Sleep Disorders in Children

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KEY POINTS

• Most sleep problems in children and teens are not serious and will go away on their own.
• It helps if you do not let your child to get too tired or stressed since this may increase the chances of sleep problems.
• Talk with your child's healthcare provider if you are concerned about your child's sleep. Some sleep problems may need treatment by a healthcare provider.

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Most sleep problems in children and teens are not serious and will go away on their own. Some sleep problems, however, may need treatment by a healthcare provider.

Insomnia

Insomnia means children often have trouble falling or staying asleep or going back to sleep if they awaken. 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 cause daytime sleepiness, irritability, or learning problems.

Often, insomnia will get better if you follow a good sleep routine for 2 weeks. This means no TV, computer, electronic games, or phone for 30 minutes before bed. A good sleep routine includes 30 minutes of quiet time such as a bath or reading a story before bedtime. Make sure that your child wakes up and goes to bed at about the same time each day of the week, including weekends. Daily exercise can be helpful. It may also help to have your child cut out caffeine. Make sure your child’s bedroom is quiet, dark, and slightly cool.

Sleep medicines work differently in children and young teens, so they are rarely used.

Insomnia that lasts for more than 2 weeks may be a symptom of pain, a medical problem, or problems such as depression, an anxiety disorder, or hyperactivity. If you think your child has insomnia, talk to your child's healthcare provider.

Sleep Rocking

Some children rock their bodies during part of the night or during naps. Episodes may last up to 15 minutes. Most rock from side to side, but some rock forward from their knees to their elbows. They may hum or make other sounds at the same time. Sleep rocking is most common in infants and children up to the age of 3 or 4. Usually it is not serious and will stop on its own. However, in severe cases a child may bang his head or body against the bed or wall. You may want to protect your child by putting up guardrails. Don’t encourage the behavior by going to check on your child each time the rocking occurs. It’s more important to give your child attention during the day instead of at night. If your child gets injured or if you have concerns that your child sleep rocks, talk with your child's healthcare provider about it.

Sleep Walking

Children who sleep walk usually start between the ages of 2 and 7 and stop before the teen years. Most sleep walking happens within the first few hours after your child falls asleep. They may walk for 2 to 20 minutes and then return to bed or lie down somewhere else. Their eyes are usually open, but are staring and not focused. They don’t usually recognize people. They may do things like open doors or change clothes. Sometimes the child will talk, but may not make sense. They will not usually wake up or respond if you talk to them. Your child may go back to bed when you tell him to do so, or you can calmly lead your child back to bed. Most have little or no memory of the sleep walking in the morning.

Most children don’t need treatment for sleep walking. Some things you can do if your child sleep walks:

• The most important thing is to make your child is safe. Make sure that your child cannot trip, walk down stairs, or go places where they could get hurt if they sleep walk. Close and lock windows and outside doors. Put a bell on the bedroom door. If there are guns in your home make sure they are locked away safely. If you find your child sleepwalking gently guide him back to bed.
• Try not to let your child get too tired or stressed since this may increase the chances of sleep walking.
• Cut back on fluids and make sure your child goes to the bathroom before he goes to bed.
• Avoid anything with caffeine in the evening, such as colas and chocolate.
• 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.

Talk with your healthcare provider about your child's sleep walking, especially if the walking happens after your child sleeps for more than half of the night.

Night Terrors

Night terrors are common in children between ages 3 to 8 and may run in families. Within the first few hours after going to sleep, a child with night terrors usually screams or calls out without actually waking up. Usually the child's eyes are wide open, but are staring and not focused. They may thrash about and look upset. The child does not fully 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 up to 10 minutes. Not being able to comfort the child is scary for the parent, but night terrors are usually not dangerous. The child almost never remembers what happened the next morning. The terrors usually fade away during grade school years. Night terrors are different from nightmares. During a night terror, your child is very active and upset, but still asleep. Nightmares are bad dreams that may awaken your child.

There is no special treatment for night terrors. It may help if you:

• Try not to let your child to get too tired or stressed since this may increase the chances of having a night terror.
• Don’t try to wake your child up. Just wait until he calms down on his own and interact directly only if your child isn’t safe.
• Purposely wake your child (enough to sit up and respond) about an hour after he falls asleep.

Talk with your child's healthcare provider if you are concerned about your child's terrors.

Sleep Apnea

A child with sleep apnea may stop breathing for more than 10 seconds many times an hour while asleep, and your child’s body gets less oxygen than it needs. Your child may gasp, choke, or snore. 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. Your child will not remember waking up, but may be tired or cranky during the daytime or have trouble concentrating in school. In children sleep apnea can be caused by enlarged tonsils or adenoids, or by being overweight.

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, sleep too much at night, have trouble waking up, and also take naps during the day. Other symptoms besides the need for a lot of sleep may be poor attention or poor memory. Hypersomnia is more common in teens 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.
• If your child is always tired, or has new medical symptoms, or if you think your child has depression, talk with your child's healthcare provider.

Bruxism

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

If your child grinds or clenches his 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 your child is. Most children outgrow bruxism. If it happens often, or causes headaches or tooth pain, talk with your child's healthcare provider and dentist. Repeated grinding or clenching of the teeth can damage the teeth or the jaw. Your child may need to wear a tooth guard when he sleeps.

For more information, contact:

• National Sleep Foundation
  703-243-1697
  https://sleepfoundation.org/