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hvparent.com ■ Hudson Valley Parent 13 Nemours/Alfred I. duPont Hospital for Children Sleep Lab in Wilming- ton, DE. Other SDB warning signs include sleeping in strange positions, experi- encing night terrors, bedwetting, or perspiring during sleep, says Dr. Re- nee Turchi, board-certifi ed pediatri- cian with St. Christopher's Hospital for Children in Philadelphia. How to help The good news: nearly all oth- erwise-healthy children with sleep apnea respond well to having the tonsils removed, says Marcus. Back-sleeping can exacerbate snor- ing; regular snorers or those with sleep apnea should choose another position ("back to sleep" is still best for babies, though). Beyond snoring: sleep and special needs Rates of sleep apnea and other sleep troubles skyrocket for children with special needs. About two-thirds of children with Down syndrome have sleep apnea, says Marcus; a larger tongue, a small mid-face, and lower muscle tone make these children more prone to SDB and apnea. Children with cerebral palsy, spina bifi da, and other conditions associated with low muscle tone also have higher rates of sleep apnea. Ac- cording to multiple studies, over half of children with Down syndrome ages 7 to 11 wake during the night, and nearly 40 percent wet the bed. Children with autism can have diffi culties with the circadian rhythm, the sleep-wake cycle that governs wakefulness and sleep, driving them to stay up too late, says Marcus. "Our brains regulate sleep, so if the brain is abnormal for any reason, sleep is going to be impact- ed, too." How to help Though some special-needs sleep problems are physiological in nature, such as those related to low muscle tone, many are behavioral, such as habitual night wakings, waking too early in the morning, or fi ghting bedtime. "Often, parents may not set the same bedtime limits for children with special needs that they set for other children," says Marcus. Defi n- ing clear parameters for sleep —in- cluding when bedtime occurs, where a child sleeps, and what is an accept- able hour to wake in the morning — and gently yet fi rmly enforcing these household rules, night after night, can help get sleep on track for children with special needs. Malia Jacobson is a nationally published health journalist and mom. Her latest book is "Sleep Tight, Every Night: Helping Toddlers and Preschoolers Sleep Well Without Tears, Tricks, or Tirades." Common medications that impact sleep Some medicines can nega- tively impact sleep for children with special needs. Talk to your pediatrician if your child experi- ences sleep problems and takes any of these medicines (do not discontinue a medicine or change dosage without discussing it with your child's primary-care physi- cian). • Stimulant medication often used to treat ADD/ADHD (meth- ylphenidate, dextroamphetamine, methamphetamine) • Corticosteroids (Prednisone and other steroids) • Some cold and allergy medica- tion (ephedrine, pseudoephed- rine, Benadryl, Nyquil) • Thyroid medication (levothy- roxine) • Anti-depressants: sertraline (Zoloft), paroxetine (Paxil) and escitalopram (Lexapro) • Some anti-convulsants (medi- cine used to treat seizures) • Diuretics Win and view prizes at contests.hvparent.com Enter our Party Giveaway! October 1 to October 11 WIN Over $200 in prizes!