a chance to change and get teeth brushed, potty, etc. Then they start placing the probes on the child.  Ours explained everything to the child as they were going and answered all the questions of the child w/o even hesitating.  Once everything is on, you do your normal night time routine, and put the child down for sleep.

A parent could stay in the room, but since we don't stay in the room with the kids when they go down..we left the room till after he was asleep, then came back in when we were ready for bed.

They woke us up about 6 or 7 in the morning, gave him a chance to shower there or he could go home and shower.  And we headed home to wait for our follow appt.

[Rose-Roget]

Interesting.  I guess they have to feel like they get accurate enough reads like that, even though I would think that the child would maybe sleep worse than usual because of being in a new place, having probes on them, etc.  But trying to keep the routine as normal as possible would help.  

So part of our bedtime "routine" (not really) is that we put him down and then he's up again (and again) with a tummy ache or a headache or a leg ache or is too cold or just plain can't sleep...  I guess he would just press the call button for those things.  And he's such a mover in the night, so I would hope that the probes would stay on!  I guess they account for those things, since evaluating sleep patterns is exactly what they are set up to do.  Hmmm...

Maybe I should call the Dev'l Ped and see if she could help us rule some things out, including sleep.