Getting a good night's sleep

Children’s Sleep Problems:
What They Are and How To Deal With Them

About 69 percent of children 10 and under experience some type of sleep problem, according to the National Sleep Foundation’s (NSF) 2004 Sleep in America poll. Some of the most common are outlined below:

Insomnia is a sleep problem that occurs when a child complains of difficulty falling asleep, remaining asleep, and/or early morning awakenings. Insomnia can be short-term due to stress, pain, or a medical or psychiatric condition. It can become long-term if the underlying cause is not addressed or healthy sleep practices are not employed. Treating underlying conditions, developing good sleep practices and maintaining a consistent sleep schedule can improve the ability to fall asleep and stay asleep.

Nightmares are frightening dreams that occur during REM sleep and awaken a child. They usually occur in the later part of the night. Most children have at least one nightmare during childhood; three percent of preschool and school aged children experience frequent nightmares, according to NSF’s 2004 Sleep in America poll. They can be upsetting and a child will need reassurance when they occur. Nightmares can result from a scary event, stress, a difficult time or change in a child’s routine. Use of a nightlight or security object is often helpful.

Restless Legs Syndrome (RLS) is a movement disorder that includes uncomfortable and unpleasant feelings (e.g. crawly tingly or itchy) in the legs causing an overwhelming urge to move. These feelings make it difficult to fall asleep. RLS can be treated with changes in bedtime routines, increased iron, and possibly medications.

Sleeptalking occurs when the child talks, laughs or cries out in his/her sleep. As with sleep terrors, the child is unaware and has no memory of the incident the next day. There is usually no need to treat sleeptalking.

Sleepwalking is experienced by as many as 40 percent of children, usually between ages three and seven. Sleepwalking usually occur an hour or two after sleep onset and may last five to 20 minutes. As sleep deprivation often contributes to sleepwalking, moving bedtime earlier can be helpful.

Sleep terrors occur early in the night. A child may scream out and be distressed, although s/he is not awake or aware during a sleep terror. Sleep terrors may be caused by not getting enough sleep, an irregular sleep schedule, stress, or sleeping in a new environment. Increasing sleep time will help reduce the likelihood of a sleep terror.

Snoring occurs when there is a partial blockage in the airway that causes a noise due to the vibration of the back of the throat. About l0-12 percent of normal children habitually snore. Snoring can be caused by nasal congestion or enlarged adenoids or tonsils that block the airway. Some children who snore may have sleep apnea.

Sleep apnea — when snoring is loud and the child is having difficulty breathing, it may be a sign of a more serious disorder, obstructive sleep apnea. Sleep apnea is characterized by pauses in breathing during sleep caused by blocked airway passages, resulting in repeated arousals from sleep. Sleep apnea has been associated with daytime sleepiness, academic problems, and hyperactivity. Treatment for sleep apnea is available.

Pointers for parents

Talk to your child’s doctor if any of the following symptoms are observed:

• A newborn or infant is extremely and consistently fussy.
• A child is having problems breathing or breathing is noisy.
• A child snores, especially if snoring is loud.
• Unusual nighttime awakenings.
• Difficulty falling asleep and maintaining sleep, especially if you see daytime sleepiness and/or behavioral problems.

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