Sleep Laboratory

Our Pediatric Sleep Medicine Clinic and Laboratory has a dedicated team of health care professionals (doctors, respiratory therapists, nurse and administrative agent) with specific expertise in sleep disorders in children.

• Dr. Evelyn Constantin, Director
• Dr. David Zielinski
• Dr. Robert Brouillette
• Lori Seller, Manager Respiratory and Anesthesia Services
• Diana Zinno, RRT, Assistant Manager Sleep Laboratory
• Sylvia Ladan, RRT
• Shelley Bartholomew, RRT
• Penny Doucet, RRT
• Alice Pilot-Handfield, inh
• Shazia Khan, RN
• Michelina Iorio, administrative agent
• Adriana Torres, administrative agent

• Hours: 8:00 a.m. to 4:00 p.m.
• Phone: 514-412-4321
• Fax: 514-412-4234
• Email: [email protected]

Our administrative agent will contact you with an appointment date that will be determined according to a triage process that establishes a medical priority to each referral. This process may be lengthy due to a high demand for our services.  Should your child’s condition worsen during this time, please return to your referring doctor for a reassessment.

Note that when the agent contacts you from the hospital, the hospital phone number will not appear; instead the phone call will appear on your phone as “private caller” or “no caller ID”.  Please be sure to provide a daytime phone number, cellular number and email when sending your referral.  This is obligatory in order to start the process.

Depending on the reason for initial consultation and in the interest of providing rapid access to care, our physicians and health care team will review your referral and may redirect your referral to another appropriate center, affiliate pediatricians or sleep specialists in the Montreal area.

Referring a patient

All information can be faxed or emailed to our administrative agent:

• Fax: 514-412-4234   
• Email : [email protected]

Once the necessary documentation has been received, the referral will go through a triaging process. Our administrative agent will contact the family with an appointment for testing or for an appointment with the Sleep specialist.

The Pediatric Sleep Laboratory is located at the Montreal Children’s Hospital:  AS1.2335 (Montreal Children’s, A Pavilion, Level S1, room 2335). 

From the S1 Parking Lot Entrance walk towards the Teddy Bear statue located outside, STOP at the stairwell next to the play area:  we are on the Right hand side.

From the Main Floor entrance (RC), take the elevator down to S1, locate stairwell next to the Play area, when looking at the giant teddy bear outside, we are on the right hand side.

We offer the following sleep studies and expertise:

• Consultation with a Sleep Specialist
• Overnight Home Oximetry
• Overnight in-Hospital Sleep Study (Polysomnography)
• Actigraphy
• Overnight Home Sleep Apnea Test

Overnight Home Oximetry

On the day of your child’s appointment, you will come to the Pediatric Sleep Laboratory. You will  be asked to complete an online questionnaire and will receive instructions on how to place the sensor on your child’s toe, how to use the oximetry machine, as well as how to fill in the Sleep Log. This visit to the Sleep Laboratory will take about 30-40 minutes. You will borrow the machine overnight and be expected to return it to the Sleep Laboratory the next day at 8:00 a.m.   You MAY be asked to bring your child in for a medical appointment/consultation with the Sleep Specialist either on the day you pick up or the day you return the machine (this will be confirmed with you by our administrative agent). In certain cases, the visit with the Sleep Specialist is not obligatory.

An oximetry test is done with a machine called a pulse oximeter.  You will place a sensor on your child’s toe.  The sensor is essentially a bandaid with light that measures the amount of oxygen in your child’s blood, as well as their heart rate. It is very simple to apply and use, and painless!Overnight pulse oximetry is done at home to measure oxygen levels when a child is asleep. This helps us determine if there is disordered breathing during sleep.  This can be due to:

• Narrowing or obstruction of the airway leading to snoring or noisy breathing
• Pauses in breathing (apnea)
• Shallow breathing (hypoventilation)

Polysomnography

A more detailed sleep study called polysomnography is done in the hospital and records your child’s sleeping and breathing patterns. It is a test used to investigate breathing problems during sleep.  

• Multiple sensors (up to 30) will be applied to your child’s head, face and chest, and maybe legs.  These sensors allow us to record many signals related to your child’s sleep and breathing;
• There are no needles involved in the set-up process. All sensors are applied with either tape or sticky cream, and these sensors do not hurt;
• The set-up of the polysomnography can take up to 1 hour, and you are with your child throughout the process;
• All children must be in the company of a parent/or caregiver who must stay overnight with the child; a cot with linen is provided for one parent throughout the night;

The test will be performed and reviewed by a Registered Respiratory Therapist. The test will be reviewed and interpreted by a Pediatric Sleep Medicine Specialist and the results of the sleep test will be sent to your referring doctor. If you would like a copy of the report to be sent to your family doctor/pediatrician, please notify the respiratory therapist or our administrative agent.

• The Respiratory Therapist (RT) will greet you in the Pediatric Sleep Laboratory at 6:30 p.m. Please ring the doorbell to announce your arrival;
• You will receive a quick tour with some explanations of the process, there is some paperwork to complete, some measurements to take (including height and weight) before we start the set-up, which is usually around 7:30 p.m.;
• Even older children who have late bedtimes tend to fall asleep once the lights go out in the sleep lab, so we will often start the sleep study earlier than your child’s usual bedtime;
• Sometimes, as part of the sleep test, the doctor will ask for a finger prick blood test in the morning upon waking;
• Typically, the wake- up process begins at 5:00 a.m., and removal of the sensors can take up to 20 minutes. Remember the RT finishes their shift in the sleep laboratory at 6:00 a.m., so please be aware that you must leave the sleep laboratory by 5:45 a.m., at the latest.  Should you be waiting to be picked up in the morning, there are seats in the atrium available to you or places in the hospital with breakfast foods available 24 hours a day.
• Remember that sleep studies are video and audio recorded as this helps the RT and the physician to interpret your child’s sleep and breathing.

We recommend you bring the following items on the day of the test:

• Two-piece pyjamas (with no feet attached to the pyjamas and separate socks; all children must wear night wear);
• A list of all medications that your child is taking; please bring any medication needed during the night or in the morning;
• If your child is on BIPAP/CPAP/Trilogy please bring the equipment plus all accessories including the mask, hose and humidifier;
• Formula, milk, snacks, dishes/cutlery:  a fridge and microwave are available for parent/patient use. Note the sleep lab is an outpatient department (meaning that patient is not admitted to the hospital), so hospital meal service is not provided;
• For gavage feeds: bring formula and the feeding pump;
• Bring personal toiletries and a change of clothes for the next day.  The lab provides towels; please note there is bathroom with a sink, but no shower;
• The white cream that holds the sensors in place on your child’s head is very sticky. Please prepare for the test by thoroughly washing your child’s hair before the sleep study. The cream is easily removed with warm water and shampoo. If you prefer to do so at home, a hat would be handy for the morning to hide the white paste;
• Feel free to bring a special pillow, blanket, child’s toys or books, white-noise device or a music box, if desired;
• Adolescents are encouraged to shower and shave, if applicable, before arriving for their test;
• Your child is here for a test and we need to be able to visualize your child’s face, chest and sometimes their legs at all times. Once they have fallen asleep we may remove the bedcovers so we can visualize your child’s breathing during sleep. Rest assured that the temperature in the rooms are at a comfortable level;
• The Respiratory Therapist may require assistance from the parent/caregiver. It is therefore important for the adult to remain in the room with the child at all times.

Reasons to cancel the sleep study

• If your child is ill and has any of the following symptoms the day of the study or the day prior to testing, please notify the lab as soon as possible before the sleep study: a fever, a cold, diarrhea, a skin rash, head lice or any other concerns;
• Please notify the lab if your child has had a contagious illness within a week of their scheduled test;
• PLEASE CALL the Sleep Lab at 514-412-2431, before 15:30 pm to advise the administration agent. After 5:30 p.m., please call 514-412-4400 extension 23130 to advise the Respiratory Therapist of your absence as soon as possible, so they can contact another family to come in that same night.
• If for any other reason you cannot attend your appointment, please call the Sleep laboratory at a minimum 24 hours prior to your appointment, as there are many families waiting for this test.

• A sleep study measures and records sleep and breathing to investigate for a sleep disorder;
• The RT will take measurements of the head, and then apply small sensors attached to very long wires applied to your child’s head, face, chest and toe and attach these with tape and sticky paste;

These sensors record:

• Brain waves (EEG) (sensors on the scalp)
• Eye movements (sensors near the eye)
• Muscle movement (sensors under the chin)
• Limb movement (sensors on the child’s lower legs)
• Heart Rate (sensors on the chest)
• Breathing (sensor placed near the nose and bands placed around the chest and abdomen)
• Blood oxygen levels (sensor on the toe)
• This is all complemented by video recording

Your child is undergoing an important test tonight.  We thank you for your collaboration to improve our chances of completing successful test in our Sleep Laboratory.  To help practice good sleep habits as recommended by our Sleep Specialists, we encourage you to follow a few simple instructions.

Please be advised that there is a video camera in the room. The Respiratory Therapist can hear and see what is happening in the room as this is helpful to assess your child’s sleep and breathing.

1.      After the set-up of all the sensors for the sleep test, the lights will be dimmed and then turned off to allow your child to fall asleep; NO phones, tablets, or TV are allowed in the room during this wind-down period.

2.      During the set up and prior to bedtime, reading is encouraged!  Soft music can also be played.

3.      We understand that lights out in the sleep lab may be before your child’s normal bedtime. This is because we need to have several hours of sleep recorded in order to assess your child’s sleep and breathing. You may pleasantly surprised by the fact that your child may fall asleep earlier than usual.

4.      If you are known to snore, please advise the Respiratory Therapist.  If you snore loudly, you may be asked to be move into another room as any noise interferes with your child’s study.

5.      Our hospital policy is that only one parent is allowed to stay in the room overnight.  We can provide the other parent with linen if they would like to sleep in the Atrium area.

6.      After your child falls asleep we ask that you don’t make calls on your cell phone.  Any quiet activity is permitted. Digital devices require earphones to be used in the room.  Otherwise, you are permitted to step outside and wander in the Atrium for a short period. Please advise the Respiratory Therapist if you need to leave the bedroom for any period of time. As much as possible, we ask that the parent stays in the bedroom during the entire study.

7.      We kindly ask you NOT to cover your child with a blanket.  Children under 12 months should not sleep with a blanket. For older children who fall asleep with a blanket for comfort, we will ask you to remove it once they are asleep or the RT may also remove it to help better visualize your child’s breathing during sleep.  The temperature in the room is purposefully raised for your child’s comfort.

8.      The RT will be observing your child’s sleep and breathing the entire night in the Sleep Laboratory.  If you have any questions, please feel free to ask the RT during the night.

Resources

Healthy sleep for your baby and child