What is Sleep Apnea?

Untitled designAccording to Dr. Sonia Smith, owner and practitioner at Emerald Coast Pediatric Sleep Consultants, LLC., sleep apnea is defined as prolonged pauses in breathing during sleep.  Sleep apnea affects approximately 10 to 20 percent of children.

“Sometimes sleep apnea is noticed by parents when they notice that their child stops breathing periodically during the night,” Dr. Smith said. “Typically, the child will have a lot of loud snoring, stop breathing for a few seconds and the resume breathing with a loud snore or choking sound.”

The symptoms of sleep apnea in children include loud snoring, pauses in breathing during sleep, daytime sleepiness, restless sleep, sleeping in unusual positions, bed wettings, problems learning or daytime behavior problems.

“Sleep apnea can be caused by something blocking the airway such as enlarged tonsils or adenoids, or if the brain forgets to tell the body to breathe, like the pauses we all have after we yawn or sigh heavily,” she said. “Although some pauses in breathing during sleep are normal, if the pauses become prolonged, occur frequently, or if they are associated with a drop in oxygen or a rise in carbon dioxide the pauses may be considered abnormal.

Children who are obese, have enlarged tonsils or adenoids, have low muscle tone, have a chronic illness such as asthma, and children with Down Syndrome may be at risk for sleep apnea.

Sleep apnea is diagnosed by performing a sleep study in a sleep lab. For more information, click here.

What is Narcolepsy? 

narcolepsyNarcolepsy is a neurological condition in which people have excessive daytime sleepiness.

According to Dr. Sonia Smith, owner and practitioner at Emerald Coast Pediatric Sleep Consultants, LLC., narcolepsy is characterized by uncontrollable sleep attacks during the day.

Although narcolepsy is relatively uncommon in children – with an estimated 20 to 50 cases per 100,000 children in the Western World— it’s impact on a child’s life can be dramatic.
The condition commonly begins in the teenage years, but has been diagnosed in children as young as five. Children with narcolepsy often have difficulty staying awake in school, which can affect their academic performance.

Narcolepsy may be accompanied by hallucinations while falling asleep or waking up, loss of muscle control with heightened emotions (cataplexy), and feelings of an inability to move the body when waking up (sleep paralysis).
Narcolepsy is most commonly diagnosed by performing a Multiple Sleep Latency Test (MSLT).

“The MSLT measures how fast a patient goes into REM (rapid eye movement) sleep,” Dr. Smith said. “Patients with narcolepsy go into REM sleep much faster than they should.”
Other less common tests for narcolepsy include testing for the decreased amount of a sleep molecule called hypocretin in the spinal fluid.
Currently, there is no cure for narcolepsy but symptoms can be managed with a combination of medications, including stimulants, to keep patients awake during the day.

“Patients are also encouraged to have a good sleep routine with a regular sleep/wake schedule and to exercise regularly,” Dr. Smith said.

Information for this blog was obtained from: Kotagal, S. 2017. UpToDate: Narcolepsy in Children

IMG_6246Halloween festivities are always an exciting time for many children, with festivities such as trick-or-treating or pumpkin carving often at the very top of their “to-do” list.

Dr. Sonia Smith, owner and practitioner of Emerald Coast Pediatric Sleep Consultants, stresses the importance for parents to be aware of the many Halloween-related factors that can affect a child’s sleeping routine.

Trick-or-treating is often done shortly after the sun sets, posing a risk for children to stray away from their night time routine. “Try to trick-or-treat early in the evening to avoid major disruptions in your child’s bedtime schedule,” Dr. Smith said. “Also, avoid letting your child eat treats that may have hidden sources of caffeine such as chocolate. Once you get home, try to transition into your bedtime routine as quickly as possible to help your little ghosts and ghouls settle down for the night.”

While it is a myth that too much sugar can make it difficult for children to sleep at night, fluctuations (spikes and falls) in their blood sugar can interfere with their sleep. “Unless your child is overly sensitive to sugar intake, moderation is the key,” Dr. Smith said. “Therefore, limit the amount of sugary sweets your child has close to bedtime, even on Halloween!”

Before leaving the house to begin trick-or-treating, remember to grab a pack of antibacterial hand wipes or a pocket-sized hand sanitizer. “If your little one wants to sample treats before they come home, you don’t want them to be exposed to any unnecessary germs,” Dr. Smith said. “Kids with stuffy noses do not sleep well!”

If you decide to forego trick-or-treating, another great activity families can do together is pumpkin carving. While cleaning out the inside of the pumpkin, Dr. Smith recommends saving the seeds for a bed time snack. “Lightly-salted roasted pumpkin seeds are a great source of tryptophan,”  she said, ” Tryptonin converts to melatonin, which helps you to fall asleep.”


Return to Your School Routine

Sleep Matters (National Sleep Foundation[NSF], Summer, 2017) offered some great tips for training the body to get to sleep earlier. As the new school year rapidly approaches, it is time to start instituting a modified “school sleep routine”. Here are some tips, adapted from the NSF to help your child get back into their routine:

1. Set a curfew for your child. Re-establish routine sleep and wake times. Try to make them as close to your anticipated school routine as possible (within reason). If your child has to wake up at 5:30 in the morning to catch the school bus, a reasonable wake up time before school starts would be somewhere around 6:30 or 7:00. No more sleeping in until late morning! The American Academy of Sleep Medicine recommends the following hours of sleep per age:


• Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health.


• Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health.


• Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health.


• Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health.


• Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health.


2. Exercise earlier in the day. The sun is still out until 8:00 or so, depending on where you live. In preparation for bed, children should not engage in strenuous exercise 4 hours before their designated bedtime. If your child has difficulty getting into the sleep mode, try some gentle stretches or yoga approximately one hour before bed to help relax them.


3. Avoid stimulants in the evening. Remember hidden sources of caffeine including iced tea, chocolate, and some flavors of ice cream. Offer foods high in tryptophan in the evenings to help promote sleep. Such foods include: seeds, nuts, milk, cheese, and most meats.


4. Re-institute your bedtime rituals. Summer makes everything a little wacky. Schedules often go awry with vacations and fun summer activities. In preparation for school, start “setting the stage for sleep” by doing those things that help to remind your child that bedtime is coming soon: brushing teeth, showering, putting on PJs, lowering house lights and noise, quiet play, etc.


5. Set an alarm. Help your child to wake up at your desired time by setting an alarm, just as you would for school. The trick is, don’t let them sleep through it!

 Follow these guidelines to help transition your child (and you) back into the school routine. Your child deserves to start the school year with his or her best foot forward. A night of restful, restorative sleep will help them hit the ground running!

3 Tips for a Happy 5th of July

The staff at Emerald Coast Pediatric Sleep Consultants would like to wish each of you a Happy Fourth of July! This year, the holiday falls on a Tuesday. For many of us, that means a return to work, daycare or summer school on July 5. So, what can we do to help our children wake up happy, smiling and playful after a restful night’s sleep the day after the holiday? 

Here are three quick tips you might find helpful: 

  1. Many children like to stay up to watch the fireworks. With a little pre-planning, you may be able to locate a fireworks display that starts in the early evening rather than later at night. Remember to account for travel time and traffic. A 30-minute 7:00 pm show could equate to a three to four hour ordeal depending on the size of the crowd and the distance from home.
  2. If you opted to stay home to keep the kids on schedule, consider putting some white noise in their room at night (a box fan, looping music, etc.) to help drown out your partying neighbors and their impromptu fireworks.
  3. Barbeque is a 4th of July tradition. So are soft drinks, sweet tea, chocolate desserts, and watermelon. Be sure to remain aware of hidden sources of caffeine that may affect your child’s sleep. Watermelon, while delicious, can cause increased trips to the bathroom and disrupt sleep if eaten too close to bedtime.

Have a safe, happy holiday! Wishing you restful, restorative sleep!

The Benefits of Exercise for Sleep

3Is your child have difficulty sleeping at night? Try incorporating some type of physical activity into their daily routine.

According to Dr. Sonia Smith, owner and practitioner at Emerald Coast Pediatric Sleep Consultants, LLC., children should have at least one hour or more of physical activity each day.

“Exercise and sleep go hand-in-hand,” Dr. Smith said. “Exercise helps to lower the risk of obesity, speed up metabolism and increase your energy during the day. Studies have shown that people who exercise frequently report better quality sleep.”

Exercising helps to regulate the sleep and wake cycle in children by increasing the body temperature during the day and lowering the body temperature at night, resulting in a good night’s rest.

Lack of exercising can lead to obesity, which can directly impact your child’s quality of sleep. Obese children often have difficulty exercising and are at an increased risk for breathing problems during sleep.

Dr. Smith recommends children stop exercising three hours before bedtime. “Exercising right before bedtime can interfere with the body’s ability to fall asleep. Exercise increases your metabolism, which heats up the body. For good sleep, the body’s temperature needs to be cool.”

Food and Sleep: The Importance of A Balanced Diet

UntitledEating a balanced diet not only affects the way your body looks physically, it can also affect your quality of sleep. According to Dr. Sonia Smith, owner and practitioner at Emerald Coast Pediatric Sleep Consultants, LLC., what you eat during the day impacts how well you sleep at night.


“A balanced diet, consisting of three meals a day plus snacks, helps to optimize growth and development during sleep,” Dr. Smith said. “Foods that are high in fiber and protein make the stomach feel full so that you are less likely to wake up hungry during the night.”


To help improve your child’s quality of sleep, try incorporating foods such as seeds, nuts, soy beans, cheese, milk, lamb, beef, pork, turkey chicken and fish. These foods are high in tryptophan, which can positively affect your quality of sleep as it converts to melatonin, the sleep hormone.


Try to avoid foods with hidden sources of caffeine such as sodas, chocolate, many flavors of ice cream, energy waters, iced tea and some pain relievers, as they can keep your child up at night. “Foods that are high in carbohydrates may satisfy your child for a short time, but will convert to sugar rather quickly,” Dr. Smith said. “This raises then lowers their blood sugar, which may leave your child hungry in the middle of the night.

Children and families can learn more about nutrition for children here.

The Importance of Sleep Hygiene

We’ve all heard of personal hygiene, but what exactly is sleep hygiene? According to Dr. Sonia Smith, owner and practitioner of Emerald Coast Sleep Consultants, LLC., sleep hygiene describes the activities and practices that people do every night in preparation for a restful, restorative night of sleep.

“Sleep hygiene includes personal activities, as well as factors in the environment, that can either help to improve sleep or prevent people from falling asleep and staying asleep,” Dr. Smith said.

Although practicing good sleep hygiene is beneficial for everyone, establishing a bedtime routine is the most important sleep hygiene practice for children. Other good practices include turning off electronic devices one to two hours before bed, relaxation before bed, and preparing the household environment for sleep.

Dr. Smith said problems such as getting children to settle down for the night, multiple night awakenings, and problems with daytime functioning due to fatigue may be the result of poor sleep hygiene.  Avoiding caffeine prior to bedtime, dimming bright lights in the home and limiting heavy meals before bed are positive sleep hygiene measures.  Eliminating electronics one to two hours before bed— including television, cell phones, tablets and computers—may also enhance your child’s ability to fall asleep and stay asleep.

Practice good sleep hygiene every day to help maximize your child’s chances of achieving a restful night’s sleep. “Establish a bedtime routine that works for the entire family and stick to it as much as possible,” Dr. Smith said. “Practice makes perfect.”

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Emerald Coast Pediatric Sleep Consultants Welcomes Lindi Evers, MSN, ARNP


Lindi Evers recently joined Emerald Coast Pediatric Sleep Consultants where she will serve as a nurse practitioner.

Evers received her Bachelor of Science in nursing from the University of Florida in Gainesville.   She then earned her Master of Science in nursing in pediatric primary care from the University of South Alabama in Mobile, Ala.

Before joining Emerald Coast Sleep Consultants, she served as a nurse in women’s health, with a focus on caring for mothers and newborns in the postpartum units at Sacred Heart Hospital in Pensacola, Fla., and North Florida Regional Medical Center in Gainesville, Fla.

She is nationally certified  as a  pediatric nurse practitioner by the Pediatric Nursing Certification Board, and an advanced registered nurse practitioner by the Florida Board of Nursing.

To make an appointment with Lindi Evers, call (850) 932-3830.


What is a Sleep Study?

imageA sleep study, also known as a polysomnogram, is a test that evaluates the patient’s breathing, heartbeat, leg and arm movements, oxygen levels and brainwaves while they sleep.

According to Dr. Sonia Smith, owner and practitioner of Emerald Coast Pediatric Sleep Consultants, LLC, sleep studies are an important tool used to help identify, diagnose and develop a treatment plan for children experiencing problems sleeping.

Emerald Coast Pediatric Sleep Consultants recommends children who snore loudly, children who are restless and children who do not seem well-rested after sleeping to consider participating in a sleep study. Children with behavior or learning problems are also candidates for the study.

Sleep studies are painless and are conducted in a sleep lab. “Our sleep lab resembles a child’s bedroom, helping the patient to feel relaxed and comfortable,” Dr. Smith said.  “I recommend sleep studies because they are important tools to help correctly diagnose sleeping problems in children. Sometimes we find problems on a sleep study that we were not anticipating, which allows us to personalize your child’s care and develop treatments that are specific to their individual problems.”

Once your child arrives at the sleep lab, usually around seven or eight in the evening, the sleep staff will assist the child in getting settled for the night. The study begins by attaching wires to the child’s head, face, arms and legs. These wires feed information to the control room. While placing the wires, the child may watch TV or play games. After the wires are secured, it is time for bed.  Parents have the opportunity to sleep in the room with their child during the study. The study concludes the following morning and the child is able to go home.

To learn more, click here.

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