How to Get a Handle on Sleep Disorders in Children?

Parents find it such a challenge to discover and deal with sleep disorders in children! Studies suggest that nearly 30% of children experience the symptoms of a sleep disorder at one point in their lives.

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The effects can include daytime behavioral issues, poor academic performance, and even anxiety and depression. Fortunately, most of these sleep disorders can be treated.

Parents must recognize their signs so that appropriate and prompt actions can be made, both in terms of medical intervention and lifestyle remedies.

Children will need their parents’ guidance and support during the treatment phase. But first let’s take a look at two important matters in relation to sleep disorders in kids.

These are the number of hours sleep recommended for children and the symptoms that suggest sleep disorders. Then, we can discuss the what, why and how of the common sleep disorders among children.

How Much Sleep Do Children Need?

The answer depends on the age of the child involved. Experts agree on the following general guidelines:

  • Newborns 16-17 hours per day
  • 1- to 4-month old infants 16-17 hours per day but more regular night/day sleep
  • 5- to 12-month babies 14-15 hours each day
  • 1- to 3-year old kids 12-14 hours
  • 3- to 6-year old children 11-12 hours of sleep
  • 7- to 12-year old kids about 10-12 hours of sleep
  • 13- to 18-year old teens about 8-10 hours of sleep but might only get 6-8 hours because of their daytime activities.

You can maintain a sleep journal for your child if you suspect that he may have a sleeping disorder. You can include useful information including:

  • Daytime activities that can affect his sleep patterns (e.g., sports)
  • Bedtime routines (e.g., taking a bath or eating before bed)
  • Possible issues in his personal relationships at home and in school
  • Changes in his daytime routine 
  • Medications that he may be taking (i.e., difficulty in sleeping can be a side effect)

You will be able to provide more in-depth information to your child’s pediatrician during the consultations.

General Signs of Sleep Disorders in Children

Each of the sleep disorders in children have its own set of symptoms. But parents and pediatricians can work together to determine the possibility that their child/patient may have a sleep disorder.

Parents should be aware of these common signs of sleep disorders among kids:

  • Excessive daytime sleepiness is a common sign in narcolepsy, obstructive sleep apnea, and restless leg syndrome. Children can feel overly tired on occasion but if their daytime sleepiness becomes a fairly regular occurrence, then there may be a problem. This is true when they appear to get sufficient sleep at night yet they still feel overly tired the day after.
  • Look for signs like being sleepy throughout the day; taking naps when his age doesn’t warrant it; or struggling with getting up in the morning. Even a general lack of energy during the day can be a sign.
  • Difficulty in going to sleep or maintaining sleep. Listen to your child when he complains about these things because he may have insomnia.
  • Snoring may also be caused by nasal congestion, enlarged tonsils, or respiratory infections. But it may also be a symptom of obstructive sleep apnea, which as many as 3% of children have.
  • Nightmares occur during the REM phase. Children can wake up feeling afraid, threatened and terrified by their nightmares thus making it difficult to fall back asleep. These typically begin around the age of 3 but gradually decline in frequency after the age of 10.
  • While nightmares are common in many children, you should be concerned if these happen regularly or when your child becomes too distressed. Aside from sleep disturbances, nightmares can also lead to daytime sleepiness and behavioral issues.
  • Night terrors are different from nightmares. Children with night terrors never fully awaken from their sleep. In contrast, children who have nightmares who wake up from their sleep.

Parents are likely to be the most affected because they can witness their children’s disturbing behavior. But the children themselves will not remember. Children can sit up in bed, as well as scream or cry, while in the throes of night terrors.

When you observe a few or several of these signs in your own children, you should consult with the family pediatrician. You should also look out for significant changes in sleeping patterns and/or behavior.

You will be able to see these changes, if any, gradually developing instead of making a sudden appearance. Keep in mind that the following discussions on sleep disorders common in children are general in nature.

You have to visit your family pediatrician for the diagnosis and treatment of your child’s case. You will find that while affected individuals share common symptoms, their treatment plans will be unique to their circumstances.

Sleepwalking

Sleepwalking, or somnambulism, is characterized by the affected child walking while still asleep. But it isn’t just walking since the behaviors can include:

  • Sitting up in bed
  • Opening doors and windows
  • Wandering outside
  • Mumbling nonsense
  • Opening a closet door and peeing inside

No matter the action, sleepwalkers rarely remember it! The episode can last from 30 seconds to 30 minutes, and happen within an hour or two after falling asleep. Sleepwalkers are also difficult to wake up although it isn’t recommended in the first place.

What causes sleepwalking? Studies suggest that it may run in families although there are also other causes including:

  • Sleep deprivation
  • Fatigue
  • Stress
  • Irregular sleeping schedule
  • Fever
  • Underlying illness
  • Certain medications

Sometimes, children who sleepwalk may also have sleep apnea, night terrors, or bedwetting. Your family pediatrician can recommend treatments and/or specialists who can treat these conditions.

Sleepwalking per se isn’t harmful. It is neither a sign of psychological issues nor cause psychological damage so you can rest easy. But you will still want to know how to stop sleepwalking in case it becomes dangerous for your child.

This is the case when your sleepwalking child may fall down the stairs, wander outside the house, or even drive a car.

Emphasis must be made that you can’t stop sleepwalking. You shouldn’t even attempt it because it can only result in embarrassment and anxiety for your child. You may even be worsening the situation when your child becomes more stressed because of it.

Instead, your best course of action is to take the appropriate measures to keep your child out of harm’s way.

  • Avoid waking up your sleepwalker. You will not only find it difficult to do so but your child will be so dazed and confused from being woken up. Instead, you should gently but firmly guide him back to his bed.
  • Let your child sleep in a regular bed instead of a bunk bed. You don’t want him to come down its ladder and fall flat on his face.
  • Lock the doors and windows in your home every night. You may also install child safety locks while also hiding the keys inside a secure location.
  • Install safety gates at the top of the stairs and/or outside his room. You don’t want him to go down the stairs, which will otherwise increase his risk for falls.
  • Keep your child’s room as clutter-free as possible, especially the floor. Your sleepwalker can stumble on scattered toys, shoes and clothes.
  • Remove dangerous objects from his room and the areas where he usually walks into. Your vigilance in getting sharp, pointed and breakable objects out of his reach will pay off in his safety.

Don’t fret because most children will outgrow their sleepwalking habits by their teenage years. Your job as a parent is to reduce the risks of his sleepwalking habits and offer your support. You may discuss it but only to explain the measures adopted for his safety.

Narcolepsy

Narcolepsy is a neurological condition with the following symptoms:

  • Excessive daytime sleepiness. Your child may report falling asleep at unusual times and locations, such as when they are eating or talking with others. You may also observe their continuing struggle to stay awake during the day or their frequent dozing in the daytime.
  • Cataplexy. This refers to the sudden but temporary loss of muscle control that can be triggered by a strong emotion, even by stress. Your child may report experiencing a sudden yet brief feeling of weakness in the knees. But you will be more concerned when he experiences a complete collapse, perhaps by a sense of choking.
  • Not every person who has narcolepsy will have it. But in case your child reports these symptoms, you shouldn’t dismiss it because it may be a sign of an underlying medical condition, too, instead of narcolepsy.
  • Sleep paralysis. This is similar to cataplexy but it happens when the affected person is either falling asleep or waking up. Your child may tell of a feeling of being unable to speak and/or move even when he’s fully awake and aware of his surroundings. You may be able to snap him out of it by gently touching him.
  • Hypnagogic hallucinations. These are akin to nightmares but they happen just before a person falls asleep or just after he awakens. Your child may wake up feeling terrified because the hallucinations look and feel real.

Other symptoms of narcolepsy also include disturbed sleep during the night, memory loss, and automatic behaviors. These symptoms can develop gradually over several years although there are cases when these suddenly appear.

If you are observant about your child’s sleeping behavior, you will likely see the signs. But if you don’t see them, you shouldn’t blame yourself but instead you can take the appropriate actions. 

Your child will need a strong and supportive parent who can be his guide as he struggles with his narcoleptic symptoms. Scientists have yet to determine the exact causes of narcolepsy. But the current theories include:

  • Disruptions of function in the area of the brain with control over sleep and wakefulness
  • Loss of orexin, or hypocretin, chemicals in the brain

Studies have shown that the sleep disorder affects boys and girls equally. Even younger children have been observed with its symptoms. Doctors use several diagnostic tools to make a definitive diagnosis of narcolepsy.

  • A thorough medical examination including laboratory tests will be conducted. A medical history will also be taken as part of a process to rule out any underlying medical conditions aside from narcolepsy.
  • An overnight sleep study in a sleep laboratory may also be conducted by a sleep specialist. Your child will be monitored while he is sleeping to determine whether there are other sleep disorders present. Your doctor will also recommend a multiple step latency test the day after.

In case these diagnostic tools aren’t definitive, your child’s doctor may also recommend genetic and spinal fluid tests. Your family should work with medical professionals in order to make an accurate diagnosis.

Your child will obviously benefit more from an effective treatment plan based on it, thanks to the numerous tests conducted.

Narcolepsy doesn’t have a cure yet. But there are several treatments that can manage the symptoms so that an affected person can enjoy a near-normal life. In case your child was diagnosed with it, your child’s treatment plan will likely include the following approaches:

  • Prescription medications are used to treat the symptoms. Your child should experience reduced frequency, intensity and duration of excessive daytime sleepiness, hallucinations, and cataplexy with these drugs.
  • Behavior modification refers to the lifestyle changes that your child should be encouraged to adopt in order to lessen his symptoms. A few examples include:
  • No drinking of caffeine-rich food, such as colas, chocolates, and non-cola pops, in the late afternoon and evening.
  • Follow a regular bedtime schedule including a strict sleep-and-wake time schedule.
  • Get sufficient hours of sleep every night.
  • Take 1-2 naps during the daytime.
  • Exercise regularly.
  • Avoid physical activities that may place your child in harm’s way, especially when you’re prone to sudden sleep attacks or cataplexy.
  • Reduce the frequency of performing repetitive tasks.
  • You, the parent, have the responsibility of guiding him in behavior modification. You can set his sleep schedule and monitor his progress, for example. Your involvement in this treatment aspect will vary depending on your child’s age and severity of his condition.
  • Education refers to providing information to your child’s close friends, family members and even teachers about his condition. You want them to be informed so that they, too, can be your partners in ensuring his safety in and out of the home. Your child will also benefit from it not just in terms of his safety but also in a better understanding of his symptoms.

Your child’s teachers, for example, may have mistaken his excessive daytime sleepiness as a sign of his lack of ability or interest, even his laziness. With the information, your child can work with his teachers about his study load.

Narcolepsy may seem like a scary sleep disorder in your child but it need not be. You can work with your family pediatrician, as well as with your child’s siblings, relatives and teachers, to ensure his safety and well-being.

Insomnia

Insomnia in children is similar to that in adults. Children also have difficulty falling asleep or staying asleep during the night, even of waking up too early in the morning.

Younger children will be unable to express their experiences with it so parents have to be vigilant about it, primarily by being aware of the signs. Older children may complain about it on their own so parents can take the proper actions.

There are two types of insomnia based on the duration of the symptoms.

  • Short-term insomnia occurs for a few days to a few weeks before becoming resolved on its own. The factors resulting in it are usually temporary, such as a short-term medication or sickness.
  • Long-term insomnia occurs for a month or longer with its frequency at least 3 times a week. In many cases, there may be no obvious causes or reasons. But in many cases, too, the underlying causes requires medical intervention, such as pain, depression, or illness.

Parents should also take note that sleep-related dependency and bedtime resistance on the part of children are also considered as insomnia. The most common cause is behavioral issues that prevent said children from enjoying normal sleep patterns.

The common symptoms of insomnia in children include:

  • Difficulty in falling asleep or staying asleep
  • Anxiety about bedtime including the ability to fall asleep
  • Daytime sleepiness
  • Mood swings including an irritable disposition
  • Behavior problems in the home and/or in school
  • Hyperactivity
  • Aggression
  • Depression
  • Reduced attention span
  • Memory issues

Your child may have a few or several of these signs of insomnia, especially the first three symptoms. But you shouldn’t jump to conclusions either as these symptoms are also present in other physical and psychological health issues. 

You should see your child’s pediatrician about your concerns so that appropriate diagnostic tests can be conducted. What causes insomnia? Scientists have identified the following possible factors:

  • Stress has been shown to increase the risk of insomnia among children. Your child may think too much about his personal concerns related to your family, as well as his friends, teachers, and schoolwork. You will then find him sleeping too little because of his worries.
  • You shouldn’t hesitate about showing interest in his life in and out of your home for this reason. You can be his sounding board and advisor, just as any concerned parent must be. You can then become part of his solution to his bouts with insomnia.
  • Consumption of stimulants including caffeinated drinks, alcohol, and nicotine. These products interfere with the body’s sleeping cycle, such as when alcohol makes it difficult to maintain restful sleep.
  • You must educate your children about the dangers of alcohol and cigarettes. Better yet, you should be a role model, if possible, for them.
  • Certain medications can also result in insomnia. These include antidepressants, anticonvulsants, and corticosteroids as well as drugs used for the treatment of attention deficit hyperactivity disorder.
  • Your child’s doctor may change the dosage or the medication itself to reduce the risk of insomnia. You should also read the labels on your child’s medications so that you will be aware of their side effects.
  • Illnesses and injuries can also cause insomnia. The common examples include untreated nighttime asthma, respiratory infections, and heartburn, even muscle cramps. There may also be underlying medical conditions, such as obstructive sleep apnea, autism, and bipolar disorder, to name a few.
  • Your family pediatrician will likely perform a comprehensive medical examination to rule out underlying illnesses or injuries. Your child’s insomnia may be a sign of an underlying illness that requires appropriate treatment, too.
  • Environmental factors can also interfere with normal sleeping patterns. These can include the light, temperature and noise conditions in the bedroom as well as the mattress condition. The sleeplessness can also be caused by excessive use of electronics before bedtime, a bad habit in the digital age in kids and adults.

You have to look at these environmental factors closely because these have an impact on your children’s sleeping habits. Even your relatively healthy child may suffer from sleepless nights because of a saggy mattress, for example.

Remember that insomnia will likely be caused by a set of factors instead of just one factor. Your child’s symptoms may be worsened by a non-conducive sleeping environment aside from his reaction to his ADHD medication.

Your next question will then be, “How to cure insomnia in children?” Each child’s treatment plan will be different because the factors behind his case will be different. But doctors recommend the following general treatment approach to insomnia.

  • Encourage healthy sleep habits. These include maintaining a regular sleep schedule; restricting bed activities to sleeping; and avoiding stimulating activities an hour before bedtime. These should also include the avoidance of food and drinks with a stimulant effect, such as caffeinated products, alcoholic drinks, and tobacco.
  • Teach children about relaxation methods that they can adopt on their own. Even deep breathing is beneficial in young children.
  • Ensure a comfortable sleeping environment. Check that his bedroom is comfortable, calm and quiet so that he can go to sleep faster. Place a nightlight if he doesn’t want a dark bedroom.
  • Avoid discussions that can cause stress and anxiety in children, such as arguments. The morning after when everybody is relaxed and rested is the better venue for discussions about their concerns.
  • Consider getting your child into behavioral therapy. Your child may benefit from working with a child therapist coupled with the above mentioned lifestyle remedies.

Medications aren’t recommended in children and teens with insomnia unless these are merited by special circumstances. This is because medications may worsen the symptoms, even increase the risk of other illnesses.

Instead, lifestyle remedies and treatment of underlying conditions are highly recommended.

Final Words

Parents are understandably concerned about sleep disorders in children because of their physical and mental impact. Early diagnosis is crucial in effective treatment so we suggest being aware of your children’s sleeping patterns. Be sure to share this article so that you can make your fellow parents aware, too!