Maggie McKay (Host):  It's bad enough when parents don't get a good night's sleep, but what about when your children have sleep issues? Pediatric Neurologist, Dr. Thuan Dang will discuss sleep, children, and how pediatric sleep medicine may help. Welcome to Pediatric Specialty Care Spotlight with Shriners Hospital for Children, Chicago.

I'm your host, Maggie McKay. Welcome Dr. Dang. Thank you for joining us.

Thuan Dang, MD, MPH: Thank you, Maggie, so much for having me.

Host: Well, let's just start with what are the biggest concerns parents have for children when it comes to sleep?

Thuan Dang, MD, MPH: The biggest concern that I always see in my clinic is parents are very concerned as, is my child getting enough sleep? And that's one of the first things I reassure parents is that when you look at sleep in a child, you really have to look at sleep over a 24 hour period. It's important to focus on the overnight sleep, but we also have developing young minds.

So, we really have to look at what kind of sleep is happening during the day, including naps, whether that is intended or not intended, and how does that factor into the overnight sleep also.

Host: For parents who don't know, can you explain why is pediatric sleep medicine treated by neurologists?

Thuan Dang, MD, MPH: So, neurologists are equipped to look at the developing brain and a child's overall development. And so, having a subspecialty within neurology of sleep medicine allows the physician and the team to look at overall, all the child's medical conditions and how that can contribute to sleep. And as we all know, as children grow, their brains develop, and so as pediatric neurologists, our focus is really looking at the development of the brain and how this can affect sleep patterns.

Host: Dr. Dang, what are some of the treatments you provide for sleep issues in children?

Thuan Dang, MD, MPH: The first intervention or assessment that I provide is really looking to see, is there a potential medical issue that may be affecting a child's sleep? And the number one issue affecting most children's sleep is obstructive sleep apnea. And so, in clinic I would speak with parents and patients about risk factors for obstructive sleep apnea disrupting a patient's sleep.

Host: What are some common symptoms that might point to sleep issues in children?

Thuan Dang, MD, MPH: It's really important that parents and families recognize and can identify common symptoms, such as napping during the day when a child normally does not nap can show that they could be very tired and not getting enough sleep or fragmented sleep at night. Patients who snore more than three times a week can also present with sleep concerns. Patients who are having behavioral issues such as dysregulation, tantrums, can also be signs that there are sleep issues that are affecting their ability to get a restful night of sleep.

Host: And Shriner's Children's sometimes treats children with complex conditions. Are there sleep issues unique to these patients?

Thuan Dang, MD, MPH: Yes, Maggie. Shriners, being a very specialized hospital, treats many orthopedic conditions that are very much related and can affect a child's ability to sleep throughout the night. For example, children with significant scoliosis can actually have hypoventilation, which is that they are breathing less at night and actually retaining carbon dioxide.

This actually can lead our patients with significant scoliosis to have significant fatigue during the day, and this affects their ability to function and engage in their activities of daily living during the day. That's just one example of many complex medical conditions that Shriners treats and works with our patients and how their sleep can be really affected by their orthopedic conditions predominantly, but also some of the syndromes that are associated with many of our patients.

Host: And in closing, is there anything else you'd like to add that parents should know about sleep issues with their children?

Thuan Dang, MD, MPH: I think the most important thing to recognize in sleep with children is that for adults, when adults are not getting a restful night of sleep, they kind of present as being very tired during the day, falling asleep. And children are actually the opposite. Children are going to be more hyperactive, they're going to have a harder time regulating their emotions.

You'll see more tantrums. So if you're seeing in your child that they're having difficulty concentrating, symptoms or concern that they might be too active, really look at what's going on at night? Are they getting a quality amount of sleep? And if not, talk to your pediatrician about it and let's investigate further because most of the time we can hopefully restore the children's sleep and get them back to growing and developing.

Host: That's very encouraging. Thank you so much for sharing your expertise. I'm sure you helped a lot of parents with this information.

Thuan Dang, MD, MPH: Thank you so much, Maggie, for having me.

Host: Absolutely. Again, that's Dr. Thuan Dang. Shriner's Children's Pediatric Neurologists are able to care for children with medical concerns related to other conditions.

Shriner's Children's treats in orthopedic surgery, craniofacial and plastic surgery, or pediatric rehabilitation. To request an appointment for your child, call 773.385.KIDS. That's 773.385.5437. Or visit ShrinersChildrens.org.