My child has Down syndrome. What should I know about his sleep?
For all children, whether or not they have Down syndrome, falling asleep at the beginning of the night, and falling back to sleep after natural night-time waking, is something they have to learn how to do. For some children this comes naturally, for others it is a bit harder. Struggling to settle to sleep, and needing help settling back to sleep in the middle of the night, are problems for many children. The good news is that you can help them to learn these skills. For some children with Down syndrome this may just take longer, just like learning to sit and crawl may take a bit more time.
You may have some idea of what milestones your child has reached. A good way to know what to expect of your child’s sleep is to think about their other developmental milestones. So although your child may actually be 2 years old, perhaps their learning abilities are a little behind this, say 16 months. Your pediatrician may have assessed your child’s “developmental age.’ The good advice given in the age categories on this website are not just about ‘birthday age’ but about learning ability age, too. All children are unique and learn skills at different ages. So, for that 2-year-old it may be helpful to think about what we are expecting of a slightly younger child. However, remember children with Down syndrome still need the same amount of sleep as other children of the same age, so use ‘birthday age’ to find out about that.
Are there any things I should look out for?
There are some sleep problems that are more common in children with Down syndrome. One to look out for is ‘sleep apnea.’ This affects the throat (between the mouth and the voicebox) which is an important passageway for food to get to the stomach, but also air to the lungs. Because this tube is floppy it can block when children sleep, as their muscles relax. Children with Down syndrome have naturally lower muscle tone and a narrower airway, which is why they are more likely to have sleep apnea.
How would I know that my child has sleep apnea?
When children snore, gasp for air and struggle to breathe in their sleep, this suggests the tube may be blocked. This is called ‘obstructive sleep apnea.’ It can happen throughout the night or only at certain times during the night. Often this causes children to wake up, but others simply become restless and toss and turn. Many children with this problem will sleep in unusual positions as they try to make more space in their airway to breathe, for example, sleeping with their head tipped back or sleeping sitting up. Either way, their sleep is disturbed and this can make them cranky or sleepy in the day. It can also make it harder for them to learn things during the day.
What to do if you are worried.
If you think your child may have sleep apnea get this checked out by your child’s health care provider. Remember there will be nothing much to see in the day when your child is awake, so they need to be checked out when they are asleep. The good news is that sleep apnea can be treated and this can make a real difference to children’s sleep and daytime functioning.About Dr. Catherine Hill