We have a 5yo who has quite honestly never slept the night.  Restless sleep, bad dreams, always awakens while dreaming all confused and incoherent, sleeps in weird positions, hyperactive.  Even as an infant he only slept in 45min intervals.  Needless to say, I'm tired!!!  I thought about apnea years ago, but we knew it required surgery and kids often outgrew it, so we decided to wait.  Asked his ped about it last August, because I mean how many 4 year olds don't sleep the night most of the time (or at least don't wake up several times each and every night)?  He doesn't snore, so his response was to give me a pamphlet on infant sleep and crying it out, etc.  Not only do I not agree with those methods, I was like um he is 4?!  What part of we have tried everything do you not understand?  But I digress!!!  We live in NYC, I'd like him to go, I think, to the sleep center at Columbia Children's...but where do I start?  Do I call them and go right to a sleep doctor?  Does his regular ped refer him for a study?  My insurance doesn't require referrals to see a specialist.  My husband was just diagnosed with OSA too, incidentally, which has made him more convinced that that is our son's problem as well.  I'd love help, advice, doctor rec's, btdt's....

We're tired over here, help us!!!

Sounds like you do need to see a specialist just to tease out what might be happening.  Find a sleep specialist and call them up and make an appointment for a consult.  They can refer you for a study if that is what is necessary.  (If it is a behavioral sleep disorder, then an overnight sleep study is probably not necessary.)  It sounds like it might be good if you can see someone who has experience in Pediatric Behavioral Sleep Medicine, but anyone who specailizes in sleep should be able to help you out, or set you on the right path with referrals, etc.