As a sleep consultant, I’m in the business of helping families sleep better. In most cases, I can help. But in some instances, the root cause of the child’s sleep issue isn’t something I can help with, because there may be something going on medically.
How do I know which is which??
Well, I’ve been trained to screen for certain things and if I see any red flags, I will refer potential clients out before we even start working together.
Other times, though, I see it from sleep patterns we’re tracking, and I will refer a family out if I come across something that doesn’t seem quite right to me.
What other medical issues could be interfering with your child’s sleep?!
We’re going to get into a few today.
Iron and Magnesium Deficiencies
Iron is the single most common nutritional deficiency worldwide. Did you know that 20-25% of children have Iron Deficiency Anemia (IDA), and just as many have iron deficiency without anemia?
If you suspect this could be your child at all, it’s not a bad idea to get their iron levels checked with a blood panel. Make sure you ask for a complete blood count (CBC), hemoglobin levels, blood iron levels, and ferritin levels to be checked. It’s difficult to know how deficient your child is and how much to supplement without having the blood tests done, so make sure you start with this step.
This is also one of those things you don’t want to “wait and see” – in this study, researchers found that 4-year-olds who had IDA as infants showed altered sleep patterns throughout the night, even if they weren’t anemic anymore.
After digging a little deeper in this study, they found
“Former IDA children showed a higher number of REM sleep episodes, statistically significant in the first third and a suggestive tendency in the third, whereas they showed fewer REM sleep episodes in the second third of the night. In addition, the first sleep cycle in former IDA children differed markedly relative to controls. The latency to the first REM sleep episode was shorter, the episode tended to be longer, and the episodes of NREM2 and SWS were shorter.”
In normal sleep patterns, the first third of the night is where we see more deep sleep cycles occurring and less REM cycles. Deep sleep is where cell repair and restoration take place, growth hormones are released, and your immune system ramps up, so it’s incredibly important that children who are growing and developing are not missing out on these cycles.
Typically, REM cycles are more frequent in the second half of the night and the early morning hours. This is when your brain does a lot of the work consolidating memories and pruning what it no longer needs.
There are mixed findings on whether supplementing with magnesium helps improve sleep quality, so more research is needed in this area, but magnesium deficiencies can be common.
Magnesium is a mineral that helps with an array of systems in the body, but one to note as it relates to sleep, is the nervous system. It’s needed for more than 300 biochemical functions in the body at the cellular level, so, as one might imagine, having a magnesium deficiency likely means your body is out of whack since it’s utilized in so many different functions.
According to integrative medicine specialist Naoki Umeda, MD, magnesium may “help regulate neurotransmitters that are directly related to sleep.” Circling back to its effects on the nervous system, magnesium can help calm the muscles in the body and can improve symptoms of Restless Leg Syndrome.
Restless Leg Syndrome
Restless Leg Syndrome keeps many people up at night, and some believe it’s due to a magnesium deficiency. We don’t know the actual cause of RLS.
It’s actually diagnosed from a doctor’s evaluation and a description of the patient’s symptoms. Babies, who are nonverbal for at least the first 6 months or so of their lives, cannot describe what they may or may not be feeling when they lay down in their crib at night. So, guess who is never diagnosed with RLS? Babies. That doesn’t mean they don’t have it…just to give you something to think about!
In this study, researchers found that iron supplementation seemed to help with symptoms of sleep disorders, including Restless Leg Syndrome.
From a 2019 systematic review where eight studies with relevant data were found (from 855 articles), researchers found that “it is not clear whether magnesium helps relieve RLS or PLMD or in which patient groups any benefit might be seen.” So, as with much research in the field of sleep, more research is needed.
Sleep Apnea, Adenoids, or Tonsils
Defined by Mayo Clinic, “pediatric obstructive sleep apnea (OSA) is a sleep disorder in which your child’s breathing is partially or completely blocked during sleep. The condition occurs when the upper airway narrows or is blocked during sleep.”
Causes of this upper airway dysfunction can include enlarged adenoids or tonsils, underlying factors such as birth defects affecting the shape or structure of the face or head, or other disorders that affect muscle and nerve function.
From a 2016 article published in Current Problems in Pediatric and Adolescent Health Care, titled “Consequences of Obstructive Sleep Apnea in Children,” Belchner and Williamson report:
“OSAS may cause or worsen obesity as well. Sleep fragmentation and decreased quantity of sleep results in daytime sleepiness, which can limit physical activity. It may also alter metabolic hormones including leptin and ghrelin. Leptin is produced by adipocytes and is a satiety-producing hormone whose effects are mediated in the arcuate nucleus of the hypothalamus. Ghrelin is produced by cells in the stomach and is an appetite stimulating hormone. Both are believed to play a role in body weight regulation. With sleep deprivation, there is a significant decrease in levels of leptin and an increase in levels of ghrelin. It has also been shown that with sleep restriction, there is an increase in hunger and appetite, especially for carbohydrate-rich foods.”
In some cases, you may observe snoring, snorting, pauses in breathing, mouth breathing, and bedwetting. If your child is older, they’re waking and not feeling rested, they’re struggling with behavior and you’ve observed these symptoms, it’s definitely possible they have OSA and a sleep study should be completed to get a diagnosis. Then, a plan of treatment will be put into place.
Why would you want to treat this? Well, sleep is a pillar of our health and wellbeing as human beings. OSA has significant morbidities that affect the cardiovascular, neurocognitive, and metabolic systems. It basically affects many areas of your child’s life and should be addressed accordingly.
Did you know that 10-20% of all children have eczema? And of those, up to 83% have difficulties falling and staying asleep during flare ups, which doesn’t help the situation.
From a 2010 study in the Journal of Clinical Sleep Medicine, researchers found that, “compared to controls, children with eczema had a greater number of sleep problems with a greater percentage in the clinical range, lower quality of life, and higher levels of ADHD and oppositional behavior. They also had elevated rhinitis and asthma severity scores.”
If you’re a parent of a child with eczema, it’s imperative that you do what you can to keep it under control and prevent flare ups. I know, easier said than done.
Dennis Rosen, MD, shares more about how you can help your child get better sleep even when they’re experiencing a flare up. Not so coincidentally, a lot of what he recommends, I recommend for ALL children to get a better night’s sleep, not just those with eczema.
And if you find that your child’s sleep issues aren’t medically related, then I’m here to help you!
You can learn more about how I work with families here.