The National Institute of Health (NIH) estimated that approximately 12-15% of all students sitting in the classroom have a significant sleep disorder, such as sleep apnea, that is negatively impacting their academic progress, behaviors, social-emotional development, health, and/or safety (National Institute of Health Research & Grant Website, 2001). Therefore, it is important to screen and identify children who have any sleep problems and get them corrected immediately because of this negative impact on school performance and health.

There are new and exciting medical research findings showing significant improvements in students' IQ, grades, and behaviors after pediatric sleep disorders are corrected, and most pediatric sleep disorders are correctable. Here are a few interesting studies showing the importance of identifying children with pediatric sleep disorders and getting the disorder corrected:

1. Friedman et al., (2003) studied the relationship of mild-to-moderate Obstructive Sleep Apnea Syndrome (OSAS) on neurocognitive functioning (IQ) by comparing 27 Israeli children (mean age 6.8 + 0.2) with OSAS to 20 Israeli children in the control group without OSAS (mean age, 7.4 + 1.4 years). The Kaufman Assessment Battery for Children (K-ABC) was used to measure cognitive functioning, which is an intelligence test frequently used in the Israeli population. Before correction of the pediatric sleep disorder, the students with OSAS had significantly lower IQ scores than the children without a pediatric sleep disorder. However, within six-to-ten months after correction of the sleep apnea, these students gained 11 IQ points compared to only a 2-point gain for the group without sleep apnea. The students whose OSAS was treated and corrected caught up with the control group having normal sleep patterns.

2. Gozal (1998) found that 18% of the lowest achieving first graders in a New York sampling had Obstructive Sleep Apnea Syndrome (OSAS) or Sleep Disordered Breathing (SDB). After the obstructive sleep apnea was corrected, these students' grades improved significantly compared to no improvement in grades for the students' whose sleep apnea was not corrected.

3. In studies conducted at Johns Hopkins Pediatric Sleep Clinics and Stanford Sleep Disorders Clinic, Luginbuehl et al. (2003) reported significant gains in students' Grade Point Average and a significant decrease in behavior problems (aggressiveness, impulsivity, withdrawal, irritability, opposition/defiance, depression, moodiness, tantrums, distractibility, and frustration) 1-2 years after the children's sleep problems and pediatric sleep disorders were corrected. These sleep disorders were Obstructive Sleep Apnea Syndrome, Narcolepsy, Periodic Limb Movement Disorder or Restless Legs Syndrome.

4. A recent study of 25 children with OSAS and a psychiatric diagnosis of Disruptive Behavior Disorder (DBD) was conducted to measure behavioral improvement after correction of the OSAS (Garetz et al., 2004). DBD included either a diagnosis of ADHD, Conduct Disorder, or Oppositional/Defiant Disorder. These children were assessed by a psychiatrist after adenotonsillectomies were completed to correct the Obstructive Sleep Apnea. Twelve of the parents reported that their children's obstructive sleep apnea had been corrected after surgery, and 13 parents reported continued obstructive sleep apnea problems at night that had not been corrected with surgery. One year after surgery, psychiatrists (who did not know the outcome of surgery) reported that the DBD behaviors in the corrected obstructive sleep apnea group had disappeared in contrast to no improvements in DBD behaviors for the children who continued to experience obstructive sleep apnea at night. Similar findings have been reported for correction of other children's sleep problems and major pediatric sleep disorders. The possibility of children's sleep problems or a pediatric sleep disorder needs to be ruled-out with all children exhibiting learning problems or features of ADHD, DBD, Depression, or other Mental Health Disorders.

There are Five Main Sleep Disorders that Parents & Professionals Need to Screen For in Children/Students:

1. Obstructive Sleep Apnea Syndrome (OSAS) - Obstructive Sleep Apnea is an obstruction partially blocking the air passages during sleep which causes either a belabored effort to breathe, or an absence of breathing for at least two respiratory cycles. If this occurs frequently during sleep, it may result in either waking the person from deep, restful sleep, or causing a deficit of oxygen reaching the arterial blood flow and brain. Obstructive sleep apnea negatively affects the student's daytime functioning (concentration, work production, moods, academic and behavioral performances). It also causes many accidents and car wrecks due to sleepiness, etc. It can cause many health problems such as SIDS, lowered cognitive functioning, high blood pressure, heart attacks, strokes, etc.

About 2-3% of all children and possibly a higher rate of teens have Obstructive Sleep Apnea. The incidence rate increases to about 7-8% in older men and about 4% in older women.

2. Narcolepsy (NARC) - is a sleep disorder that usually appears between 9-and-18 years of age or early adulthood and consists of recurring episodes of sleep during the day (sleep attacks) and often disrupted nocturnal sleep. It is frequently accompanied by cataplexy (loss of muscle control when laughing, crying, angry, etc.,), sleep paralysis (inability to move for a few seconds to minutes when awakening), and hypnagogic hallucinations (frightening dreamlike hallucinations when awakening or falling asleep). The person experiences excessive daytime drowsiness, or falls asleep at inappropriate times (in class, church, while talking to someone, while driving a vehicle, etc.).

The prevalence rate in the USA is about 1 in 2000, but could be higher due to frequent misdiagnoses as mental health disorders (depression, psychosis, ADHD, etc.).

3. Periodic Limb Movement Disorder (PLMD) - is a children's sleep problem or sleep disorder characterized by the periodic (every 20-40 seconds) and sustained (0.5-4.0 seconds in duration) contractions of one or both front leg muscles often causing unperceived arousals from light or deep sleep. These contractions result in repetitive jerks for about 2 seconds of the toes, feet, legs, and/or thighs which often occur in stages 1 and 2 of NREM sleep and disrupt the quality of sleep. There is a strong correlation between children's sleep problems like PLMD and ADHD in children, and some sleep specialists believe that it is PLMD or Restless Legs Syndrome causing the ADHD symptoms. They suspect this because when the PLMD is corrected with medication taken before bedtime (often Neurontin or Mirapex), the daytime ADHD behaviors diminish significantly or disappear.

4. Restless Legs Syndrome (RLS) - is an adult and pediatric sleep disorder or a frequently occurring leg movement disorder where the child experiences uncomfortable searing or tingling leg sensations causing irresistible urges to move the legs. These uncomfortable sensations begin, or become worse, when the child sits or lies down at night, and they are partially relieved by leg movements which can disrupt sleep. RLS frequently occurs together with PLMD (about 60-80% of the time).

The childhood incidence rate for PLMD and RLS are unknown at this time because it is a newly discovered pediatric sleep disorder. If PLMD exists, it is often misdiagnosed as ADHD in children instead of a pediatric sleep disorder. In adults, PLMD and RLS increase with age. Some incidence rate surveys have reported 9-to-15% of the adult population has either PLMD or RLS, or both together. In adults over 60 years old, the rate may increase to 34%.

5. Delayed Sleep Phase Syndrome (DSPS) - It is a children's sleep problem or a circadian rhythm disorder and form of insomnia, which is very common in adolescents. It appears to be caused by biological changes in puberty, which are influenced by sleep habits and hygiene. Some adolescents' circadian sleep clock is longer than the typical 24 hour daily cycle. DSPS usually begins with a tendency for the teenager to stay up later on weekends or during summer vacation, and then sleep in late, or take afternoon naps. As a result, the circadian sleep cycle and melatonin production, which promotes sleep onset, gets delayed until after midnight. When school starts again, the teenager cannot shift their circadian sleep rhythm back to an earlier sleep/wake time and oversleeps in the morning, resulting in tardiness or absence in early morning classes. If the student makes it to the early classes, then s/he is often very tired or sleeps through these classes. The incidence rate in adolescents is at least 7 %. Unless this problem is corrected, many of these students make poor grades, fail, and/or drop out of school. There are many helpful home interventions for this problem that can be obtained in the screening report if you screen your child/teen for this children's sleep problem.

ADULTS:

6. Insomnia - It is very common sleep disorder for adults, especially people over 40 years old, to start having difficulty with insomnia, especially the type where they awaken between 3 - 6 a.m. and cannot go back to sleep. Then they are tired in the afternoon and want to nap. It appears to be due to the body gradually decreasing the amount of melatonin it produces after the age of 25 years in some people, especially women, with a major decrease after 40 years of age. It is the melatonin that helps people fall asleep and stay asleep for 7-to-8 hours at night.

The incidence rate is high in people over 40, but not definitely known due to many misdiagnoses such as depression. This sleep problem is usually easy to correct by taking non-addictive Melatonin supplements or Unisom, which can be purchased over-the-counter at grocery or drug stores.

If you have concerns that your child or teen has any of the five pediatric sleep disorders mentioned above, CLICK HERE to screen him/her for these children's sleep problems or sleep disorders and receive suggestions of interventions or treatment for your child's sleep problems. This Sleep Disorders Inventory for Students (SDIS) is designed for children between 2-and-19 years of age. This Sleep Disorders Inventory for Students (SDIS) is designed for children between 2-and-19 years of age.

If your Child has Academic or Behavior Problems, it could be caused by a correctable Pediatric Sleep Disorder.