Does Your Child Have a Sleep Disorder

As many as 30 percent of children have a sleep disorder at some point. Many conditions go away on their own, but others may need treatment. Certain problems are more likely to affect children at certain ages. Parents can help their children by recognizing the symptoms and talking to their doctor if they are concerned about their children’s sleep habits.

Infants, Toddlers and Preschoolers

“In many cases, sleep problems in young children are fairly harmless and disappear over time,” says Carol Rosen, MD, Medical Director of the Pediatric Sleep Center at University Hospitals Rainbow Babies & Children’s Hospital. Some children rock their bodies and repeatedly bounce their heads on the pillow until they fall asleep. Others may walk or talk in their sleep.

In addition, young children often experience nightmares and night terrors, Rosen says. Preschoolers may describe nightmares, that is, vivid, scary dreams that usually happen early in the morning. Less common are night terrors, which occur earlier during sleep, usually one to two hours after falling asleep. During a night terror, children may breathe fast, sweat, cry or scream, but do not seem awake or responsive to the parent’s attempts to comfort them. Night terrors and sleepwalking rarely need treatment and tend to go away on their own as children get older. Occasional nightmares are common throughout childhood. However, recurrent, intense, upsetting dreams may be a sign of stress or can follow a traumatic experience. Talk with a specialist if your child is experiencing recurrent, severe nightmares.

School-Aged Children

Other types of sleep problems appear when children reach school age. One such disorder, sleep apnea, is serious and requires treatment. “In this disorder, which is potentially life-threatening, children stop breathing for brief periods during sleep,” Dr. Rosen says. Enlarged tonsils and adenoids are a common trigger for sleep apnea in children and sleep apnea can be seen in even younger children with enlarged tonsils and adenoids. Symptoms of sleep apnea include heavy snoring and struggling to breathe while sleeping. Because this condition causes disturbances in the sleep pattern, children with sleep apnea may also be either sleepy during the day or the opposite, hyperactive. If parents or grandparents have sleep apnea, then children are more likely to have sleep apnea. It runs in families.

Another problem fairly common among young children is bed-wetting. It can have many causes, from genetics to body processes that are not fully developed. Most children outgrow this problem, but when snoring and persistent or recurrent bed-wetting in school-aged children occurs, sleep apnea may be the cause.

Finally, children should be “energizer bunnies,” so when a child is sleepy no matter how much sleep he or she gets, it should be taken very seriously, says Dr. Rosen. Although we typically think of hypersomnolence (“too sleepy”) problems as something that happens to adults or teenagers, children can develop hypersomnolence disorders like narcolepsy. “If your child is getting enough sleep, but is falling asleep in school or starting to take regular daytime naps when their friends are out playing, it is time to see a sleep specialist,” she says.

Teenagers

Staying up late and sleeping in, to a certain degree, are considered normal among teenagers. However, in teens with delayed sleep phase syndrome, this behavior is taken to the extreme. “Teenagers with this condition may feel wide awake in the late evening and not go to sleep until late at night, often at 3 or 4 a.m.,” Rosen says. Warning signs include academic failure, tardiness, truancy and falling asleep during classes. Teens with this condition often sleep until the afternoon on the weekends.

In most cases, delayed sleep phase is a fixable problem. “The teen’s internal clock is not broken, it just needs to be ‘reprogrammed,’” Dr. Rosen says. If your teen has symptoms like this, talk to your physician about seeing a sleep specialist.

Narcolepsy is one of the “too sleepy” disorders that can show up in teenagers. Narcolespy can be associated with an unusual symptom called “cataplexy,” in which a strong emotion, like laughter, will bring on a sudden loss of muscle tone. “Narcolepsy has been recognized for years, but we now know that patients who have narcolepsy with cataplexy have low levels of a chemical messenger in the brain that is responsible for organizing sleep, wakefulness and dream phenomena,” Dr. Rosen says.

Narcolepsy can run in families. “The main symptom of narcolepsy is overwhelming daytime drowsiness, even after a good night’s sleep,” Dr. Rosen says. “Teens with narcolepsy often have irresistible urges to sleep during the day, and they may do so at inappropriate times and places.” These “sleep attacks” can occur with or without warning.

rosen-carol Carol Rosen, MD
Medical Director
Pediatric Sleep Center UH Rainbow Babies & Children's Hospital
Professor
Case Western Reserve University School of Medicine

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