I never thought about the ped endocrinologist. maybe I can see if his urologist would consider a referal. I doubt his primary care doc would do that since he told me he's not hypothyroid by asking a series of ?'s.
Yes, I would ask the urologist for a referral to a pediatric endocrinologist so that you can evaluate your son's risk for thyroid issues given a family history of thyroid disorders. You and his aunts make him higher risk. Also you should request that antibody panel run. the lab codes are TPOAb and TGAb (for Hashimoto's), and ANA (for general autoimmune attack).
As far as sleep schedule it's pretty good. He's a morning person and is usually the first one up. He's in bed by 9:30 reads for too long sometimes and is up around 6:00. He used to snore and have night terrors when he was a toddler and I'd find him standing somewhere in the house sleeping, in the middle of the night.
You description is classic obstructive sleep apnea with sleep deprivation side effects. My son has severe sleep apnea. We had his adenoids out at 2 and his tonsils out at 3.5. This cured the snoring and made things better, but he still has sleep apnea (severe) and needs his CPAP. It might be worth while to get a consultation with a Neurology specialized sleep specialist. If your son still has sleep apnea, ADD/ADHD medication will react adversely in his system and cause increased aggression and many other nasty side effects as time goes on. After he had his tonsils and adnoids removed at age 4 he was like a new kid. No more snoring or night terrors or walking in his sleep. He's a fairly deep sleeper and sleeps through almost anything.
Your son is age 8 now? Did I decifer that right from your initial posting? Sleep requirements change as children get older. Sleep apnea symptoms change as well. Eight appears to be the cusp when childhood sleep apnea symptoms transition over to adult sleep apnea symptoms. You do not have to snore to have sleep apnea or one of 80 other sleep disorders. My family is riddled with both sleep issues and endocrine issues. Now 2 year olds are supposed to get 14 hours sleep on average. Then 3-4 year olds are supposed to get 12-14 hours sleep. Then 5-7 year olds are supposed to get 11-13 hours of sleep a day. I have to fight to get my 5 soon to be 6 year old 11 hours of sleep a day.. school and such seem to be against sleep. 8-10.. I have a chart.. let me dig it up.
Age(years) Ave. hours of sleep required (Range from 2-98 percentile of study)
0.5 14 (10 – 18)
0.75 14 (11 – 17)
1 14 (12 – 16)
2 14 (12 – 16)
3 13 (11 – 16)
4 12 (11 – 14.8)
5 12 (11 – 14)
6 11 (10 – 12)
7 11 (9.5 – 12)
8 10.5 (9 – 12)
9 10.4 (9 – 11.7)
10 10 (9 – 11)
11 9.6 (8.5 – 11)
12 9.3 (8 – 10.7)
13 9 (8 – 10)
14 8.5 (7.5 – 10)
15 8.5 (7 – 10)
16 8 (7 – 10)
This is a study that incorporated thousands of children in various cities and lifestyles.
They noted trends in families related to growth phases and genetic predisposition. The more the child is growing and developing the more sleep a child needs. A child's growth curve is exponential until the age of three. After three the growth curve begins to slack off. In children with sleep apnea the growth curve is suppressed. As a result is the issue is treated the lost growth can be recovered but sleep deprivation effects must be overcome. What does this mean really? If a child has sleep apnea, they often loose growth time because their sleep sucks. This means they have to make up for lost growth periods of sleep, when sleep quality improves.
My son stopped growing for a year. He went from 100+ % to 60 %. This lost growth needed to be made up.. but until we had his surgeries and got him on his CPAP, it wasn't happening. As soon as we treated the obstructions and apnea my son started sleeping 12 hours straight at night and still needed naps in the day. He was sleeping more than the average, but he grew 4 inches in a matter of months went through 4 shoe sizes. Climbed back to the 100+ % in growth and became a happy and rested boy. Now in Kindergarten we there are no naps. UGH! My son can not sleep more than 10 hours at night, but he still needs a nap. With out it the sleep deprivation monster rears its ugly head. This tells us that my son needs at least 11 hours to meet his genetic sleep needs 12.5 is his sweet spot. He will turn 6 soon managing his sleep requirements is challenging to say the least.
Your son may be still trying to make up a sleep growth deficit as well. an 8 - 6 sleep routine is 10 hours. 9:30 - 6 is 8.5 hours (2 hours less than the statistical average where 80% of the population's sleep requirements reside) and that is if your son passes out right at 9:30 pm. Now I am not saying you are doing anything wrong, there is the genetic factor. Some families require less sleep, they are perky and active and real energizer bunnies on 4-6 hours of sleep. But if there are signs on sleep deprivation and a history of apnea, it is worth checking into in my opinion.
We are not alone in trying to get our kids to have enough sleep:
The National Sleep Foundation’s recommendations about sleep requirements are that children should get the following amounts of sleep every 24 hours:
< 1 year: 14-15 hours
1-1.5 years: 14-15 hours
1.5-3 years: 12-14 hours
3-5 years: 11-13 hours
5-12 years: 10-11 hours
Teens: 8.5-9.5 hours
The contemporary American kids are not meeting these guidelines. Mine is just making it on most days. Our hectic schedules are kicking our sleep hygiene tail. On average the study shows kids are getting less and less sleep.
6-8 mos: 12.8 hours average
9-11 mos: 12.1 “”
12-17 mos: 12.5 “”
18-23 mos: 11.6 “”
2 years: 11.4 “”
3 years: 10.8 “”
4 years: 10.5 “”
5 years: 10.1 “”
6-10 years: 9.3-9.8 “”
Making kids go to sleep can be an in house War. Having kids sleep and keep a schedule when you keep them in child care and run about doing 10 things at once causes sleep to be sacrificed as well. We have and still must make sacrifices to try and get our son's sleep requirements met. In the end I lose sleep so he can sleep more.
Sleep specialists deal with a lot of thyroid cases as well. My sleep specialist is very serious about complete thyroid testing and monitoring. Too many under/un-treated hypoTs come in with sleep apnea that can be corrected. Hypothyroidism and sleep apnea go hand in hand. If your Urologist cannot make the recommendation a sleep specialist might. It never hurts to get a second opinion and sleep is one of the best medicines for young children.
*jumps down off the soap box and blushes* Sorry didn't mean to lecture. I had a thyroid storm several years ago and they told me it was thyroiditis and it probably never happen again. Every once in a while i could tell something was acting up w/my thyroid but bloodwork always came back normal ranges. I had nodules and got them tested a few months ago and it came back atypical cells and had my right thyroid removed. I feel so much better now after 1 1/2 weeks I think those nodules must have been messing with my gland function. I am taking levothyroxine for support and am waiting to see how i do with it.
Did they ever confirm Autoimmune thyroiditis or Hashimoto's from your PT? Have you ever been tested for Hashimoto's antibodies? If not get the same autoimmune antibody panel run as your son. If he has it.. you most likely have and I would bet your mom has it and husband's sisters as well. Nodules and fluxing hyperT and hypoT are very common early symptoms of Hashimoto's. I really think my mom has something amiss w/her thyroid she is really scatterbrained at times and sometimes goes off her rocker with paranoia and accusations and other odd behaviors.
Can you go in to her GP with her and request a full thyroid panel with antibodies run. My mom is the same way. She has Hashimoto's and Graves Disease. She had to have half her thyroid removed. Her MDs haven't supported supplementation as of yet. We have to continually fight for every mcg of hormone. *grumble* Okay refrained for a vent session. She's on mertazipine. I've asked her to have hers checked and she won't give me a straight answer on if she's had it checked or not. Not much I can do there.
I got my mom to consent and get things checked out, BECAUSE my pediatrician and endocrinologist signed a letter I wrote up requesting direct line family members be tested in order to determine genetic dominance and aide in the treatment and management of my children.. and me. Your mom might be willing to do it, if she thinks it will help you and your son out. My dad's sisters have thyroid problems but that's all they'd say. Don't know what type of problem they have either.
You should call them up again and tell them that you are filling out your son's medical history background in preparation for a visit to an pediatric endocrinologist. You need to know if they are hypothyroid or hyperthyroid, AND if there thyroid condition is autoimmune in nature (Hashimoto's or Graves). Stress names are not requested just genetic lineage Paternal/Maternal Aunt/Uncle, Grand Parent.. etc. Sometimes more are willing to share if you put it into a one word reply format.
I am wishing you luck. That is the bulk of my ideas at this time.