Sleep is crucial for a child's growth and development. Forty years ago, the Hôpital Universitaire des Enfants Reine Fabiola (HUDERF) established a dedicated pediatric sleep unit, spearheaded by Pr André Kahn. This unit, the first of its kind in Belgium, has made sleep a recognized field of pediatric expertise, with significant contributions from Dr José Groswasser, Dr Sonia Scaillet, and Fabienne Modard. This expertise continues today under the leadership of Dr Alina Andrei, a neuropediatrician, within the Neuropediatrics Department of H.U.B, directed by Pr Alec Aeby.
In its early years, the unit focused on understanding and preventing sudden infant death syndrome (SIDS). Teams developed sleep recordings to study respiration, heart rate, and apneas in at-risk infants, particularly premature babies. Research led by Pr André Kahn, with active participation from Dr Sonia Scaillet and Fabienne Modard, enhanced knowledge of infant sleep and factors associated with these tragedies. Elisabeth Rebuffat contributed to prevention efforts, and psychologist Martine Sottiaux provided support to families. Home cardio-respiratory monitoring also played a role, though its indications have evolved with research advancements and prevention recommendations, such as infant sleep position.
Over time, sleep medicine has expanded to encompass sleep disorders across all childhood ages. Diagnostic tools now identify conditions like obstructive sleep apnea, sleep-related epilepsies, periodic limb movements, and rare pathologies such as Ondine's syndrome. This diversification has fostered multidisciplinary collaboration among neuropediatricians, pulmonologists, ENTs, psychologists, and nurses. The development of non-invasive ventilation has significantly improved care for children with neuromuscular diseases affecting respiratory muscles. Modern polysomnography simultaneously records multiple parameters, aiding in the identification of complex disorders. Since 2020, the Neuro-Epilepsy-Sleep unit further strengthens this synergy.
It is important to distinguish between sleep pathologies and difficulties related to a child's sleep rhythms and habits. Issues like trouble falling asleep, repeated night awakenings, or irregular schedules can disrupt families without requiring specialized medical examination. Adapting sleep routines, schedules, and environments, along with informing parents, are key aspects of care. Narcolepsy, a neurological condition often difficult to diagnose in young people, is also a particular concern, requiring tailored diagnosis and medical, familial, and school support to improve patients' daily lives.
Children's sleep environments have also transformed with the prevalence of screens (smartphones, tablets), which can delay bedtime and shorten sleep duration, exacerbating sleep deprivation in adolescents. Specialists increasingly consider the links between sleep, attention, learning, neurodevelopmental disorders, and psychological health. The current challenge is to help children and their families prioritize sufficient sleep in their daily lives. The expertise developed over 40 years at HUDERF, initiated by Pr André Kahn and continued by Dr Alina Andrei, aims to better understand sleep to support children's development and well-being.
