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Sleep Lab

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Children, youth and families   Healthcare providers

About the Sleep Lab

The CHEO Sleep Lab is located in clinic C20.

We see children up to 18 years old with symptoms of breathing problems during sleep.  Sleep studies are used to diagnose and manage breathing problems associated with sleep (ex. Obstructive sleep apnea, central sleep apnea, hypoventilation), and to guide and adjust treatments for sleep-disordered breathing such as:

  • Tonsillectomy and adenoidectomy
  • Continuous positive airway pressure (CPAP)
  • Bi-level positive airway pressure (BPAP)

Some children are at higher risk of having symptoms of sleep-disordered breathing, including children with:

  • underlying obesity
  • neuromuscular diseases
  • genetic syndromes (ex. Down Syndrome)
  • craniofacial anomalies (ex. Pierre Robin Sequence, Pfeiffer Syndrome)

We also evaluate technology-dependent children, such as children receiving home ventilation through a tracheostomy, as well as children with symptoms of a condition called Narcolepsy (ex. very severe sleepiness despite adequate nighttime sleep).

It is important to note that Sleep Studies are NOT helpful in the management of other sleep disorders, such as:

  • parasomnias (ex. sleepwalking, sleeptalking, night terrors, etc)
  • insomnia (sleep-onset, ie. difficulty falling asleep; or sleep maintenance, ie. difficulty staying asleep, frequent awakenings)
  • delayed sleep phase disorder (ie. difficulty falling asleep until late at night, resulting in sleeping late in the morning, common among teens)

For information that may be helpful in understanding and managing these sleep disorders, please see our Sleep Resources page.

NOTE: This page is only for information about the CHEO Sleep Lab. For information about the CHEO Sleep and Home Ventilation Clinic, visit their clinic page.

Please note that while we do prioritize referrals based on the severity of symptoms, given how common these are, there is a long waiting time for sleep studies. Depending on the circumstance, you may expect to wait 1-2 years. If your child’s symptoms worsen in this time please discuss this with their physician, who may send an update if appropriate, or may refer as well to the Sleep Clinic or to other specialists for assessment (ex. Ear, Nose and Throat surgeons).

About our team 

Our team includes 3 Physicians, 2 Nurse Practitioners, 2 Respiratory Therapist/Polysomnographers, 3 Sleep-Respiratory Therapists, and 2 Home Ventilation Respiratory Therapists. 

We also work with other teams that provide support to our patients, including the Neurodevelopmental Health Team. 

Information for children, youth and families 

Before your appointment

Please sign up for a MyChart account, prior to your first visit.

Our scheduling team will contact you by phone to schedule an appointment.  

If something changes and you need to reschedule your appointment, please let us know at least 24-48 hours in advance if you are unable to make it by calling 613-737-7600 x2222.

We will make 3 attempts to contact you to arrange your appointment. If we do not receive a response, we will cancel the referral and inform the referring physician. Given our long waitlist, a no show (ie. not attending an appointment without informing us first) for a confirmed initial visit will result in cancellation of the referral. No-shows or frequent cancellations for follow-up appointments may result in discharge from the service.

Visit our Sleep resource page to find a video showing what to expect. You can help your child prepare by showing them the video as well. It also helps to play with them ahead of time to practice some of the things they will experience (ex. play with a stuffed animal with stickers on their head, face and chest, and yarn around their chest and belly; do the same with your child, etc.).

What to bring

  • Pack a comfort bag – bring items that will help your child be comfortable the night of the study, for example a favourite stuffed animal, blanket, pillow, books to read as part of the bedtime routine, etc.
  • Please bring any formula, feeding supplies, etc. that you need for the night.
  • Bring any usual medications your child takes at bedtime.

What to expect during your appointment

Your appointment will be booked for 8 or 9pm.

During your stay, the child or youth's sleep will be monitored. They will be kept overnight, with one staff monitoring up to two children. We will also look at: 

  • Breathing 
  • Sleep stage 
  • Movement 
  • Heart rate 
  • Oxygen 
  • Carbon dioxide levels 

When you arrive, the therapist will explain the test and the equipment needed. Sleep studies are not painful. For the sleep study, we will apply sensors to different parts of your child or teen's body (this doesn't hurt). These sensors give us a lot of information about breathing during sleep. During the study, your child or teen will have: 

  • Sensors on the head to monitor brain activity 

  • Elastic belts around the chest and abdomen measure breathing 

  • Sensors under the nose to measure airflow in and out of the nose 

  • A clip on the finger or toe to measure oxygen levels 

  • A microphone to record any snoring 

  • Electrodes on the sides of the eyes to monitor eye movements 

  • Sensors under the chin to measure muscle tone (whether or not the muscles are relaxed) 

Some patients have another sensor on the forehead or chest to measure carbon dioxide (air we breathe out). 

It takes about 20-30 minutes to put on all the sensors. After this, you can help your child to settle to sleep. Parents or guardians are responsible for the care of children and youth during the sleep study. There is a pull out bed for parents. 

The therapist will watch patients while they sleep by video monitor from a separate room. We'll wake you and your child or teen up between 5:30- 6:00 a.m. We'll remove all sensors and you can leave the lab shortly afterwards. 

Visit our Resources page to watch a video showing what the sleep lab rooms and set-up look like. 

After your appointment

We will send the results to the referring doctor in about 4-12 weeks, depending on the severity of the findings noted the night of the study.

Solutions and treatment options can include: 

  • Changing their sleep schedule 

  • Adenoidectomy and/or tonsillectomy 

  • Positive airway pressure (CPAP) 

  • Referral to mental health services

Frequently asked questions

How are pediatric sleep labs different from adult labs? 

Children and youth have different medical needs than adults do. These are some of the differences:

  • Our equipment needs to be specialized for children and youth
  • We may need to spend more time comforting and reassuring a nervous child or parent
  • Children require more supervision – adult sleep labs can have one technician monitoring up to 4 patients. At CHEO, we have one technician monitoring two children and we limit how many very young children we have in the lab at once
  • Scoring and diagnostic criteria are different for children and adults 

We understand that children and youth aren't just tiny adults — to help them feel comfortable in an unfamiliar setting, they can bring some of these items with them for their stay:

  • Their own blanket and pillow
  • A favourite stuffed animal
  • A book 

We also keep most of the equipment out of the room overnight, to help them sleep peacefully. 

How can I make an appointment?

All patients must be referred by a Physician or Nurse Practitioner.  After a referral is received, we will notify the referring Physician or Nurse Practitioner whether the referral has been accepted or denied, and if accepted we will provide an estimated ideal wait time. The actual wait time, however, will vary based on demand and urgency.  

If you would be available for a short notice cancellation spot (ex. would be informed by 4pm, for a spot that night), please let your referring physician know, so that they can include this information on the initial referral. 

Once we have an appointment spot to offer, our Scheduling Team will reach you by phone to schedule an appointment. 

How long will the wait be?

Concerns about breathing during sleep are very common, and we receive a high volume of referrals. Unfortunately, this leads to a longer wait time than we would prefer. Depending on the severity of your child’s symptoms, you can expect to wait 6-24 months for an initial appointment. Should symptoms worsen while you are awaiting your appointment, you can discuss with your physician who may send an update if appropriate.

What can I do while I’m waiting for my appointment?

If you are concerned about your child’s snoring and/or pauses in breathing, and your physician has prescribed a nasal steroid spray or a medication called montelukast, it is important to use this/these on a regular daily basis while awaiting your appointment. If this has not been prescribed, please consider discussing this option with them. This will help us provide advice based on your child’s test results. It is important to know that these medications do not have an immediate effect, and you may not notice any effect for many weeks. If there are side effects of concern, please discuss these with your child’s physician to decide if the medication should be stopped. If your child’s symptoms resolve with this treatment, we ask that you cancel your referral to help keep space for those patients with ongoing symptoms.

If your child has difficulty falling or staying asleep in addition to breathing symptoms, please see our resource page for a handout on strategies for healthy sleep hygiene and work on implementing these strategies prior to your visit. The more your child sleeps during their study, the more reliable the results will be.

If your child has autism, please attend the Foundational Family Services Sleep Solutions Workshop prior to your appointment. We will also refer you to the Sleep Lab orientation program to provide more help in preparing your child for their sleep study so that we can optimize their ability to tolerate the study. If you have not yet heard from the program at least 3 weeks prior to your sleep study appointment, please call us to let us know.

Sign up for MyChart to access your CHEO health record anywhere, any time. 
MyChart is a secure, online patient portal that connects you to parts of your CHEO electronic health record and allows you to send two-way secure communication to your care team, complete any questionnaires your care team sends and much more. 
To learn more about MyChart and sign up, visit our MyChart page and fill out the MyChart Access Request Form.

Looking for more resources or supports on Sleep and Sleep studies?

Visit our Sleep resource and support page to find helpful websites, local contacts, videos and more.

Information for healthcare providers

The CHEO Sleep Laboratory is focused on the assessment and management of breathing-related sleep disorders (ex. obstructive sleep apnea), from birth to age 18 years, with a focus on children with complex medical and/or developmental histories. 

For otherwise generally healthy children aged 14yo and over with a question of sleep-disordered breathing/OSA or narcolepsy, we recommend referral to either the Royal Ottawa Sleep Centre or West Ottawa Sleep Centre/MedSleep. For Quebec patients, we recommend referral to Somnocor. This will help facilitate timely care. If there is a specific reason you wish the Sleep Study to be performed at CHEO, please specify this on the referral form. 

We accept referrals for PSG + MSLT to assess for narcolepsy (ex. symptoms including true hypersomnolence, ie. severe difficulty staying awake during the day, despite appropriate amount of sleep at night - note, this is different than fatigue; sleep attacks, cataplexy, etc.) ONLY from Respirologists and Neurologists. Referrals from other physicians/providers will automatically be redirected to clinic. 

Note that sleep studies to not help in the management of behavioural sleep disorders, and so we do not accept referrals for these, including: 

  • parasomnias (sleepwalking/sleeptalking/night terrors) 
  • insomnia (sleep-onset and sleep maintenance) 
  • delayed sleep phase disorder 

We recommend: 

  • Provide family with link to CHEO Sleep Resources page 

  • If patient has autism, suggest family attend the Foundational Family Services Sleep Solutions Workshop 

  • Champlain Base eConsult to Dr. H. Myron  

  • Or, if > 14yo referral to Royal Ottawa Sleep Centre or West Ottawa Sleep Clinic/MedSleep 

Make a referral

Note: this referral is only for sleep studies. For information about, and to make a referral to the CHEO Sleep Clinic, visit their clinic webpage. If you want to refer to BOTH Sleep Clinic AND for a Sleep Study, both forms must be completed. Waitlist and triage are separate.

All patients must be referred by a Physician. Please fill out the below Sleep Lab request form and mail or fax it to us using the contact information below.

Sleep study request form

Referral criteria and eligibility
Reason for referral/request Mandatory information to include in referral/request Other information

Assessment re:

 

  • Obstructive sleep apnea 
  • Central Sleep Apnea 
  • Hypoventilation 

Relevant clinic information. As per request form:

  • Nocturnal symptoms:
    • snoring - < 3 nights/wk or > 3 nights/wk
    • witnessed pauses with effort – occasional/frequent
    • gasping – occasional/frequent
    • labored breathing
    • mouth breathing
    • secondary enuresis
  • Daytime symptoms:
    • morning headaches
    • excessive somnolence
    • irritability
    • poor concentration
    • poor/declining school performance
    • Physical examination findings:
    • tonsil size
    • BMI %ile
  • Past Medical History. Please specify if any of the following:
    • Obesity
    • Genetic disorder/Syndrome - specify
    • Epilepsy
    • Congenital heart anomaly
    • Pulmonary illness (ex. asthma)
  • Whether an interpreter is required 

  • Whether patient would benefit from Sleep Lab Orientation consultation through Foundational Family Services 

  • Whether family open to being booked in a last minute cancellation spot (ie. Would be notified by 4pm for an appointment that night) 

Other information

  • Failure to include above requested information may impact our ability to accurately triage the referral
  • For symptoms of OSA, please prescribe a 3 month trial of regular daily nasal steroid and/or montelukast based on relevant indications/contraindications pending assessment in Sleep Lab
  • Please cancel the referral if:
    • Symptoms resolve with the above
    • Symptoms resolve spontaneously
    • The patient is assessed by ENT and plans made for adenotonsillectomy
  • If symptoms worsen while your patient is awaiting their sleep study, please do not hesitate to send us a clinical update (please identify as an update to the previous referral and cite date of original referral)
  • Please note that referrals will be cancelled if the family does not attend a confirmed initial appointment, or if we receive no response after 3 attempts over a month to schedule an appointment. As such, please ensure contact information is accurate on the referral, and please provide an update if information changes.

Contact us 

Clinic C-9
Sleep Lab, CHEO
401 Smyth Road
Ottawa, ON K1H 8L1

Fax: 613-738-4298
Main Sleep Lab Reception (C9) (scheduling center): 613-737-7600 extension 2222

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