Sleep Medicine at Sydney Children's Hospital, Randwick

The Sydney Children’s Hospital, Randwick Sleep Medicine Unit is a state-of-the-art facility solely dedicated to the diagnosis and treatment of sleep disorders in children. It is one of only a handful of independent Sleep Medicine Departments in the world dedicated to this specialised area of paediatric medicine.

Using the latest technology, children with suspected and confirmed sleep disorders are admitted to the Sleep Medicine Unit for an overnight sleep study. Considered the 'gold standard' for the diagnosis of conditions such as obstructive sleep apnoea, periodic leg movement disorders or narcolepsy, sleep studies are often used to guide treatment.

What is a sleep study and what does it involve?

A Sleep Study ("polysomnogram") serves many purposes. It is considered the 'gold standard' for the diagnosis of your child's problem, such as obstructive sleep apnoea, periodic leg movement disorder, or narcolepsy. Treatment often depends on the Sleep Study results. There are over 80 different classified sleep disorders.
The sleep study is often used to guide treatment, such as adenotonsillectomy. It is important that a follow-up appointment is made to ensure that the results are communicated and treatment arranged.

A sleep study begins with the painless application of monitoring equipment.

• Seven leads are attached to previously measured and marked positions on the scalp. These record brain waves indicating the various stages of sleep.
• Four stickers are placed on the face to monitor eye movement and chin muscle tone.
• A small plastic tube, with two soft prongs, is placed beneath your child's nose. This will measure nasal airflow.
• Seven stickers are placed over the chest and abdomen. These monitor the heart rhythm and muscle activity from the diaphragm and abdomen.
• Two elastic straps are placed around the chest and abdomen. These monitor chest and abdominal movement.
• A lead with a sticker is placed over each calf, to measure leg movement.

We ask you to come in the early afternoon so that you and your child have time to settle into the Sleep Unit. We apply the stickers and leads shortly after your arrival so that your child has time to get used to wearing them so as to cause the least amount of disruption to your child's normal sleep routine. Following the application, your child is free to move around the ward, to play or to watch TV.

Bedtime is around the usual time for your child, ideally in bed by 8 or 8.30pm to begin the sleep study by 8 or 9pm.

At bedtime further equipment is applied:

• An oxygen saturation probe is applied to the finger or toe. This measures the oxygen. It consists of a simple red light source and a sensor
• A carbon dioxide monitor is applied to the skin. This will estimate the carbon dioxide in the blood
• A small plastic sensor is placed beneath the nasal prongs, to measure airflow through the mouth
• Most studies will involve sound and video recording.

At bedtime, everything is connected to the computer for the overnight study.

We expect your child will be monitored for about 8 hours overnight. During this time, should your child wake, please do whatever you would normally do to resettle your child. Nursing and technical staff will assist you as required. Your child should be able to continue the usual feeding pattern if they are taking overnight feeds.

Preparing for your visit

The following may assist you in preparing for your visit to the Sleep Unit:

• Admission time is 2.30pm
• Discharge time is around 7am
• Time to set up equipment is 40 minutes to an hour
• Each room has a phone, the number of which may be given to relatives and friends who may wish to contact you. Please ask them to call prior to your child's bedtime. A phone card is required for outgoing calls. These may be obtained from the cashier's office between 9 AM and 5 PM. (next to the Admissions Office)
• Each room has an intercom to communicate with the nurses in the monitoring room
• Between 5AM - 6 AM the night staff will wake your child and remove the equipment
• Dinner and breakfast is provided for your child. Please advise us before admission of any dietary requirements. Parent/carers need to provide their own food. There is a cafeteria open until 7pm and several food outlets in the area. You may use the facilities in the kitchen to prepare food.

Things to bring on the day of the sleep study

• If your child has long hair, a hairbrush and bands are helpful
• Any regular medication that your child may take
• Familiar pillows, toys, blankets, or comforters
• Favourite books and games
• A good book for you, some nightwear and toiletries
• A camera. Some children like to have a memento of their study. Printouts of the actual study are usually available on follow-up
• Comfortable pyjamas or nightie, preferably button-fronted. For babies a 'sleep-suit' is ideal, but not essential. Mittens may be of assistance in preventing equipment removal by little fingers
• Routine overnight toiletries. Please bring shampoo and conditioner
• Please remove any nail polish, as this may interfere with monitoring of your child
• Secure car parking is available and can be accessed from the main campus entrance on Barker Street, Randwick.

One parent or carer must stay with the child overnight. A single sofa bed is provided in the room for one carer. Only 1 parent / carer can be accommodated in the unit, if other family members are travelling with you and require accommodation please refer to our Handy Hints for Your Stay in Hospital brochure

Please do not hesitate in calling the Sleep Medicine Unit if you have any further inquiries regarding a sleep study.

Results of the sleep study must be obtained at a follow-up appointment in the Sleep Clinic two weeks after the study has taken place.

If you are from outside the Sydney area, the results can be obtained from the referring doctor.

Staff

Name	Role
A/Prof Arthur Teng	Head of Department and Senior Staff Specialist
Dr Greg Blecher	Senior Staff Specialist
Dr Brad Martin	Senior Staff Specialist
Dr Vishal Saddi	Staff Specialist
Emeritus Prof Colin Sullivan	Honorary Consultant
Dr Ganesh Thambipillay	Senior Staff Specialist
Dr Natalie Gentin	Honorary Medical Officer
Mr Bruce Williamson	Senior Scientist
Ms Sonia Pithers	Hospital Scientist

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