Pearls of Wisdom: Sleep Disorders in Children

Most children have nightly rituals before going to bed, whether it’s reading a story, cuddling with a special blanket or toy, turning on their own night light or battling their parents about bedtime. We know you’ve been there at least once before!

Kids may struggle with nighttime sleep and may be transient, intermittent, or chronic in nature. Babies who have difficulty establishing normal sleep patterns may be fussy and irritable as part of their temperamental characteristic. Sometimes parental anxiety or strife could also contribute to sleep disorders. Older children may have temporary fears of loud noises like thunder and lightning, being hurt by intruder, or of monsters under the bed. Your child may be able to express their fears overtly, or disguise them in the form of delaying tactics at bedtime. Therefore, it takes an astute parent to detect the problem and encourage their child to share and express these fears with them.

Some children equate sleep as a time when they are removed from parental love and care, may it be unconsciously or symbolically. Separation anxiety such as child’s first day of school or a divorce can lead to bedtime fears. As growing children mature and become more aware of death, they may have fear of not waking up from sleep. Stress and depression related to any area of her life such as family, friends and school performance can cause sleep disorders.

About 7-15 % of children have reported problems with nightmares. These “anxiety dreams” happen during REM (rapid eye movement) sleep; the child immediately wakes up lucid and remembers part or the entire dream. Nightmares usually begin before the age of 10, and affect girls more than boys. These are also commonly seen in children with anxiety and effective disorders.

“Night terrors” are another nighttime occurrence in children that usually begins during pre-school years. The exact cause is unknown, but it does run within families. This occurs at the beginning of the sleep cycle with arousal from stage IV (non-REM) sleep. Your preschooler will be lying in bed, appearing to be awake while looking confused, disoriented and upset. He may also have labored breathing, sweating and complain of a strange visual phenomenon. She also may point to imaginary objects; appear extremely frightened and generally inconsolable.

Night terrors are often self-limited and may be related to a precipitating traumatic event that the child experienced.

Incidences of night terrors are about 2-5 % and seen more commonly in boys than girls. The upside is that although these events are more disturbing and unsettling for the parents who witness them, children who experience night terrors usually settle down after a few minutes, go back to sleep and remember nothing the next day. The only thing a parent or caregiver can do is to hold the child, trying to calm him during the episode and making sure he is protected from possibly hurting himself.

A period of sleepwalking may also occur which can pose a more serious risk to the child. Sleepwalking usually happens during stage 3 or 4 of non-REM sleep in 10-15% of children. The condition usually remits by early adolescence, but a history of sleepwalking throughout the family is common and can be associated with bed wetting. Treatment, therapy, and relaxation techniques are supportive and ensuring that the child is safe.

Establishing a healthy sleep routine such as a consistent time for a warm bath, reading a story, or keeping the house quiet after a certain hour is helpful for both parents and children. Forming an early bedtime to make sure she gets a sufficient amount of sleep is vital for mental and physical growth and the best preventative method for crankiness and fatigue. In time, all these nighttime woes will disappear as your child matures. Leaving everyone well rested, especially you!

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All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site.

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.