I’m Not Lazy, I’m Sleepy

Sleep Disorders in Children
Written by Alison Johnson
Sleep Disorders in Children and Teens

Lazy, disrespectful teenager. That was the first assumption of many people in Snow White’s life when she began napping in class and constantly dozing off at home, on car rides, mid-homework and even mid-conversation. 

Her mother, Alfreda Williams of Hampton, Va., also worried Snow—her real name–might be depressed after losing her grandparents and father in a short time period. But then Snow’s symptoms grew more extreme, and stranger. She couldn’t stay awake even at loud parties with her friends and had vivid hallucinations, such as seeing spiders with human heads crawling up the walls at school. 

All were signs of narcolepsy, a chronic brain disorder marked by poor control of sleep-wake cycles. Doctors diagnosed Snow, 16, last April after an overnight sleep study at Children’s Hospital of The King’s Daughters, in Norfolk, Va. While medication has helped, Snow still endures bouts of extreme daytime fatigue and struggles to keep her grades up. 

“At least knowing what is wrong with me makes me feel a little better,” Snow says. “It changes your life. It changes how you hang out with your friends, and teachers at school are mean because they don’t understand and don’t try to. Sometimes it’s sad knowing that I will deal with this for the rest of my life.” 

Parents have long dealt with bedtime issues, from sleepless toddlers to sluggish teenagers. What’s changing is a growing awareness of the many medical, behavioral and emotional consequences of truly abnormal sleep, says Dr. Michael Strunc, a pediatric neurologist at CHKD.

Along with narcolepsy, disorders such as insomnia, restless leg syndrome and sleep apnea–pauses in breathing that interrupt rest–all can hit children and their families hard, says Strunc, who is board-certified in pediatric sleep medicine.   

“Sleep medicine is becoming more and more a part of what we do in children’s hospitals,” he says. “Primary care doctors are now much more commonly asking about how kids sleep, when they sleep and if their sleep is ‘normal’, or if kids snore, gasp, wake, wet the bed or have any other unusual episodes.” 

Sleep is critical for body and brain health, hormone balances and immune system function. Disorders can cause hyperactivity or lethargy and disrupt focus, mood, school performance, growth, metabolism and appetite, which can lead to obesity. Many children go undiagnosed or are misdiagnosed with depression or attention deficit disorder. Still others have treatable sleep disorders mixed in with complex medical issues such as autism, epilepsy and Down syndrome.

Statistics vary by disorder. Between one third and half of children who snore regularly–8 to 10 percent of kids do–turn out to have sleep apnea, Strunc says. Narcolepsy, which can first surface in young kids, affects an estimated one in 2,000 Americans, according to the National Sleep Foundation. 

CHKD has established a Center for Pediatric Sleep Medicine and plans to open two new, larger sleep laboratories by year’s end in Norfolk and Chesapeake, Va. Specialized equipment can detect abnormal breathing and brain wave patterns that may appear differently in younger patients.   

Behavioral therapy, adjusted sleep schedules, medication or surgery can transform a child’s life. Removing tonsils and adenoids, for example, can permanently fix sleep apnea by opening up patients’ airways. 

Snow, an aspiring singer and art student, takes medicine to help with nighttime sleep and daytime alertness. As doctors tweak her dosages, the 10th grader is fighting to get back on track academically. “She’s so smart,” Williams says. “This is a person who taught herself Japanese, but she just started to think she was stupid, so why try? Luckily, she has a lot more better days than before we knew what this was.” 

Tips To Help Kids Sleep

Follow a sleep schedule. Ideally, kids should go to bed and wake up at the same time every day, including weekends. If they have trouble falling asleep at night, try cutting out naps. 

Limit light and noise at bedtime. Use nightlights and relaxing “white noise,” such as a fan, and wind down by reading–with an actual book, not an eReader or tablet–for 15 minutes. 

Turn off electronics. Stay away from phones, social media, television and video games in the 45 minutes before scheduled bedtime. 

Exercise daily. Aim for at least 30 minutes of vigorous aerobic exercise a day–just not within two hours of bedtime. Late afternoon, after school, is a great time.

Don’t watch the clock. If kids get anxious about falling asleep easily, hide their clock from sight or let them read until they feel sleepy. Just maintain a regular wake time.

Get a professional opinion. If kids have trouble falling asleep for several months, see a sleep specialist. 

About the author

Alison Johnson

Alison Johnson is a freelance writer who specializes in feature stories on health, nutrition and fitness, as well as biographical profiles. A former full-time newspaper reporter, she has worked for two Virginia dailies and the Associated Press in Richmond. She lives in Yorktown, Va., with her husband and two sons.