Sleep disorders occur in as many as 25 to 30% of infants and children, and can range from bedtime problems and insufficient sleep to sleep apnea and sleepwalking. Though many parents are familiar with the effects sleep troubles have on their child—including irritability, moodiness, and behavioral and learning problems—many are unsure about what to do next. If you think your child has a sleep problem, it can help to understand what is involved in diagnosing sleep disorders so you know the next step to take. Your Child’s Sleep Team The first step in diagnosing your child’s condition is talking to his or her pediatrician. With an understanding of your child’s symptoms, the pediatrician may refer you to a sleep disorder physician for a sleep consultation. This doctor, along with other professionals who make up your “sleep team,” will conduct a thorough medical and sleep history and give your child a physical exam to identify any medical problems. As part of evaluating your child’s sleep history, you may be asked to keep a sleep diary (or sleep log) for 1 to 2 weeks. This will give your doctor a glimpse into your child’s sleep habits to help accurately diagnose his or her disorder. A typical sleep diary includes dates, daily activities, food and drinks, medicines, naps, bedtimes, and the times your child wakes up throughout the night and in the morning. Testing for Sleep Disorders in Children Once your team has gathered data about your child and his or her sleeping habits, they may recommend some sleep tests. This could include an overnight sleep study where your child is observed at a sleep lab. Typically, this is a comfortable, bedroom-like setting where a child sleeps with a parent nearby. Children are generally able to sleep without difficulty, but sometimes, if needed, this can be done in your home. Talk to your team to discuss what may work best for your child. Polysomnogram During overnight sleep testing (polysomnogram), electrodes are placed on your child to record brain activity, eye movements, and muscle activity. Additional sensors are placed around the nose, chest, and abdomen to record breathing patterns. This does not hurt. If patterns are missed on the routine polysomnogram, sometimes doctors use esophageal pressure monitoring, placing sensors through the nose and into the esophagus. All efforts are made to keep your child comfortable with these sensors. Actigraphy Monitoring Sleep specialists also utilize actigraphy to help diagnose sleep disorders. This is a method of monitoring your child’s leg movements while she sleeps, which can tell your doctor more about her specific sleep problems. The actigraphy device looks like a watch and is attached to your child’s foot or ankle to detect and record her movements. Your child may wear the device in a sleep lab or at home for a few nights. Once you return the device to your doctor, he or she will download and analyze the results. Treatment for Children’s Sleep Disorders After your consultations and once any sleep tests have been evaluated, your sleep team will talk with you about your child’s diagnosis and recommended treatment. This may include: Behavioral techniques Medications Continuous positive airway pressure or CPAP (in the case of sleep apnea in children) Micronutrients (vitamins and minerals) Bright light therapy (simulated natural light to help regulate the body’s sleep-wake cycle) Surgery Your child may benefit from a combination of treatments. Talk to your doctor about what you think would work best for your child and his individual needs, as well as any concerns you may have. Working closely with your child’s sleep team is one of the best things you can do to help your child get the quality rest he needs.