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Why Your Child Is Always Tired (And How To Help!)

Sometimes, it’s not that your kid’s sneakily staying up at night.


1. Obstructive Sleep Apnoea (OSA)

This occurs when your child’s airways are blocked during sleep. He stops breathing frequently – as often as once every minute, cutting off precious oxygen supply, which his body needs to grow healthily.

The disorder affects about a fifth of obese kids, who are at a higher risk of getting it because they have more fatty tissue in the throat and neck, which narrows the airways, causing breathing obstruction, explains Dr Theodric Lee from the Division of Paediatric Pulmonary and Sleep at the National University Hospital (NUH).

But most children who suffer from OSA get it because they have enlarged tonsils and adenoids (the patch of tissue sitting at the back of the nasal passage); which is hereditary, says ear nose throat (ENT) surgeon and sleep specialist Kenny Pang, medical director of Asia Sleep Centre. These kids struggle to put on weight because the lack of oxygen at night hampers their ability to grow.

“The brain and body needs oxygen to develop properly. When a child has OSA, he experiences low oxygen levels when he sleeps. This can be detrimental to his development,” adds Dr Pang. 

Watch for signs like loud snoring, accompanied by choking, grunting sounds and gasping for air during sleep. Your child might wake frequently at night, and toss and turn in his sleep, says Dr Pang. Even with sufficient hours of sleep, he appears tired because he does not get enough oxygen.

Get better rest Get help from a sleep specialist right away and don’t bother experimenting with over-the-counter anti-snoring products. “All these won’t work on OSA, because what you apply or put on the outside isn’t going to help,” says Dr Pang. 

Your child might be required to undergo an overnight sleep study known as a polysomnography, says Dr Lee of NUH. During the assessment, he will be monitored overnight in a paediatric sleep lab by sleep technicians and doctors.

“For kids with OSA, surgery to remove the adenoids and tonsils is typically the first-line treatment and is an almost complete cure for the majority of the cases,” says Dr Lee. There are other non-invasive methods like having your child use a continuous positive airway pressure machine, or oral mouthpieces to keep the airways open while he sleeps.


2. Nasal allergies

This condition occurs when your child breathes in particles in the air that he is allergic to. They irritate the nasal passages, causing symptoms like sneezing, itchy eyes and a blocked nose. In Singapore, the most common allergens are house dust mites, pet dander and grass. 

“Kids who have allergic rhinitis, especially the more severe forms, have problems breathing properly when they sleep. This causes poor-quality sleep and can affect how they perform in school,” he says.

Watch for runny, congested noses. Most kids grappling with it also have itchy, watery eyes and might have persistent phlegm, cough or a sore throat. You will also notice that he breathes through his mouth or opens his mouth during sleep, says Dr Pang.

Get better rest About 70 per cent of kids outgrow their nasal allergies by the time they turn 17, says Dr Pang. In the meantime, an allergy test to find his triggers can help you know what to avoid, and relieve uncomfortable symptoms.

Treatments include medications like antihistamines or nasal sprays, but always check with a doctor instead of self-medicating. Having a humidifier in the bedroom might help your child get some respite from his symptoms at night, he adds.


3. Too much artificial light in the evening

Being exposed to bright light from the TV and electronic gadgets delays the body’s circadian rhythm, warns Dr Ignatius Mark Hon Wah, an ENT surgeon at the Ascent Ear Nose Throat Specialist Group. The circadian rhythm is your body’s 24-hour internal clock, which tells you when you need sleep.

Artificial light from computers and electronic gadgets in the late afternoon and evening is particularly disruptive to sleep, as it makes the brain think it is still daytime. In fact, it can delay sleep cycles by as much as six to eight hours and cause children to experience a jet-lag effect.

Watch for If Junior is not getting enough rest, you might find it hard to wake him in the mornings. During the day, he might be irritable, hyperactive 
and have difficulty focusing on tasks, says Dr Pang.

Get better rest Unplug and keep gadgets out of the bedroom, and focus on doing quiet activities at least two hours before bedtime, he suggest. In general, soft yellow light is more conducive to sleep than bright white light, he adds.


4. He does strange things at night 

The lights are out and your little one has been tucked in bed. But after an hour or so, he’s up screaming his lungs out and crying non-stop. Or he might suddenly get up, walk around, or worse, exhibit strange behaviour such as urinating in the cupboard.

Parasomnias like sleepwalking and night terrors, which run in the family, are a relatively common phenomenon among kids, says Dr Lee of NUH. About 15 per cent of kids are estimated to sleepwalk, while up to 6 per cent are thought to experience sleep terrors. But the good news is that most kids outgrow them by the time they reach their teens. 

Watch for any potential danger hotspots around your home. Safety is important if your kid sleepwalks or bolts out of bed during a night terror. “Prevent injuries by modifying your home, like installing gates at the top of the stairway, locking doors and windows,” advises Dr Lee.

Get better rest Stress and changes in sleep schedules, such as during a holiday or the start of a school term, can trigger an episode. Having regular bedtimes and getting enough sleep can help reduce the frequency of sleepwalking or night terrors, 
he says.

It’s important that you never wake your child during an episode. “He is likely to be very disoriented if awoken. It is also unhelpful to discuss the event with him the next day, because he will not remember what happened,” adds Dr Lee.


By Young Parents, 26 January 2016


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