What is Pediatric Sleep Medicine?

July 30, 2024

Andrew Valenzuela, MD, FAAP, is a specialist in pediatric sleep medicine, a field that has historically been underrecognized. Thankfully, more clinicians across various disciplines are beginning to understand the importance of quality sleep, leading to increased awareness. Today, collaboration in pediatric sleep medicine spans multiple specialties, including pulmonology, ENT, neurology, but most importantly pediaticans.

He is affiliated with Banner Health in Phoenix, Arizona's capital and most populous city, and the fifth largest in the U.S. Despite its size, the region has only about half a dozen pediatric sleep specialists, leading to a significant patient backlog.

When children do run into sleep problems, Valenzuela contends that the multidisciplinary approach is ideal, with treatment depending on the patient. Some patients have classic sleep apnea, a frequent problem, while others have insomnia or difficulties staying asleep or falling asleep. “A lot of the patients we see have breathing challenges or anatomical problems,” Valenzuela says. “We see some craniofacial abnormalities and these are disruptive to normal airflow”.

With adults, poor sleep can lead to sleepiness, but pediatric sleep disorders often lead to the opposite. “If a child doesn't sleep well,” Valenzuela points out, “they tend to have more hyperactivity, irritability, and inattentiveness—more of an ADHD picture.”

The gold standard for diagnosing sleep apnea is a sleep test and ideally these patients would spend the night in a lab. That’s tough enough for adults, so Valenzuela reveals: “A lot of our pediatric patients get home sleep tests which are much cheaper and more well tolerated.”

Valenzuela confirms that CPAP can be started at age 5 or 6. Of course, the dental approach is another big category of treatment that includes oral appliances and/or mandibular advancement devices that pull the jaw forward and open the airway. “The main people involved in sleep treatment for kids are going to be sleep medicine professionals like me, and ENTs for airway-focused approaches such as tissue reduction, tonsils/adenoids, lingual tonsils, and palatal adjustments as well,” Valenzuela adds.

Finally, the emotional payoff of helping children can’t be underestimated in any discussion of pediatric sleep medicine. “It really is a nice payoff at the end of the day when patients are sleeping and functioning well again,” Valenzuela enthuses.

(Dr. Valenzuela currently serves on the American Sleep and Breathing Academy Diplomate Credentialing Board)

Dr. Valenzuela completed his residency in Pediatrics at Dell Children’s Medical Center and a Fellowship in Sleep Medicine at Baylor College of Medicine. Dr. Valenzuela is a well-rounded physician specializing in adult & pediatric sleep medicine. He is Board-Certified in Pediatrics and Sleep Medicine. Professional interests include the role of artificial intelligence within sleep medicine, wearables and nearables for sleep tracking and diagnostics. He is especially interested in Narcolepsy and the pharmacologic options for symptomatic treatment.

Dr. Andrew Valenzuela presenting on Pediatric Obstructive Sleep Apnea at a recent meeting of American Sleep and Breathing Academy members.

Source: Greg Thompson, ASBA