Pediatric Sleep Lab
What is "pediatric sleep lab"?
A sleep lab is a place where children come in overnight, or for a sleepover. That's what we like to tell our kids; you're going to come for a sleep over, a special place where you'll come and sleep with Mum or Dad, and what they do is we connect them to a whole bunch of sensors to record a bunch of things. So what are they? Well, we put sensors on the head to look at brain waves, and that helps us to see what sleep state stages that they're in. We have sensors that look at eye movements, and they go on the eyes. We have sensors that go under the chin to look for muscle movement because during certain sleep stages some muscles are more active than others. We measure heart rate. We have belts that go across the chest and the stomach, so we can see when you breathe, we can record your chest movements, and we can record your stomach movements, because there are implications to how they move; whether they move in synchrony or whether they move opposite each other. We have sensors that go on the legs that look for movements of the legs. We have a number of sensors that go under the nose, which measure carbon dioxide levels or measure the flow of air. We happen to have a sensor that measures air flow, and gives us different information about air movement. This all gets imputed into a computer programme, and we're able to look at all those things in tracings. Some of the other things we have are microphones. We have microphones in the room so we can hear snoring. So, we look at breathing related information on the computer to see if a child is having problems with breathing, and we can look at snoring. We can look at how the chest moves in relation to the stomach. We can see how it affects sensors that we use to measure oxygen levels in the blood; those carbon dioxide levels. By looking at all the data that comes in, we're able to look at breathing issues and we're able to look at sleep cycles, and it's like piecing a puzzle together to identify what the problem is. If we are suspecting that a child has sleep apnoea, then we will look at the data and we're able to measure the severity of the sleep apnoea. If the problem is that the child is waking up frequently at night, and we're not sure if these are seizures or whether these are parasomnias, we're able to look at the behaviour of the child, because in addition to all the connections we have, we also have the camera and we're able to video the child throughout the study. So, we can also look at their behaviour, and be able to dovetail that with the data we see on the computer. So, a sleep lab is a really great way of looking at sleep in a very comprehensive manner to assist making diagnosis.
How do I know if my child needs to go to a sleep lab?
Well the first thing is to identify that your child has got a sleep problem. Because the majority of sleep problems in children are behavioral related. Usually it's useful to get a good history to figure out 'is this behavioral or is it not?' Now, some children may present to the ear, nose and throat doctor or the pulmonologist they have pulmonary problems, the parent may say 'my child is snoring.' The ear, nose, and throat doctor might look in their mouth and say, 'gosh, these tonsils are gigantic, they're huge' and then they might want to rule out obstructive sleep apnea. And so that would be an indication of referral for a sleep study. Sometimes when you see a child with a sleep problem and you can't really figure out, is this behavioral, could this child be waking up because of seizures, could this be parasomnia, could this child be waking up because of leg movements? Then you'd want to bring them into the sleep lab to do a study.
What is the most common reason for a child to attend a sleep lab?
A child may need to attend a sleep lab to carry out sleep studies, most of which regarding children are because of difficulties with breathing. They either present with snoring at night or the parents observe that they actually stop breathing. So, breathing-related problems in sleep are the most common reason why kids have sleep studies. The numbers of kids who have breathing problems when they sleep vary. It's probably between three and five percent of the child population. It can occur at different ages; from very young ages, from six months, right up into adulthood. There are a variety of reasons for them to have those problems; the most common in children is usually enlarged tonsils and adenoids.
