A sleepless child means your house also has at least one sleepless parent—and maybe suffering siblings as well. If your child struggles with sleep, snores, exhibits symptoms of excessive daytime drowsiness—or, conversely, is hyperactive during the day—he or she might benefit from an overnight sleep study.

A night spent in a lab, hooked up to wires, might not sound like much fun (especially for those already short on sleep). But rest assured, our Yale Medicine pediatric sleep specialists are highly experienced at putting even the most over-tired (and grumpy) children at ease.

We have two state-of-the art, pediatric-only sleep labs, one located at Yale New Haven Children’s Hospital and the other at Bridgeport Hospital. Parents can sleep in a bed alongside their child if they like, too.

“We have been providing pediatric-specific, family-centered care for children who need their sleep assessed and treated for 20 years,” says Yale Medicine’s Craig A. Canapari, MD, director of the Pediatric Sleep Medicine Program. “Our laboratory is accredited by the American Academy of Sleep Medicine and our technicians have extensive experience working with children to make their time with us as pleasant and unintimidating as possible.

We offer overnight sleep studies, or polysomnograms, to children of all ages—infants through teenagers. Through the various tests performed during the night, we check for a number of conditions, including obstructive sleep apnea, in which breathing repeatedly stops and starts during sleep. In children, obstructive sleep apnea, or OSA, is often caused by enlarged tonsils or adenoids.

But before a sleep test is done, most children start with a visit to a pediatric sleep specialist. Dr. Canapari is board-certified in pediatric sleep medicine and pediatric pulmonology.

“Sleep problems are very common in childhood. Up to 40 percent of parents come to their child’s pediatrician with concerns about their child’s sleep,” Dr. Canapari says. “We treat a variety of respiratory and non-respiratory sleep disorders, from insomnia to restless leg syndrome to obstructive sleep apnea to complications from neuromuscular disease.”

Issues that may prompt a visit to a pediatric sleep specialist include: 

• Trouble falling asleep
• Waking up during the night
• Difficulty waking up in the morning
• Daytime sleepiness
• Loud snoring
• Hyperactivity

 Additional reasons for a sleep study include: 

• Monitoring of continuous positive airway pressure (CPAP) machine, which improves airflow during sleep
• Determination of respiratory needs for oxygen and ventilator support
• Infants with apparent life-threatening events (when parents are worried about the breathing of their baby)
• Pre- and post-operative evaluation for sleep problems related to scoliosis, spina bifida, cleft palate, and other neurosurgical and craniofacial disorders
• Restless leg syndrome
• Respiratory complications of neuromuscular disease
• Sleep disturbance including parasomnias (sleep walking, night terrors, nightmares, bedwetting)

In some cases, home sleep testing equipment and daytime monitoring devices might be an option. These can be useful to evaluate whether a child has narcolepsy or certain other conditions.

You and your child will arrive at one of our sleep laboratories around 7 p.m. We have three private bedrooms, which are cheerfully decorated. Our friendly staff will make your child comfortable with a TV show or movie to watch.  

Once your child is settled, we will begin applying the monitoring equipment. This includes sensors on the face, arms, legs and stomach to study brain and muscle activity. We also place small plastic prongs in your child’s nose to measure airflow during exhalation. It takes about an hour to get everything right and often, by the time we are done, your child falls asleep easily.

The tests we run throughout the night include:

• Electrocardiogram (EKG): This monitors heart rate and checks for any abnormal heart rhythms.
• Electromyography (EMG):This tracks REM sleep and measures muscle movement to assess for restless leg syndrome, a disorder characterized by unpleasant sensations in the legs and an irresistible urge to move them.
•  Electroencephalogram (EEG): This measures sleep stages and looks for abnormal brain activity, including seizures, during sleep.
• Breathing test: This looks for respiratory problems, including issues with chest and abdominal movements, and airflow through mouth and nose, which can help doctors diagnose sleep apnea.

As this information is captured, it is monitored by a technician sitting at a computer outside your child’s room. Most studies are completed by 6 or 7 a.m. Results are available two weeks after the study, and will be fully explained to you during a follow-up appointment with one of our physicians.

Treatment options for sleep disorders vary based on your child’s diagnosis. If the sleep study indicates restless leg syndrome, for example, we might follow up with a blood test to measure iron levels. Low iron levels are often associated with restless legs. If that is the case, a simple daily supplement for a few months might bring their iron levels to an appropriate level and you can stop supplementing.

If your child has obstructive sleep apnea related to enlarged tonsils, we will provide a referral to one of Yale Medicine’s pediatric ear, nose and throat surgeons to talk about possibly removing the tonsils and/or adenoids. If the tonsils or adenoids are not the cause of apnea, your child may benefit from the use of a CPAP machine.

Few places in the state have pediatric-only sleep laboratories, and Yale has two: one at Yale New Haven Children’s Hospital and the other at Bridgeport Hospital. Both are staffed by highly trained pediatric sleep specialists who are not only skilled at obtaining the data they need, but also at putting children at ease.

We also collaborate closely with our colleagues in Yale Medicine Pediatric Otolaryngology (ear, nose and throat), along with other pediatric specialists to ensure that every child is receiving the multidisciplinary care that will help solve his or her specific problem.