Sleep – Melbourne Children’s Sleep Centre

Melbourne Children’s Sleep Centre (MCSC) is Victoria’s only dedicated children’s sleep centre and laboratory providing consultations and sleep studies for all paediatric sleep problems.

The Adamson Sleep Laboratory has four overnight sleep bedrooms and provides sleep services for infants, children and teenagers.

Our expert team performs nearly 1000 sleep studies on patients a year.

Associate Professor Margot Davey is director of the centre which is staffed by consultant sleep and respiratory paediatricians, sleep scientists and nurses experienced in the diagnosis and management of all paediatric sleep disorders.

The MCSC is located in the new Monash Children’s Hospital, Ward 4E , Level 4, and operates Monday to Friday. Home overnight oximetry is offered Monday to Friday.

What is a sleep study? 

A sleep study is used to investigate:

• snoring and obstructive sleep apnoea
• abnormalities in the control of breathing
• excessive daytime sleepiness
• unexplained nocturnal waking
• monitoring ventilatory support.

Sleep studies or polysomnography involve the continuous measurement of physiological parameters related to sleep and breathing. These include oronasal air flow, oximetry, TcCO2 and/or exp CO2, respiratory and abdominal effort, EEG (electroencephalogram), EOG (electrooculogram), EMG (electromyogram), and ECG (electrocardiogram). Information regarding sleep architecture and quality, and ventilation and respiratory patterns, is obtained.

A sleep study is performed as an outpatient procedure, with the child (and parent/caregiver) coming to the unit at 7:30pm and leaving the next morning.

Patients must be seen by a sleep physician before a sleep study can be ordered.

A home oximetry service is also offered by the MCSC as part of the assessment of children with obstructive sleep apnoea.

Non-invasive ventilation

Nocturnal non-invasive ventilation (NIV) is required by some children to maintain their airway and normalize their breathing patterns when they are asleep.

Children who have ongoing obstruction to their upper airway despite surgery to remove adenoids and tonsils, or children who are weak due to a variety of medical conditions, may experience problems breathing and maintaining normal oxygen levels overnight. These groups of children may benefit from NIV which involves the use of a mask that is placed on the child’s face which is connected by tubing to a machine.

The most common form of NIV is called Continuous Positive Airway Pressure (CPAP) and is used to treat children who have obstructive sleep apnoea. This involves using a machine or pump to deliver room air through tubing to a mask on the child’s face. The delivery of low pressure air keeps the airway open and results in improved sleep and ventilation during the night.

Children who suffer from neuromuscular weakness may require another type of machine to help them breathe when they are asleep.

The mask can sit either over the nose or mouth or both, and is kept in place by small head straps.

Starting a child on NIV requires experienced staff to educate both the child and the family, and to individualize a management plan for ongoing treatment. Generally a sleep study is required to optimize the machine pressures to normalize a child’s sleep and breathing patterns.

Services 

Melbourne Children’s Sleep Centre runs the following services:

1. Outpatient assessment and consultation
2. Overnight sleep studies
3. Home oximetry service
4. Non-invasive ventilation service
5. Home apnoea monitor program

Clinical problems we look after include:

• Sleep Disordered Breathing
  • Obstructive sleep apnoea
  • Apnoea of infancy
  • Hypoventilation
• Initiating and Maintaining Non-invasive Ventilation
• Behavioural Sleep Problems
  • Bedtime struggles
  • Night wakings
• Parasomnias
  • Night terrors
  • Sleep walking
• Insomnia and Circadian Rhythm Disorders
• Narcolepsy and excessive daytime sleepiness

Appointments

To make an appointment you will need a letter of referral from a doctor (GP, paediatrician, ENT surgeon etc).

For an appointment you can call (03) 9594 2900 or fax to (03) 8572 3878.

For general enquiries call (03) 8572 3592 or (03) 8572 3593.

To make an appointment with the sleep clinics at the Melbourne Children’s Sleep Centre (MCSC) you will need a letter of referral from a doctor (GP, paediatrician, ENT surgeon etc).

At the medical appointment it will be decided whether your child will need a sleep study. All sleep studies are performed at MCSC which is a four bed paediatric unit based at Monash Medical Centre, Clayton, that services Victoria and Tasmania.

A sleep study involves measuring your child’s sleep and breathing patterns which requires sticking small wires and electrodes onto your child’s head and chest.
There are no needles involved and it does not hurt.

It takes around an hour to prepare the child for monitoring overnight, and families are encouraged to bring items that will make the child feel more at ease (special toy, videos or DVD’s, pyjamas, pillows etc).

A sleep study is performed as an outpatient procedure, with the child (and parent) coming to the unit at 7:30pm and leaving the next morning between 6:30am and 7:30am.
The sleep unit operates five nights a week, Monday to Friday.

Each family is allocated one of four bedrooms with a parent/caregiver expected to spend the night with the child, and a bed is provided for them to sleep in.

Melbourne Children’s Sleep Centre does not provide inpatient care for mother–baby sleep problems unless related to breathing issues. For Victorian services that do help with mother-baby sleep problems, see here.

Document download 

• What is a Sleep Study?
• What happens during a sleep study with CPAP and Bilevel?
• What is a Sleep Study and Multiple Sleep Latency Test (MSLT)?
• What is Home Overnight Oximetry?
• CPAP brochure: An introduction for parents and children
• Childhood obstructive sleep apnoea (OSA) parent information sheet

Other useful resources:

• The Australasian Sleep Association based in Australia. Information for consumers and health professionals: http://www.sleep.org.au/
• Raising Children Network parenting website based in Australia. Showcases sleep for different ages: http://raisingchildren.net.au/
• National Sleep Foundation based in the US. Information, education, tips: https://sleepfoundation.org/
• Sleep Health Foundation based in Australia. Includes sleep health fact sheets and information library: http://www.sleephealthfoundation.org.au/

Media reports:

• ABC Online: Kids need a good night’s sleep
• Herald Sun: Kids who snore could experience learning disruption
• Hearld Sun: Waking up to kids sleep; what parents need to know
• ABC Online: Monash Medical Centre’s sleep laboratory helps kids who struggle through the night

To refer a patient, please review the Children’s Sleep Referral Guidelines prior to completing the appropriate form below and returning as each individual form instructs:

• Sleep study and oximetry request form
• Sleep study request form – Non-Invasive Ventilation
• External Oximetry Request Form
• Internal respiratory/ward oximetry request form
• Oximetry – Request for interpretation of external oximetry

Head of Unit: Associate Professor Margot Davey

We also conduct ongoing research studies to help provide better outcomes for children and improved treatments. Our partnership with Monash University’s Ritchie Centre over the past decade has resulted in $5 million of government funding to help fund 90 research studies.

To read about our research and how you can take part see here.

For our research publications see here.