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December 26, 1997     Cape Gazette
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December 26, 1997

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CAPE (AZETYE, Fr/day, December 26 - January 1, 1998 "31 HEALTH & FITNESS Beebe Medical Center now services for It's not always funny - or healthful - when Jimmy Jr. or little Janey acts "just like Daddy," snoring loudly or falling asleep in front of the television. Children who snore heavily every night may be experiencing the same sleep apnea that puts adults at higher risk of heart attack and stroke. And youngsters who routinely fall asleep watching TV may suffer from one of several sleep disorders that cause sleep deprivation, which can impede children' s physical, emotional and social development. Although the public is only now learning that children are affected by sleep disorders, Beebe Medical Center has been preparing for months to accept their first pedi- atric patients in the Sleep Disor- ders Center. "Every snoring kid doesn't have to be rushed off to a sleep special- ist," cautioned Dr. Michael A. Salvatore, the center's director. "'But every chronically snoring kid should be brought to the atten- tion of his physician. It's never normal for a child to snore chroni- cally." Salvatore explained that snoring is more than noisy sleep. It is an audible record of a child strug- gling to breathe. Sleep apnea is a more severe condition in which breathing actually stops for a brief time. Affected sleepers literally cannot breathe for several seconds many times during the night. Other sleep disorders affecting children are Restless Leg Syn- providing sleep lab children drome (RLS) and Periodic Limb Movement (PLM), characterized by the involuntary movement of arms and/or legs throughout the night. Once called "growing pains," children who have RLS typically complain of "creepy, crawly" or "achy" feelings which make them uncomfortable even during waking hours. These movements cause what Salvatore calls "mini-arousals" throughout the night. Although the child never wakens complete- ly, each episode rouses him or her from meaningful sleep. The mini-arousals are one fac- tor in a very small minority of children who wet their beds. These partial awakenings may al- so trigger sleep walking or talking and night terrors. Sleep walkers risk real injury if allowed to wan- der. Sleep talking and night ter- rors disturb the sleep of other fam- ily members. Salvatore said there may be undue concern about night terrors, which most children out- grow. But each of these behaviors, like snoring and sleep apnea, is a disruption of meaningful sleep patterns. "People have an absolute need for sleep. It is a biological need like hunger," Salvatore said. "If you don't get enough sleep, soon- er or later, sleep will get you." Pediatricians agree that infants require at least 16 hours of sleep each day. Children of school age need at least 10 hours each night, while adolescents must have be- tween eight and 10 hours. Chronic Families share Christmas at Lewes Convalescent Center Lewes Convalescent Center residents share a meal with family members and friends on Thursday, Dec. 18, during the center's annual family Christmas dinner. The center provided meats for the dinner, and family members provided the rest of the food for the meal that was attended by approximately 100 people. sleep deprivation affects concen- tration and can hinder learning during the important school years. Once parents are aware of heavy snoring or suspect sleep ap- nea, a confirmed diagnosis is usu- ally not difficult. If air passages are constricted by asthma or aller- gies, appropriate medication can allow free breathing. When en- larged tonsils and adenoids or ir- regular jaw formations are respon, sible for blocking airways, surgery may be required. The sign of other sleep disor- ders may be complaints from sib- lings who share bedrooms and are disturbed by talking or movement. "Parents have to be aware that most sleep in kids is quiescent. If kids are walking, talking or mov- ing a lot in their sleep, parents need to check it out," Salvatore said. In most instances, however, the first sign of sleep deprivation is a child routinely falling asleep in school or in front of the televi- sion set. "Daytime sleepiness is not a characteristic of normal children," Salvatore said. "And the thing about kids, as opposed to adults, is when adults don't get enough sleep, they act sleepy, but when a lO-year-old doesn't get enough sleep, he doesn't act sleepy, he's cranky." "Cranky" sometimes becomes inappropriate behavior. Irritable and unable to concentrate, sleep- deprived children may become unruly at home and disruptive in class. In some cases, sleep depri- vation can be a contributing factor in attention deficiency problems. "There are many factors that in- fluence how a child acts during the day and sleep disorders may be a part of it," Salvatore said. Other sleep-deprived children never act sleepy or exhibit cranki- ness, but cannot go to sleep until very late, then have difficulties getting up in the morning and awaken very slowly. These youngsters, typically adolescents who have more control over their own schedules, have re-set their biological clocks until they are out of synch with home and school schedules. "Kids aged 6 to 12 are the best sleepers in the world. They usual- ly go right to sleep and wake up refreshed and ready to go," Salva- tore said. "If you don't get enough sleep, sooner or later, sleep will get you. You cannot live habitual- ly deprived, then catching up, without significant conse- quences." When sleep deprivation is sus- pected, the first step is determin- ing whether an appropriate sleep Continued on page 33 Learn strategies to keep the holiday blues away Here are some strategies you can adopt to keep the blues at bay and to make the most of the holi- day season: Be realistic. The picture-perfect holiday gathering is usually just that - a picture that is often seen in the media. However, it does not char- acterize most families. Try to keep expectations of the holidays in line with the true cir- cumstances of life, and celebrate the joy of what exists, rather than the unattainable joy of what we wish we had. Holiday traditions must change over the years, just as the partici- pants change. Clinging to old ex- pectations and trying to recreate old feelings which are now part of a memory can contribute to a blue holiday. On the other hand, adherence to rituals that are realistic is a good idea. Openly acknowledge your feel- ings. During the holidays, give your- self permission to bring these feel- ings into your life. It's natural to feel the loss of, and grieve for, those people who are no longer a part of your life. Allow yourself to see the holi- days as a time of reflection and a celebration of what your life is now. Some people even like to make a list or keep a journal of all the things for which they are grateful. Seek out support. If you feel isolated and lonely, seek out support from friends, the community, religious organiza- tions, therapy, and other sources that can offer companionship and understanding during the holi- days. Volunteering at a religious or community function is a good way to meet people and to involve yourself in activities that will brighten the holidays. Set your conflicts aside. Acceptance can be a powerful ally. Rather than frustrating your- self with the hope that your differ- ences with family members and friends will go away during the holidays, try to accept people as they are. Leave your old grievances and discussions about unresolved feel- ings aside and save them for a more appropriate time. The holi- days are stressful enough without introducing more conflict into the situation. Find a calendar and make a schedule. Make a list of everything you need to do for the holidays and then assign certain dates for ac- complishing them. Don't leave it all till the end and don't plan to'do more than can re- alistically be accomplished. And be sure to schedule time for com- fort, relaxation, and solitude. This will provide you with a feeling of control over the situa- tion and the feelings that things are not hopeless. It helps, too, to go over the bud- get and not spend more than you can afford. Stay healthy. You are far less likely to feel overwhelmed during the holidays if you exercise and get your nor- mal amount of sleep. Don't feel pressured to eat and drink too much just because it's the holiday season. Take care of yourself, and make the holidays a true celebration of life and all it can be. HEALTH TOPICS Ioel Vanini, L.C.S.W. Joel Vanini has a private prac. tice in Georgetown. She is avail- able at Bridge Counseling Cen- ter, 856-9190 or e-mail \.