Child Sleep Disorders
Good Child sleep patterns are especially crucial for a growing child.
The slow wave sleep phase, the deepest form of sleep, is when most of the daily output of growth hormone is released.
And don't wait until your child is hysterical with tiredness before putting it down.
A distressed child will not be able to sleep. Lack of child sleep can have dire consequences for both the child and their family. If the child is deprived of child sleep, he/she will develop Deficit Disorder and child sleep disorders.
Child Sleep Disorder - Parasomnias
Parasomnias are sleep disorders characterized by abnormal polysomnography. They are episodic in nature and are a reflection of central nervous system (CNS) immaturity. Thus, they are more common in children than in adults and are generally outgrown with time. There is often a family history positive for these parasomnias.
Child Sleep Disorder - Obstructive Sleep Apnea Syndrome
Obstructive sleep apnea syndrome (OSAS) is thought to affect 1 to 3 percent of children. Symptoms include snoring, difficulty breathing during child sleep or mouth breathing during sleep.
Parents of infants with significant Obstructive sleep apnea syndrome may report difficulty with feeding.
Obstructive sleep apnea syndrome in children is frequently caused by adenotonsillar hypertrophy. Other causes include craniofacial abnormalities, obesity and neuromuscular disease. A high prevalence of allergic disease among children with snoring and OSAS has been reported
Child Sleep Disorder - Narcolepsy
Narcolepsy is uncommon child sleep disorder but may sometimes occur in adolescence. The predominant symptom, as in adults, is excessive daytime sleepiness.
Initially, children with child sleep disorder narcolepsy have great difficulty getting up in the mornings. When awakened, the child may appear to be confused or may be aggressive or verbally abusive.
These children benefit from regularly scheduled naps. Often, stimulant medication will be required. Because this is a lifetime disease with a potential for significant morbidity, children with narcolepsy should be followed by a sleep specialist.
Child Sleep Disorder - Bed Wetting or Nocturnal Enuresis
Nocturnal enuresis, or bed wetting, is one of the most prevalent and persistent child sleep problems. Enuresis is classed as primary when the child has never been persistently dry through the night and as secondary when the child starts wetting the bed after one year of continence.
Primary enuresis is much more common and less likely to have a pathologic cause. Behavioral interventions, such as limiting intake of fluids in the evening and waking the child to use the bathroom before the parent goes to bed have often been tried before the family comes to the physician.
Child Sleep Disorder - 'Pavor Nocturnus' or Night Terrors
Pavor nocturnus (night terrors) occur approximately 90 minutes into sleep during stage 3 or 4 NREM sleep. The child suddenly sits bolt upright and screams, and is inconsolable for up to 30 minutes before relaxing and falling back to sleep.
Tachycardia, tachypnea and other signs of full-fledged autonomic arousal are apparent. Night terrors usually occur in children three to eight years of age. They need to be distinguished from nightmares. They are more likely to occur during times of stress or fatigue.
As frightening as they are, parents and children usually only need to be reassured that they are generally self-limiting. Attempts should be made to alleviate whatever stress may be going on in the child's environment and to ensure that the child is getting adequate rest.
In children for whom night terrors are not self-limiting or are especially disruptive, diazepam (Valium) has been used with some success.
Child Sleep Disorder – Sleepwalking and Sleep talking
In sleepwalking (somnambulism) and sleep talking (somniloquy), a child sits up in bed with eyes open but is "unseeing." Activity may range from a purposeless restlessness in bed to actual walking through the house. Speech is mumbled and slurred, and is rarely intelligible.
These child sleep disorders occur in the school-aged child. These child sleep disorders are more often found in boys than in girls, and are often associated with bed wetting.
Sleepwalkers have the potential for physical harm, and parents must take steps to avoid unsafe situations, such as falling from balconies or down stairs. Bedrooms for sleepwalkers should be on the first floor of the home, and windows and doors must be firmly secured.
When confronting a sleepwalking child, parents should keep interventions to a minimum and refrain from shaking, slapping or shouting at the child.
These sleep behaviors are usually outgrown by adolescence and generally do not require any intervention other than those mentioned above.
Secondary Child Sleep Disturbances
These child sleep disturbances are much more common than primary child sleep problems and are characterized by normal polysomnography. The disrupted child sleep pattern is often transient, but there is potential for much distress in the family when it persists.
The most frequently encountered secondary child sleep disturbances are night awakenings and bedtime resistance, which occur most commonly in toddlers and preschool-aged children.
