Sleep Blog

For most children and teens, the beginning of a new school year is just around the corner. Not only will they be hitting the books again after a three-month-long summer break, but many of them will also participate in after-school activities.

Research over the past few years has shed light on a serious problem affecting student-athletes nationwide: the number of children and teens who are considered obese is rising. According to the American Academy of Sleep Medicine (AASM), obesity raises the risk of cardiovascular disease and other health problems, but it also increases the likelihood the person will develop obstructive sleep apnea.

William Kohler, MD, medical director of the Florida Sleep Institute in Spring Hill, director of pediatric sleep services at University Community Hospital in Tampa, and an pediatric sleep physician, warns that the health problems brought on by obesity should serve as a wake-up call, to not only student-athletes and their parents, but also to their instructors and coaching staff.

"Apnea can increase the risk for stroke, diabetes and cardiovascular disease," says Dr. Kohler. "When the child or teen puts on weight, the throat can narrow, and anything which narrows the posterior pharynx can lead to the development of sleep apnea. It’s is a serious disorder that can be harmful, or even fatal, if it is not recognized and treated."

Clinically, apnea is when a person stops breathing for a period of 10 seconds or longer at least 15 times per hour. This can happen hundreds of times each night, leading to disturbed sleep. This often results in excessive daytime sleepiness, in both children, teens, and adults.

Children or teens who are chronically tired may have cognitive, attention or behavioral problems, whether in the classroom or on the playing field, says Kohler, adding that they may be irritable or cranky or have ADHD.

Kohler notes that sleep apnea symptoms may prevent a student-athlete from participating in a critical game or deter the ability to perform well in individual or head-to-head competition. More importantly, for life issues, undiagnosed and/or untreated sleep apnea can lead to poor academic achievement. Aside from social and societal issues, not to mention economic issues in the workplace when the teen is older, it can also make a student ineligible to compete in after-school activities, Kohler noted.

"Parents need to watch for signs of sleep apnea, such as snoring, morning headache, morning dry mouth, and excessive tiredness," he said. "It’s important for the parents of a child or a teen who may have apnea to discuss the concerns with a sleep specialist. From there, appropriate action can be taken to evaluate, diagnose, and, if necessary, treat and manage the sleep apnea or any other kind of sleep disorder."

Upon meeting with a sleep specialist, the patient will discover that there are safe and effective treatments for those diagnosed with OSA. Scientific evidence shows that continuous positive airway pressure (CPAP) and bi-level positive airway pressure (often mistakenly referred to as BiPAP, a trademark name of a specific line of PAP devices from Respironics) are the best treatment for apnea.

CPAP and bi-level/BiPAP devices provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels.

Several recent studies that outline the adverse effects of sleep apnea and other sleep problems among children and teens with regard to athletic and academic performance, including:

• Students with symptoms of sleep disorders are more likely to receive bad grades in classes such as math, reading and writing, and also perform poor athletically, than peers without symptoms of sleep disorders.
• The brain responses of those children and teens who don’t get enough sleep can accurately predict the impact sleep loss has on their ability to pay attention during the course of a day, in both the classroom and during an athletic contest.
• Research examining the impact of sleep in children and teens suggests that even mild sleep loss produces marked deficits in their ability to comprehend and disseminate the information critical to their success in school or as a participant in a sporting event.
• Aggressive behavior and bullying, common among schoolchildren, are likely to have multiple causes, one of which may be an undiagnosed sleep-related breathing disorder.
• Over the past decade, children and teens have been going to bed later and sleeping less. This can be attributed, in part, to a lack of awareness in the community concerning sleep need in children and teens and how the amount of sleep a child should get each night is dependent on one’s age.

Kohler offers the following tips for children and teens on how to get a good night’s sleep:

• Follow a consistent bedtime routine.
• Establish a relaxing setting at bedtime.
• Get a full night’s sleep every night.
• Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
• Do not stay up all hours of the night to "cram" for an exam, do homework, etc. If after-school activities are proving to be too time-consuming, consider cutting back on these activities.
• Do not go to bed hungry, but don’t eat a big meal before bedtime either.
• Avoid any rigorous exercise within six hours of your bedtime.
• Make your bedroom quiet, dark and a little bit cool. Also, keep computers and TVs out of the bedroom.
• Get up at the same time every morning.

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