​Dr. Shanah Salter
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Medical Articles For
Parents & Caregivers

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​A health-related blog for parents and caregivers of young children,
with Australianisms thrown in for good measure!

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​Back in Australia, the Land Down Under, I worked as a family physician treating snake and spider bites, colds and flus, and everything in between. Well, perhaps the snake bites are a slight exaggeration, but the spider bites are actually true. 

Now that I live in the U.S.A, I've exchanged clinical practice for blogging. So please read on and enjoy my chinwag (Aussie for chat) about all things health-related.
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P.S. If there are any topics you would like to see covered, just give me a bell (Aussie for call/contact).

Sublime Slumber

4/28/2017

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Ever wondered if striving for sublime slumber matters? Bloody oath* it does!

Why sleep matters
Poor quality sleep and/or an inadequate amount of sleep leads to:
  • Daytime sleepiness and irritability
  • Reduced concentration and attention -> learning difficulties
  • Hyperactivity (sleep-deprived kids may be misdiagnosed as ADHD)
  • Inadequate growth and cardiovascular problems (due to apnea- see below)

How to ensure a sublime slumber for your bub*
  • Make sure your child is getting an age appropriate amount of sleep. For 3-5 year olds this is 10-13hours of sleep/24 hours (including naps). Adults need 7+ hours/24 hours.
  • Don’t be fooled into thinking your child needs less sleep if they are hyperactive, stroppy*, feral* larrikins* at bedtime or wake overnight- this likely indicates they are overtired and need MORE sleep (try putting them to bed 20minutes EARLIER than usual)
  • Ensure consistent sleep and waking times
  • Have a set routine/wind-down sequence in the 30-45 minute interval before bed e.g. bath, pajamas, teeth, stories (no screen time or wild play)
  • Bedroom should be dark (black-out curtains are great!) and cool (ideally 68-70 degrees)
  • Discourage early rising by use of a clock or an okay-to-wake device that changes color when it is an acceptable time for the child to get up

Snoring
Snoring is defined as a noise caused by partial blockage of air passage through the back of the mouth when inhaling.
Occasional snoring can be a sign of an allergy, stuffy nose or respiratory infection.
Loud and regular snoring is often ABNORMAL in an otherwise healthy child and must be investigated. OBSTRUCTIVE SLEEP APNEA may be the cause.

Obstructive Sleep Apnea
Refers to a condition of intermittent airflow blockage during sleep. In its most severe form it can impact oxygen flow to vital organs such as the heart.
It is estimated that 3-12% of children snore while 1-10% of children have sleep apnea syndrome.
The most common cause of sleep apnea in children is enlarged adenoids/tonsils.
Untreated, sleep apnea leads to reduced growth, bedwetting, attention disorders, behavioral problems, poor academic performance, and heart/lung problems.
Symptoms:
  • Snoring
  • Mouth breathing and sucking in ribcage when inhaling during sleep
  • Unusual sleep position e.g. head tilted right back/neck hyper-extended
  • Chronic bed-wetting
  • Complaining of morning headaches
  • Feeling tired/flaking out* or needing a kip* (once naps given up) during the day
  • Issues with hyperactivity/inattention at school
  • Frequent overnight waking and night terrors
  • Gasps, pauses in breathing, and snorts during sleep

Diagnosis:
If your child is a frequent/nightly loud snorer please alert your pediatrician so they can consider a sleep apnea assessment. The assessment usually includes a questionnaire (asking about symptoms), review by an ENT/sleep specialist and an overnight sleep study.
Treatment:
Treatment depends on the cause of apnea. In children, adenoid/tonsil removal is usually all that is required. Weight loss (if severe obesity), jaw devices, and/or ventilation (CPAP) machines are used in some instances.

Further Reading
http://sleepfoundation.org
http://sleepcenter.ucla.edu/child-snore

*Australianisms
Bloody oath- certainly/absolutely
Bub- baby/child
Feral- wild
Flake- collapse from tiredness/fall asleep
Kip- nap
Larrikin- mischievous/wild person
Stroppy- irritable





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