Dagnachew Assefa, MD

Sleep Center Specialists

Neha Athale, NP
Mary Montague, FNP
Valerie Vitale, NP

Prepare for the study as if it were an overnight sleepover at a hotel, bringing with you toiletries, snacks and any medications your child may need to take. Parents should pack their child’s favorite comfort items like a special blanket, pillow or stuffed animal. Plan to bring things to keep your child entertained while the sleep study equipment is being placed such as books, toys or personal electronic devices. Try to keep your child’s sleep habits as close to normal as possible on the day of the study.

Please bring to your appointment:

• Registration materials as directed
• Current health information card(s) for the patient
• Proof of identification
• Copay, if applicable

Once you arrive, you’ll check in and fill out some paperwork and our sleep technologist will measure your child’s height, weight and blood pressure and take you to your sleep lab room. Then you will help your child get ready for bed including changing into pajamas and brushing their teeth. The technologist will then apply the sleep study sensors. They may need you to help comfort and entertain your child during this process. Finally, they will put your child into bed to start the sleep study. The technologist will monitor your child throughout the night and may need to come into the room to adjust the sensors.

Although your child’s sleep may not be the same as it typically is at home because of the sensors and the sleep lab environment, our sleep physicians take that into account when interpreting the sleep study data.

Results of the sleep study are usually available in two to three weeks. If your sleep study was ordered by your provider, not a Sleep Center provider, we will send the results to your doctor so please contact your doctor to discuss the study results.

Pediatric Sleep Services

We offer thorough evaluations and treatment of sleep-related problems that are unique to pediatrics. Our sleep laboratory is staffed by licensed and registered technologists experienced in conducting sleep studies for children and adolescents, and all our sleep studies (also called polysomnograms) are interpreted by pediatric sleep specialists. At Inova Children's Sleep Center, sleep studies are 30 – 40% longer than most adult studies, which makes them more comprehensive. Our state-of-the-art equipment enables us to measure more features of sleep with increased accuracy.

Inova Children's Sleep Center provides consultation and follow-up care on the full range of pediatric sleep disorders including:

• Sleep-disordered breathing (snoring, obstructive sleep apnea)
• Restless legs syndrome (Willis-Ekbom)
• Periodic limb movement disorder
• Circadian rhythm disorders including delayed sleep phase syndrome
• Narcolepsy
• Parasomnias including sleepwalking and night terrors
• Insomnia, including behavioral sleep problems with difficulty falling asleep and frequent night waking
• Sudden infant death syndrome (SIDS)

In addition to diagnostic polysomnograms and multiple sleep latency tests, we offer polysomnography with continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP) and oxygen titrations; measurement of end tidal carbon dioxide levels; transcutaneous carbon dioxide monitoring; and actigraphy. We also offer PAP desensitization, management and compliance programs.

Sleep Apnea in Children

Sleep apnea is a disorder in which a person's breathing stops and starts. It is potentially serious because not only can sudden drops in your blood’s oxygen levels increase blood pressure and strain your cardiovascular system, but it can also disrupt your ability to get proper sleep.

Sleep apnea affects people of all ages, but 2 – 10% of children suffer from obstructive sleep apnea with varying symptoms and severity.

How do I know if my child has sleep apnea?

Usually the first sign of sleep apnea is loud snoring. However, many children (10 – 20%) experience snoring, and many don’t have obstructive sleep apnea. What you need to look out for is gasping for air between the snoring. You may hear a snore, a long pause, then a louder snore or huge inhale that will sound like a snort. Between snoring, your child may also breathe heavily. It is recommended you check on your child at night. If you suspect they have sleep apnea, you should listen for their breathing patterns and monitor their sleeping position.

Children can show signs of sleep apnea during the day as well. If they have a hard time waking up, are tired during the day and daydream, or have headaches in the morning, it may be a sign of sleep apnea.

Causes of Sleep Apnea

Some causes of sleep apnea in children include:

• Excess body weight
• Family history of obstructive sleep apnea
• Deformities of the airways (throat, mouth or sinus)
• Tendency to sleep in odd positions or with an open mouth
• Certain medical conditions, such as Down syndrome or cerebral palsy

Diagnosing Sleep Apnea

The only way to properly diagnose sleep apnea is through a sleep study. If your child experiences the symptoms above, you may want to schedule a sleep study. The study monitors brain and body functions during sleep that can indicate whether your child has sleep apnea.

Sensors will be placed on certain parts of the child, and the child sleeps in the sleep center overnight. We try to make the child as comfortable as possible and aim to make the sleep study a stress-free experience for both child and parent. The sleep study monitors eye movements, noise, breathing pattern, blood oxygen levels and heart rate.

Treating Sleep Apnea

In many mild cases, lifestyle changes and some medication can help eliminate sleep apnea. The doctor may recommend your child lose weight and make changes to diet, daily activity and sleep routine.

In more severe cases, sometimes removing tonsils and adenoids can help open up the airways and stop sleep apnea. However, if this is not the cause, CPAP therapy may be recommended. With a CPAP, your child wears a mask that covers the nose and mouth. The mask is connected to a machine that continuously pumps air into the child’s air passages during sleep.

If you have questions about sleep apnea, please call Inova Children's Sleep Center at 703-226-2290 or make an appointment with one of our pediatric sleep specialists.

SIDS

Sudden Infant Death Syndrome (SIDS) is an unexplained death, typically during sleep, of a child under one year of age.

Causes of SIDS

The exact cause is unknown, though research suggests that SIDS may be due in part to defects in the area of an infant’s brain that controls breathing and arousal from sleep. Ultimately, there are a combination of physical and environmental factors that influence SIDS.

Physical Factors Include:

• Brain defects
• Low birth weight
• Respiratory infection

Environmental Factors Include:

• Sleeping on the stomach or side rather than on the back
• Sleeping on a soft surface
• Overheating
• Sharing a bed

Other Risk Factors

In addition to the aforementioned factors that impact a child's likelihood of dying from SIDS, there are several other aspects of an infant that make them statistically more vulnerable. They include:

• Age – children are particularly susceptible between the second and fourth months of life
• Sex – males are more likely to die of SIDS
• Race – nonwhite infants tend to develop SIDS more often than white infants
• Prematurity
• Family history – those with family members who have died from SIDS are more likely to die from SIDS themselves
• Secondhand smoke

The mother can also have a significant impact on her baby's vulnerability to SIDS during pregnancy. SIDS is especially dangerous when a mother is under 20 years of age, smokes, uses drugs or alcohol, or has had inadequate prenatal care.

SIDS Prevention

SIDS is impossible to prevent, but there are a few steps that you as a parent can take to lower your infant's risk. We suggest following these safety tips:

• Place your baby on the back to sleep
• Use a firm mattress in your infant's crib
• Reduce the number of items in the crib
• Avoid overheating
• Place the child's crib in your room for six months to a year
• Offer your infant a pacifier without a strap
• Breastfeed for six months or more