Could your child be dealing with a behavioral sleep problem?
Are you having trouble getting your child to go to sleep? Do they refuse bedtimes or get up regularly throughout the night? While this is a common issue for most parents, persistent insomnia in children can affect school performance, mood, and even their health. This is when parents should turn to our board certified sleep medicine physicians in Portland and Astoria, OR, Dr. Radhika Breaden, and Dr. Jennifer Kim for a consultation.
What is behavioral insomnia?
Behavioral insomnia is rather common, affecting around 25 percent of children. Behavioral insomnia is characterized as trouble falling asleep or staying asleep, which has a negative impact on sleep quality for both the child and caregiver.
One of the reasons behavioral insomnia occurs is due to negative associations with sleep, which lead to delays or strategies to avoid going to bed. If your child constantly asks to use the bathroom, to get a glass of water or read another story around bedtime, these are classic signs of behavioral insomnia.
Can teens develop behavioral insomnia?
While this is a common issue for young children, older children and teens may also develop behavioral insomnia for the same reasons: they associate negative thoughts and feelings with bedtime or sleep.
Many of them have anxiety around sleep and not being able to sleep, which leads to a cycle in which their worry about not getting enough sleep leads them to actually sleep less.
How is behavioral insomnia treated?
Since this is a sleep disorder with a behavioral basis, this means that many children and teens could benefit from behavioral interventions and strategies that educate the young patient about effective relaxation techniques, meditative exercises and other stress-relieving habits. We can show your child all of these techniques and strategies to eliminate the association between stress and bedtime.
Furthermore, our sleep medicine doctors will also work with parents to educate them on proper sleep hygiene so that they can enforce bedtimes each night and make sure that their child is practicing good sleep hygiene. Good sleep hygiene habits include,
- Turning off electronic devices before going to sleep
- Creating a warm, dark and quiet environment in which to sleep
- Performing relaxing pre-bedtime activities such as taking a soothing bath
- Reading books and avoiding electronics before bed
- Keeping children’s sleep schedule consistent, even on weekends
Pacific Sleep Program in Astoria and Portland, OR, provides children, teens and adults with the sleep medicine they need to manage sleep disorders and other problems. Call our office today to schedule a consultation for you or your child.
Find out more about restless leg syndrome and how it can be treated.
This sleep movement disorder is surprisingly common, affecting approximately one in ten American adults according to the Sleep Foundation. Restless leg syndrome is a condition that results in sudden and uncontrollable urges to move the legs while at rest. If this is something that’s happening to you our board certified sleep medicine physicians in Portland and Astoria, OR, Dr. Radhika Breaden, and Dr. Jennifer Kim can help you get your symptoms under control.
What causes RLS?
Genetics may play a role, as people with a family history of RLS are more likely to experience RLS symptoms themselves. Low levels of iron may also result in RLS. Certain medications can also trigger symptoms.
There are certain factors that can also increase your risk of RLS. These risk factors include,
- Chronic disorders (e.g. diabetes)
- Age (more common in middle age)
- Gender (women are more likely to develop RLS than men)
What are the symptoms of RLS?
The classic symptom of RLS is an uncomfortable and intense need to move your legs while sleeping or lying down. Symptoms are often worse at night. Along with this sudden urge to move you may also notice a tingling or crawling sensation in your legs. RLS symptoms can range from mild to severe and symptoms can make it difficult for someone to fall asleep or stay asleep. As a result, RLS often leads to poor sleep quality and daytime exhaustion.
When should I see a doctor?
If you are experiencing RLS symptoms regularly and it’s affecting the quality of your sleep then it’s time to consult with one of our sleep physicians. Not only can we diagnose RLS but also we can help manage the condition.
How is RLS treated?
While RLS is not reversible there are ways to manage your symptoms. Sometimes mild RLS symptoms can be reduced through simple lifestyle modifications including,
- Getting regularly exercise
- Soaking in a warm bath at night
- Reducing alcohol and caffeine intake
- Maintaining good sleep hygiene and following a sleep schedule
- Massaging your legs
If RLS is caused by nutritional deficiencies our doctor can talk to you about different supplements to include in your diet. There are also medications that can manage your symptoms.
If you think you’re dealing with restless leg syndrome then call Pacific Sleep Program in Astoria and Portland, OR, today for a proper evaluation. We can work with you to create a treatment plan to reduce uncomfortable RLS symptoms.
If you need to undergo a sleep study find out what to expect.
Has one of our Portland and Astoria sleep medicine physicians Dr. Gerald Rich, Dr. Radhika Breaden or Dr. Jennifer Kim told you that you could benefit from a sleep test, also known as polysomnography? If so, it could be because the symptoms you’re experiencing are warning signs of insomnia, sleep apnea or other sleep disorders. The sooner these sleep disturbances are identified the sooner we can help you get a better night’s sleep. So, here’s what to expect from your overnight exam:
There is nothing painful or invasive about a sleep study. While you will stay in our modern sleep center overnight we will monitor your brain and bodily activity while you sleep. During the test, you will have sensors placed on certain areas of your head and body to measure everything from blood oxygen levels and heart rate and rhythm to body movement and snoring. The electrodes will not cause discomfort or pain.
Bring Your Sleepwear
Just because you are sleeping somewhere new doesn’t mean that you can’t bring along the items that help you sleep. Feel free to bring any personal items that make you feel more comfortable, such as pajamas. We will place the sensors on your body before you go into the room. The private room will be dark and prepped for sleep. Of course, if you have trouble sleeping do not worry. We will still be able to collect the data we need even if you do not get a full night’s rest.
You’ll Have to Wait for Results
The results will not be immediate. We will collect the data and then one of our doctors will need to go through the findings. This can take up to one week or more. We will schedule your follow-up appointment so that we can go through your results and then talk to you about any recommended treatment options if you do have a sleep disorder.
Test for All Sleep Problems
Dealing with frequent morning headaches? Experiencing extreme daytime fatigue despite getting a full night’s rest? These symptoms could be a sign of a sleep disorder. Unfortunately, many people have problems like sleep apnea and don’t even know it. Furthermore, some sleep disorders can affect your health, so it’s important that you seek proper care if you are experiencing difficulty sleeping. A sleep test can help diagnose,
- Sleep apnea
- Circadian rhythm disorders
Having trouble falling or staying asleep? Not feeling rested after sleep? If you are dealing with these issues in Astoria or Portland, OR, then call Pacific Sleep Program today to schedule an evaluation. Call Pacific Sleep Program in Portland at (503) 228-4414 or in Astoria at (503) 325-3126.
Learn more about this sleep disorder that affects nearly 3 million people worldwide.
Narcolepsy is a sleep disorder that is believed to affect around 1 in every 2,000 people in the US. Unfortunately, it’s believed that only about 25 percent of people with this condition have actually been diagnosed and properly treated. From the office of our Portland and Astoria sleep medicine physicians, Dr. Radhika Breaden, and Dr. Jennifer Kim, here’s what you should know about this sleep disorder.
What are the symptoms of narcolepsy?
The most obvious symptom of narcolepsy is excessive daytime sleepiness. Those with narcolepsy will experience daytime drowsiness even after getting adequate total sleep time on a regular basis.
Unlike stereotypical portrayals of narcolepsy in the movies and on the internet, patients with narcolepsy do not typically fall asleep while talking or suddenly slump in the middle of an activity unless their narcolepsy is severe, which is very rare. Instead, most patients with narcolepsy live with their excessive daytime sleepiness during the day and try to control it with caffeine and brief naps whenever they can. However, despite these measures, the sleepiness affects their daily life and function.
Other symptoms of narcolepsy can include sleep paralysis (waking up during the night with the body feeling paralyzed), hypnagogic or hypnopompic hallucinations (seeing visions or hearing things that are not there as you are falling asleep or waking up) although these symptoms may also be noted with other sleep conditions including sleep deprivation and obstructive sleep apnea.
Some patients may also have cataplexy. The term cataplexy describes the loss of muscle control in the head, neck or shoulders or buckling of the knees during a time of intense emotion, such as laughter or surprise. Not all patients with narcolepsy have cataplexy. However, the presence of cataplexy can suggest that narcolepsy is present.
When should I see a sleep medicine specialist for consultation?
If you are dealing with the above symptoms and suspect that narcolepsy may be present, it’s important that you turn to our sleep specialists in Portland and Astoria, OR, to find out what’s going on.
How is narcolepsy diagnosed?
In order to be diagnosed with narcolepsy, our sleep doctors will need to perform certain tests. After a careful history, we may recommend a combination sleep study called a Polysomnogram with Multiple Sleep Latency Test (PSG with MSLT). During a sleep study, we will apply electrodes to the body to record everything from breathing patterns and movement to brain activity while you sleep. If the overnight polysomnogram does not show a clear explanation for the excessive daytime sleepiness, we proceed with the daytime napping test (MSLT) the next day. During the MSLT, a patient will attempt to nap every 90-120 minutes. By observing how rapidly a patient falls asleep and what stages of sleep are noted, Dr. Kim or Dr. Breaden will then determine whether narcolepsy is likely to be present.
The preparation for a PSG with MSLT follows a standardized protocol which includes adequate total sleep time for the weeks prior to testing, the absence or complete treatment of other sleep disorders such as obstructive sleep apnea, the elimination of medications which may affect testing as well as the elimination of caffeine in the two weeks prior to testing.
How is narcolepsy treated?
Your treatment plan will often include medication and lifestyle modifications to help manage your symptoms and help you get more restorative sleep. Dr. Kim and Dr. Breaden will work with you to find the right medication and treatment options to alleviate your symptoms.
You may be prescribed medication to control sleepiness and REM sleep intrusion (sleep/wake cycle). In addition to many traditional wake promoting agents, there are several newer medications that may be helpful in promoting more restorative sleep.
If you, a friend or a family member is displaying symptoms of narcolepsy or any other sleep disorder, a consultation with our sleep medicine team may help to determine the next steps in evaluation and treatment. Call Pacific Sleep Program in Portland at (503) 228-4414 or in Astoria at (503) 325-3126.
Sleep apnea isn’t something that you can just treat on your own—it requires proper evaluation and treatment from board certified sleep apnea doctors in Portland and Astoria, OR, who can determine not just the severity of your sleep disorder but also help you determine the treatment that is right for you.
That's why our sleep medicine team including Dr. Radhika Breaden and Dr. Jennifer Kim are here to provide you with the care you need to understand and manage your sleep apnea.
Symptoms of sleep apnea include
- Pauses in breathing throughout the night
- Gasping sounds while sleep
- Daytime fatigue
- Trouble concentration
- Mental fog
- Increased irritability
- Depressive or anxiety symptoms
- Insomnia or restless sleeping
- Morning headaches
- Waking up during the night to urinate
- Acid reflux/heartburn during the night
- Tooth grinding
Not all patients with sleep apnea have all or most of these symptoms. The symptoms can also vary in severity based on age. For example, in a child, sleep apnea may manifest as issues of attention or hyperactivity. For women, symptoms may include insomnia alone without any other observed symptoms.
In order to determine whether sleep apnea is present, we may consider either home sleep testing or in-laboratory sleep testing (at our clinic). There are pros and cons to both types of testing, which we will review with you at the time of your initial consultation.
Once you’ve undergone a sleep study, the next step is to create a treatment plan for you. This treatment plan will be based on how severe your sleep apnea is as well as other factors, including changes in severity based on position, stage of sleep and other medical conditions you may have. At your follow up appointment, we will review all treatment options including PAP (positive airway pressure), oral appliance therapy, surgery, Inspire neurostimulator therapy, Provent therapy and positional therapy.
Many patients can also benefit from lifestyle modifications that can help reduce symptoms. Certain lifestyle modifications that our sleep specialists in Portland and Astoria, OR, may recommend include,
- Losing excess weight or maintaining a healthy weight
- Quitting smoking
- Avoiding or limiting alcohol, caffeine, and sedatives
While lifestyle changes can reduce the severity and frequency of your symptoms, you may also require additional treatment, depending on the severity of your sleep apnea.
One common treatment option is CPAP therapy, in which the patient wears a mask interface over their nose and/or mouth. The mask is attached to a machine that generates a gentle air pressure to apply just the amount of pressure needed to keep the airways open and to prevent airflow obstruction.
Many patients may also benefit from getting oral appliance therapy. Using a custom-made device that fits over the upper and lower teeth, oral appliance therapy repositions the jaws to prevent the collapse of tissues in the back of the throat.
Surgical options including the UPPP (uvulopalatalpharyngoplasty) in which the uvula and part of the palate are removed, as well as the MMA (maxillomandibular advancement) in which both the upper and lower jaw are advanced forward to provide more airway space. These surgeries are performed by ENT (Ear, Nose and Throat) surgeons.
A newer option for treatment is the Inspire neurostimulator therapy, in which an implantable device has electrodes which stimulate the airway muscles to provider structure and tone during the night. Inspire surgery is used in patients who have moderate or severe obstructive sleep apnea with a BMI (body mass index) of 32 or less.
Other options including positional belts and collars as well as Provent therapy, which are nasal expiratory pressure stickers for the nasal passages that are used predominantly when camping or travelling internationally.
Pacific Sleep Program has two offices to ensure that patients living in Portland and Astoria, OR, get the comprehensive sleep care that they need. If you suspect that you might be dealing with sleep apnea, we recommend that you schedule a sleep medicine consultation with our clinic.
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