Sleep Disorders in Children

Is your child having trouble sleeping? We all know that restful sleep is necessary to heal and repair the body. But recent health reports suggest that many children in the U.S. are chronically sleep deprived. For instance, in a National Sleep Foundation (NSF) poll, researchers found that more than two out of every three children ages 10 and under have experienced some type of sleep problem.

There's a price to pay for sleep problems in children. In a revealing study at Northwestern University Medical Center, scientists followed the sleep patterns of 510 kids between 2 and 5 years old. The study showed that less sleep at night means more behavioral problems during the day.

Other studies have linked poor sleep in children with bad grades in classes such as math, reading, and writing. In addition, some studies show that sleep disturbed children have more depressive symptoms and anxiety disorders.

As with adults, there are all sorts of reasons why children don't sleep well. Some of those reasons are more serious than others. But if you've got a problem sleeper (or two) in your house, there are ways to help everyone, including the parents, get a good night's sleep and feel alert and productive the next day.

Are There Different Types of Sleep Problems in Children?

Sleep problems are classified into two major categories. The first is dyssomnias. In children, dyssomnias may include:

  • Sleep-onset difficulties
  • Limit-setting sleep disorder
  • Inadequate sleep hygiene
  • Insufficient sleep syndrome
  • Snoring and obstructive sleep apnea (OSA)

The second class of sleep disorders is parasomnias. Examples of common parasomnias include:

What Is Insomnia?

Insomnia is a disruption of the sleep cycle that includes difficulties with getting to sleep, difficulty staying asleep, and possibly early morning awakenings. In children, insomnia can last a few nights or can be long term, lasting weeks. Children with sleep anxiety may have insomnia. Other insomnia triggers include daily or chronic stress, pain, or mental health issues.

If your child has insomnia, here are things you can do:

  • Try to identify stressors. For example, additional homework, problems with friends, or a move to a new neighborhood can cause nighttime anxiety.
  • Establish a regular bedtime routine that allows your child time to relax before the lights go out.
  • If insomnia continues, talk to your child's doctor about ways to resolve the problem.

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What Does It Mean if a Child Snores Loudly?

Slightly more than one out of every 10 children snore habitually. Snoring can be caused by different problems. For example, chronic nasal congestion, enlarged adenoids, or huge tonsils that block the airway can all cause snoring.

With snoring, the muscles supporting the opening of the upper airway in the back of the child's throat relax during sleep. Extra tissue in the palate and uvula -- the fleshy piece that hangs from the roof of the mouth -- vibrates with each breath. These vibrations actually cause the sound we call "snoring." In some children, there is a tendency for the airway to close at any point along this area. Narrowing of the airway causes turbulence and the noises of snoring.

Snoring can be harmless. But it can also result in poor quality of sleep and changes in the child's sleep-wake cycle. Because of restless sleep and frequent awakenings, there is diminished daytime alertness. That can lead to dramatic alterations in mood and energy. A few children who snore may have a more serious problem called obstructive sleep apnea, or OSA.

What Is Obstructive Sleep Apnea?

Obstructive sleep apnea is a common problem in children today. According to the American Academy of Pediatrics, symptoms of sleep apnea in children include:

  • Nighttime snoring with occasional pauses
  • Gasping or choking
  • Sleep disruption

Children with snoring and OSA often have large tonsils and/or adenoids. Many are obese and/or have an allergic disease. Sleep apnea is associated with the following consequences:

  • Abnormal growth and development
  • Bedwetting
  • Behavioral and learning problems
  • Daytime sleepiness
  • Hyperactivity or ADHD

Treatment for children who either simply snore or who have OSA may include:

Sometimes, nasal continuous positive airway pressure (CPAP) is used for children with obstructive sleep apnea. CPAP involves using a machine that delivers a stream of compressed air through a nasal mask to the child's airway to keep it open during sleep.

Are Sleepwalking and Bedwetting Common Sleep Problems in Children?

Some sleep behaviors -- such as sleepwalking, teeth grinding (bruxism), and bedwetting -- are not unusual among children. Also, sleepwalking is more common in boys than in girls. Sleepwalking may result from an immature central nervous system or from being overly tired. It usually happens about an hour or two after the child falls asleep. Sometimes sleepwalking can persist into adulthood. Because sleepwalkers can be harmed, parents need to protect the child from injury.

Bedwetting may continue well into the elementary years for both girls and boys. While bedwetting is sometimes due to anxiety or other emotional issues, nothing is wrong in most kids. They will eventually outgrow bedwetting -- girls usually stop before boys. On the other hand, although it’s uncommon, bedwetting can be the result of an infection or an allergy.

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What Are Night Terrors?

With night terrors -- also called sleep terrors -- the child has a sudden arousal from sleep with extreme agitation, screaming, crying, increased heart rate, and dilated pupils. Like sleep walking, night terrors seem to be linked to an immature central nervous system and are often outgrown. These sleep terrors usually begin after age 18 months and disappear by age 6.

If your child has night terrors, it's important to talk to family members and assure them the episodes are not harmful. Make sure the child's room is safe to protect against an injury during a night terror. It also helps to stay on a regular sleep regimen and to manage stress so the child is not anxious at bedtime.

Are Nightmares Common in Childhood?

Nightmares are the frightening dreams that happen during rapid eye movement (REM) sleep. They are a common part of childhood.

At the toddler stage, kids begin active dreaming where it's often hard to distinguish reality from imagination. Preschoolers and elementary school-age kids may experience nightmares that are a result of everyday emotional episodes. For example, arguments with classmates or siblings, academic stress, or fear of separation can cause nightmares.

Most kids have had a nightmare at some time. According to the National Sleep Foundation's Sleep in America poll, 3% of preschool and school-aged children experience frequent nightmares. The worst nightmares seem to occur around the age of 6. As your child matures, bad dreams will probably decrease.

Can Kids Get Restless Legs Syndrome?

Restless legs syndrome (RLS) is not unusual in children 8 years of age and older. This neurological sleep disorder causes a creeping, crawling sensation in the legs (and sometimes in the arms) that creates an irresistible urge to move.

Studies show that restless legs syndrome may have a strong genetic component. Children with sleep tremors or restless legs syndrome may have difficulty falling asleep. That can result in daytime fatigue and irritability. According to recent studies, ADHD and depression may be more common in those diagnosed with RLS. Talk to your child's pediatrician about ways to treat RLS in children.

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How Much Sleep Do Children Need?

Sleep experts suggest that elementary-aged children should get 10 to 11 hours of sleep each night. Preschool-aged children should sleep about 11 to 13 hours a night.

How Can I Help my Child's Sleep Problems?

If your child is sleep walking, wetting the bed, or experiencing other sleep disturbances such as night terrors, talk with his doctor. Sometimes, emotional stress is the culprit. In most cases of emotional stress, the problem can be easily resolved with a few behavioral interventions.

In addition, watch your child as he sleeps to determine a pattern in his sleeping and possible snoring or sleep apnea. If your child suffers from allergies or asthma, make sure he is taking medication properly. Again, your child's doctor is the best source for treatments for sleep problems.

What Is a Sleep Study?

An overnight sleep study, or polysomnography, may be recommended for your child, especially if he has excessive daytime sleepiness, problems staying asleep, or OSA. The sleep study will help determine if your child has a diagnosable problem such as pure snoring, obstructive sleep apnea, restless legs syndrome, or another sleep problem. These disorders may require specific therapy that your child's doctor will prescribe.

WebMD Medical Reference Reviewed by Roy Benaroch, MD on August 02, 2014

Sources

SOURCES:

American Family Physician: "Sleep Problems and Sleep Disorders in Children."

University of Michigan Health System: "Sleep Problems."

National Sleep Foundation: "Coping with Children’s Sleep Problems."

National Sleep Foundation: "Children, Obesity and Sleep."

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