Sleep Disorders in Kids

Children can suffer from sleep disorders, much like adults. Sleep disorders are basically problems in the way a person sleeps. Some of the most common complaints include trouble falling asleep, sleepwalking, night terrors and snoring. Children often show signs of sleepiness or have trouble functioning during the day when they have sleep disorders.

What is a Paediatric Sleep Disorder?

Children who suffer from paediatric sleeping disorders suffer differently. Some have trouble falling or staying asleep, while others are inflicted with more worrisome problems such as sleepwalking. Sleeplessness in children can be caused by different factors such as stress or pain. Sometimes, physiological problems like obstructive sleep apnea can cause sleep problems in children.

What Are the Different Types of Paediatric Sleeping Disorders?

There are many different sleeping disorders that have been diagnosed amongst children:

• Sleep Apnea: Children who suffer from enlarged tonsils or obesity usually develop a sleep disorder called ‘Sleep Apnea’. Some of the symptoms of this disorder include restlessness, snoring, frequent awakening, pauses in breathing, and daytime sleepiness.
• Restless Sleep / Periodic Limb Movement Disorder: Children who have poor or restless sleep often suffer from drowsiness the next day. They have particularly limp hands and feet. There is research that suggests a link between ADHD and Periodic Limb Disorder. In most cases, this is due to iron deficiency.
• Insomnia: One of the most commonly heard of sleeping disorders out there, insomnia is a condition where people have trouble sleeping. This often leads to irritability, hyperactivity, mood swings, depressed mood and sometimes even aggressiveness in a person.
• Narcolepsy: Children with narcolepsy tend to have the urge to fall asleep several times throughout the day. Their sleep could last from a few seconds to several minutes. Narcolepsy is a chronic sleep disorder caused due to the inability of the brain to regulate sleeping and waking cycles.
• Nightmares: Nightmares are common among children between the ages of three to six years. The child may dream of danger or an instance that is scary.
• Night Terrors: A child who suffers night terrors never fully awakens from their sleep. Very often, the child will sit up in bed and scream or cry in their sleep, acting out their dream.
• Somniloquy / Sleep Talking: Talking whilst fast asleep is called ‘somniloquy’ and can range from simple sounds to long winding speeches.
• Somnambulism / Sleepwalking: Walking while asleep is called ‘somnambulism’ and on occasions, the child may speak things that don’t make sense while sleepwalking. The child’s eyes are open but unfocused or glassy.

How Much Sleep Does a Kid Need?

Everyone needs sleep and children are no exception. In fact, younger children need to sleep more as their brains are developing at an extraordinary rate. As a child grows, their sleep requirements begin to change:

• One to Four Weeks Old: Infants of this age group should sleep for an average of 16-17 hours a day.
• One to Four Months Old: Infants of this age group sleep for an average of 16-17 hours a day. At this age, their sleep cycles begin, with them sleeping longer at night.
• Four Months to One Year: Babies of this age need around 14-15 hours of sleep every day.
• One to Three Years: Toddlers need about 12-14 hours of sleep every night.
• Three to Six Years: Children of this age need approximately 11-12 hours of sleep per night.
• Seven to Twelve Years: Children of this age group need about 10-12 hours of sleep every night.
• Thirteen to Eighteen Years: Teens of this age require about eight to ten hours of sleep.

What Are the Signs of Sleep Problems in Kids?

Sleep problems can compound over the years and cause long-term sleep disorders like insomnia and narcolepsy.

1. Excessive Daytime Sleepiness (EDS): Extreme sleepiness during the day is a sign that your child may have a sleeping disorder. Children with these problems often have a general lack of energy throughout the day. Common sleep disorders with EDS symptoms are narcolepsy, sleep apnea, and restless leg syndrome.
2. Trouble Sleeping: Children who often complain about not being able to go to sleep or have trouble staying asleep most likely suffer from insomnia. These children may sometimes even wake up much earlier than is required. Insomnia in children can be caused by stress, pain, or mental disorders.
3. Snoring: Some children who snore may have obstructive sleep apnea (OSA), which can be caused by respiratory infections, nasal congestion, a deviated septum or enlarged tonsils.
4. Bedwetting: Many children wet their beds and so this is not often a cause for concern. It is only considered a disorder if your child is older than five years and wets their bed at least two times a week. Low bladder control, emotional distress or developmental lags could be reasons for bedwetting. Bedwetting, as well as daytime drowsiness in a child, could be a sign of ‘Obstructive Sleep Apnea’.

Complications of Sleep Disorders or Sleeplessness in a Child

Complications associated with sleep disorders fall into two categories:

• Psychiatric Complications: There is a reciprocal relationship that occurs between sleep disorders and psychiatric disorders. For example, when a child who is diagnosed with recurrent depression becomes worse, sleep problems often increase simultaneously. However, disrupted and inadequate sleep alone can produce behavioural, effective and cognitive problems.
• Medical Complications: Dyssomnias (disturbances in the quantity, quality, or timing of sleep) are believed to be a result of central nervous system (CNS) abnormalities that alter the sleep process. Youths with substance use disorders are a good example of how difficult it may be to distinguish a primary sleep disorder from those medically induced conditions.

Treatment and Medication to Treat Sleep Disorders in Children

There are so many reasons why your child could develop sleeping disorders, right from stress to physical problems. There are different ways to deal with this and get a handle on the situation. Some basic tips include a consistent bedtime and calm sleeping environment. However, as a parent, you need to update yourself on the disorder and the various approaches used to treat it.

• Medication: Medication like Neupro and Mirapex have been known to help deal with issues like restless leg syndrome.
• Chronotherapy: This technique employs gradual shifting of sleep timings to help reset the biological clock of your child. Studies show that patients have been able to end chronic dependence on medication with this method.
• Adenotonsillectomy: Research has shown that removing the tonsils in children can significantly improve sleep. This is because of fewer respiratory issues faced by the child.

Tips to Help Your Child Sleep Better

Below are some tips that you can try at home to help your child sleep better:

• Be Consistent with Bedtime: Set a regular bedtime for your child and do not stray away from it. Similarly, the wake-up time should remain consistent. On weekends, try not to allow your child to sleep in longer than an hour past their usual wake-up time.
• Establish a Soothing Bedtime Routine: A warm bath and reading a bedtime story can really help your child sleep better. A glass of warm milk and honey also does wonders.
• No Caffeine Before Bedtime: Avoid giving your child any food or drinks that contain caffeine less than six hours before bedtime. This includes chocolate milk as cocoa beans contain caffeine.
• Light Dinner: Try not to give your child a large meal too close to bedtime as this interferes with digestion, thus resulting in uneasy sleep.
  
• Relaxing Playtime After Dinner: Avoid physical or mental activities right before bedtime as they can keep children awake. Try indulging your child in more calm activities such as reading or drawing.
• Avoid Distractions: Turn off the television and radio while your child is going to sleep. Cell phones and computers should also be set aside at this time to avoid your child becoming distracted.
• Create the Right Ambience: Ensure that the temperature in your child’s bedroom is comfortable and that the room is dark. Keep the noise level in the house as low as possible.
• Develop Healthy Sleeping Habits: Avoid allowing your child to fall asleep in your arms or in any room they happen to be in. If you notice your child is tired, regardless of whether they are asleep or not, you should put them to bed. It is also best to not get into bed with your child to help them sleep.

Paediatric sleep problems in children cause many children to become tired and cranky. They also lead to behavioural problems at home, in school and amongst their friends. If you feel your child may have a sleeping disorder, be sure to follow the tips mentioned to above. If all else fails, speak to your paediatrician who can prescribe medication for your child having trouble sleeping.