Little Archie’s family reached out for help when he was 14 months old.

After enduring months of sleepless nights, they were exhausted and in need of some advice on how to help their son get the sleep they all so desperately needed. 

They had been down the Google rabbit hole, bought numerous sleep products hoping they would be the answer and tried all the well meaning advice from friends and family. 

None of it made a lick of difference.

In our initial conversation, Archie’s parents highlighted that he fell asleep relatively easily at bedtime, but that he woke and cried out multiple times a night and needed constant re-settling. He napped reasonably well in the daytime, even at daycare, but still always seemed tired and slightly irritable.

Nothing in the initial discovery call immediately jumped out at me - I was optimistic I could help! Their exhaustion was obvious and I badly wanted to find the solution this family was seeking  - and it turns out I was, but not in the traditional sense.

They diligently completed their sleep intake form, providing details on all the aspects of Archie’s day that could be impacting his sleep.  As I read the form, I distinctly remember a few things giving me pause for thought - Archie had only slept through the night a handful of times at 14 months old, with constant colds, runny nose and ear infections setting back any progress he was making in the sleep department. And he was a noisy sleeper, always snuffling and grunting in his sleep ever since he was a newborn. 

So I made a call to the family and dug a little deeper.  I asked a range of questions that to many would seem unrelated:

• When Archie is playing quietly, does he breath through his nose or mouth?

• How many times a day do you wipe his nose? 

• How many times this year has he been treated for ear infections?

• How is his language development going? 

The answers to these questions all pointed to an underlying medical condition being the culprit to the family’s sleep woes.  All signs pointed Sleep Disordered Breathing (SDB). 

I requested that Archie get a referral and clearance from an ENT specialist before we proceed any further with sleep training. I simply was not comfortable working together without knowing for sure that there wasn’t something more sinister causing the fragmented night. 

Back to the GP they had been to see so many times that year, but this time they left with the ENT referral and a requisition for a hearing test (standard procedure before seeing an ENT).

The hearing test showed Archie had 40% hearing loss due to an intense build up of fluid behind his ears.  The pressure would have been immense and pretty painful, especially when lying down.  It also meant he was not hearing sounds in the lower register, thus explaining the delay in speech development.

Further investigation from the ENT specialist revealed enlarged tonsils and adenoids which were causing significant restriction of Archie’s airway. 

Five weeks later, he was booked in for surgery to have his adnoids removed and grommets put in. 

Two weeks post-surgery, Archie was sleeping through the night. 

Simply put, no amount of sleep training would have helped this little boy. And without intervention, his struggles with sleep woud have persisted. 

If, like Archie’s parents, you feel like you have tried it all and sleep is not improving, consider reaching out for support. Having a certified sleep consultant who can look at the whole picture with fresh eyes could be the thing that helps put the pieces of the puzzle together. 

This case study is an anecdotal experience of one child and should not be taken as medical advice. If you have concerns about your child’s sleep and suspect there could be an underlying medical issue, please reach out to your family doctor for advice and guidance.