Circadian Medicine Clinic
Cincinnati Children’s Circadian Medicine Clinic is the only clinic in the country dedicated to childhood circadian rhythm sleep disorders. We bring together board-certified sleep medicine doctors and sleep psychologists to develop a custom treatment plan for your child.
We understand that childhood circadian rhythm problems can be disruptive for both children and parents. At Cincinnati Children’s, we can treat even the most complex circadian disorders, so you and your family can get back to a normal routine.
Circadian medicine treats problems with the the body’s circadian rhythm, which is like a person’s internal clock. Our team specializes in:
- Complex or hard-to-treat cases that haven’t responded well to treatment
- Simplified and coordinated care, so you don’t have to worry about managing appointments and specialist schedules
- A team approach to treatment that includes board-certified sleep medicine doctors, sleep psychologists and researchers
- Research and clinical trials for circadian sleep disorders
- Concierge services to help families traveling from out of town as well as financial assistance services
Conditions We Treat
Circadian sleep disorders cause kids to sleep at odd times during the day instead of sleeping only at night. For example, a child with a circadian disorder may sleep from 4 a.m. to 2 p.m., or 2 p.m. to 6 a.m.
Aside from unusual sleep schedules or “night owl” symptoms, kids with circadian sleep disorders may also have:
- Restless sleep
- Daytime sleepiness
- Frequent nighttime awakenings
Many kids with circadian issues have other sleep disorders. The goal of the Circadian Medicine Clinic is to figure out if those sleep disorders stem from a problem with the internal clock and find a treatment that gets your child on a normal sleep schedule.
We treat children of all ages with circadian conditions. Our team can help with a full range of circadian sleep disorders, including:
- Advanced sleep-wake disorders
- Delayed sleep-wake disorders
- Irregular sleep-wake rhythm disorders
- Non-24-hour sleep-wake rhythm disorders
- Genetic syndromes that cause circadian problems
Our Treatment Approach
We take a team approach to circadian rhythm sleep disorder treatment. Board-certified sleep medicine doctors work with sleep psychologists and researchers to develop a custom treatment plan for your child. We also have a care coordinator who will help manage your appointment schedule and any follow-up visits.
Circadian conditions usually need a combination of therapies, including medication and cognitive-behavioral therapy. During this therapy, a psychologist works with your child on creating healthier sleep habits. This process may include talking about emotions or worries around sleep. They may also work with your child on ways to address behaviors that may be causing sleep problems.
Depending on your child’s symptoms, he or she may need to take multiple medications to help them sleep normally. These medicines can include:
- Medications to help your child fall asleep (hypnotics)
- Medications that help your child sleep through the night (sleep consolidation)
Some genetic conditions can also cause circadian sleep problems. If your child has a genetic condition, our team will work with your child’s other doctors to make sure any new medicines won’t conflict with an existing treatment.
What to Expect
If your child has circadian rhythm problems, your pediatrician may refer you to our Sleep Center for treatment. You can also contact our Sleep Center directly for a referral.
Once you are referred to the Sleep Center, we’ll ask you to fill out a questionnaire. This form will help us better understand your child’s health history and symptoms so that we can prepare the right team of experts for you. If the questionnaire shows that your child has symptoms of a circadian sleep disorder, we will schedule a visit with our Circadian Medicine Clinic.
The Circadian Medicine Clinic allows you and your child to meet with our entire team at your first visit. That means you won’t have to coordinate multiple appointments or bring information from one specialist to another. The consultation will include:
- A sleep psychologist
- A child neurologist who practices sleep medicine
- An ear, nose and throat (ENT) doctor who practices sleep medicine
- Research team
Our team will ask about your child’s medical and sleep history. We may also ask your child to undergo testing to pinpoint what’s causing the sleep problem. These tests may include:
- Actigraphy – This test involves wearing a small sensor that monitors sleep cycles. The sensor is similar to a fitness tracker.
- Melatonin test – During this test, we’ll take a saliva sample to measure melatonin levels. Melatonin is a hormone that manages the body’s sleep-wake cycle.
- Sleep diaries – We may ask you to use a sleep diary to record your child’s sleeping habits and behavior.
- Genetic tests – These tests may help us pinpoint specific genes that cause circadian problems.
After the exam and testing, the team will collaborate on a treatment plan. Then, we’ll work with you to schedule follow-up appointments as needed. These appointments may include visits with behavioral medicine experts or sleep psychologists. We’ll also coordinate follow-ups for checking on medications and your child’s overall progress.
If you were referred to us by another doctor or pediatrician, our team will communicate with them throughout the diagnosis and treatment process. This will help make sure your home doctor can stay informed about your child’s progress and help manage any follow-up care, if needed.
Read about resources for traveling families.
Cincinnati Children’s is actively involved in research for circadian sleep disorders. Every patient who comes to our Circadian Medicine Clinic will meet with the research team during their initial visit.
The research team will help determine if your child can participate in a clinical trial for a new treatment option. We may also ask that your child join a data registry for circadian sleep disorders. This registry helps us learn and track how different children respond to therapy to improve future treatments.
Our team is also working to create a sleep gene panel test. This test would be similar to panel tests for genetic syndromes. It would allow us to pinpoint specific genes that may put kids at risk for sleep problems.
Meet the Team
The Circadian Medicine Clinic brings together board-certified sleep medicine doctors, sleep psychologists and researchers. Our team includes:
- Thomas J. Dye, MD
- Kelly C. Byars, PsyD
- Kristina Decker, PhD
- Danielle Simmons, PhD
- David F. Smith, MD, PhD, FACS, FAAP
- Rochelle Witt, MD, PhD
Locations and Directions
To schedule an appointment for your child or refer a patient to the Circadian Medicine Clinic, please contact us.
You can also reach out to the Sleep Center for more information by filling out our online form.