Sleep Disorders in Children

Most child and teenage sleep problems can be corrected by adjusting the bedtime routine or your expectations of what is "normal" for your child. Some sleep problems, however, are true disorders that need special attention, and sometimes treatment by a healthcare professional. The common sleep disorders with children and teenagers are:

Insomnia

Insomnia means children often have trouble falling or staying asleep or going back to sleep if they awaken. Generally, insomnia is much less of a problem for children and teens than for adults. Most children go to sleep within 20 minutes of being in bed and quiet. Teens often take 30 minutes or longer to fall asleep. Insomnia in children is not usually a serious problem. However, when getting to sleep takes more than half an hour, it can affect wake up time and cause daytime sleepiness or irritability. When they cannot fall sleep, children may get out of bed many times, which can be hard for parents.

Most of the time, insomnia will get better or go away if you follow a good sleep routine for 2 weeks. A good sleep routine includes quiet time such as a bath, reading a story, and a regular bedtime. Quiet time should start at least 30 minutes before bedtime. If an improved sleep routine does not help, try stopping all caffeine and giving warm milk 30 minutes before bedtime. Sleep medicines work differently in children and young teens, so they are rarely prescribed for these age groups.

Ongoing insomnia may be a symptom of depression, an anxiety disorder, or hyperactivity. If you think your child has ongoing insomnia, talk to your child's healthcare provider. It is important to review your child's medicines and any other symptoms the child has.

Sleep Rocking

Some children rock their bodies during part of the night. Most rock from side to side, but some rock forward from their knees to their elbows. It is most common up to the age of 3 or 4. Usually sleep rocking is not serious and will stop on its own. However, in severe cases a child may bang his head or other body parts against the bed or wall. If this occurs, you may need to protect your child, for example by padding the wall. If you have concerns that your child sleep rocks, talk with your child's healthcare provider about it.

Sleep Walking

Getting out of bed and walking around the room or house a few times each month is quite common with preschool and elementary school children. They may walk for 2 to 20 minutes and then either return to bed or lie down somewhere else. Their eyes are usually open, but are staring and not focused. They may do things like open doors or change clothes. Sometimes the child will talk, but will not usually wake up if you talk to them. Many times they will go back to bed when you tell them to do so.

In the morning they rarely remember anything about sleep walking. It is possible for children to walk into furniture or to fall. For this reason, make sure your child cannot walk down stairs or be where they might trip and fall.

Children usually start sleep walking between the ages of 2 and 7 and stop on their own before the teen years. Most sleep walking occurs a few hours after the child falls asleep. Sleep walking tends to run in families, but the exact cause is not known. Talk with your child's healthcare provider about your child's sleep walking, especially if the walking occurs after sleeping more than half of the night.

Being very tired or stressed, or going to bed late can increase the chances that a child will sleep walk that night. Some sleep walkers are more anxious and shy than other children their age. However, most children who sleep walk do not have emotional or behavioral problems.

There is no special treatment for sleep walking. Some things you can do if your child sleep walks:

• Try not to let your child get too tired or stressed since this may increase the chances of sleep walking.
• Calmly lead them back to bed.
• Do not talk about the sleep walking the next morning since they will not remember walking around and you may make them feel bad by talking about it.
• Some children will not sleep walk if you purposely wake them (enough to sit up and respond) about an hour after they have gone to sleep.

Night Terrors

Children with night terrors usually seem to wake within the first few hours of going to sleep and scream or call out. Usually the child's eyes are wide open, but are staring and not focused. The child does not wake up even if you talk to them or sit them up. Often they are not calmed by hugging or talking to them. The terror may last for several minutes. The terror and not being able to comfort the child is scary for the parent. The children almost never remember what happened the next morning. Most night terrors are not caused by stress, diet, or parent behavior. In some cases, a high fever can cause night terrors during the illness. The terrors usually fade away during the grade school years. Talk with your child's healthcare provider if you are concerned about your child's terrors.

There is no special treatment for night terrors. If your child has night terrors:

• Try not to let your child to get too tired or stressed since this may increase the chances of having a night terror.
• Comfort your child until they calm. This may take several minutes.
• Do not talk about the night terror the next morning since they will not remember the terror and you may scare them by stories about it.
• Some children will not have a night terror if you purposely wake them (enough to sit up and respond) about an hour after they have been asleep.

Sleep Apnea

A child with sleep apnea usually snores and stops breathing for a few seconds at a time when sleeping. This signals the brain to wake them up. This cycle of not breathing and then waking up to breathe again may happen many times during the night. While children seldom remember waking up, they may be tired or cranky during the daytime. In children a common cause of sleep apnea is enlarged tonsils or adenoids. Sleep apnea is much more common in adults than children.

If you think that your child has sleep apnea, talk with your child's healthcare provider.

Hypersomnia

Hypersomnia is a condition in which your child sleeps far more than is normal for his or her age. Your child is always tired, even after a good night's sleep. A young child with hypersomnia may often be whiny and irritable and sleep too much. Other symptoms besides the need for a lot of sleep may be poor attention or poor memory. Hypersomnia is more common in teenagers than in younger children. Sometimes, especially with teens, it can be a symptom of depression.

If you think your child has hypersomnia:

• Try setting a clear routine of bedtime and nap times for several days.
• Watch children and teens for symptoms of depression, especially saying negative things about themselves or talking about thoughts of harming themselves or others.
• If your child has symptoms of hypersomnia often, or has new medical symptoms, or if you think the child has depression, talk with your child's healthcare provider.

Bruxism

Bruxism is grinding or clenching the teeth during sleep. Children and teenagers who do this may also grind or clench their teeth when angry, upset, or anxious. Bruxism is more common in teenagers than in young children.

If you child grinds or clenches their teeth during sleep, try reducing stress in your child's life. Plan a quiet time of at least half an hour before bedtime no matter how old the child is. If the bruxism happens often or is violent, talk with your child's healthcare provider and dentist. Repeated grinding or clenching of the teeth can damage the teeth or the jaw. Special tooth guards may need to be used for nap and nighttime sleep.

For more information, contact:
National Sleep Foundation
1522 K Street, NW, Suite 500
Washington, DC 20005
Telephone: (202) 347-3471
Web site: http://www.sleepfoundation.org