Sleep Disorders

Child Sleep Disorders

Current research has confirmed that children are not getting the sleep they need these days.
Children these days appear to be doing worse in school and have reduced attention spans. Most
parents are not aware of a common problem effecting thousands of children in this country: sleep
disorders. Parents often fail to follow there children's sleeping patterns which can result in some
serious side effects if that child has a sleep disorder. A study done at Tulane University in New
Orleans studied about 300 first graders that preformed poorly in school. They found that 18 per cent
showed signs of a sleeping problem. The percentage of children with bad grades found to have
sleeping problems was six to nine times higher than found in a previous study done over all of the
childhood population. (The Toronto Star). Most people believe that sleep disorders only affect adults
but in reality 30% of all children have some sort of sleep disorder. (Burcum).

Sleep disorders are defined as a group of syndromes characterized by disturbance in the patient's
amount of sleep, quality or timing of sleep, or in behaviours or physiological conditions associated
with sleep. To qualify for a diagnosis of sleep disorder, the condition must be a persistent problem,
cause the patient significant emotional distress, and interfere with his or her social or occupational
functioning. (Frey p265). Some sleep disorders can affect children of all ages. The sleep disorder that
children are subject to often depends on their age and development. Sleep disorders change most
frequent in the middle-school years. Children often experience more anxiety at this time. (Burcum).
The source of the certain sleep disorder cannot normally be pin pointed in every case. Many factors
come in to play when dealing with the cause of a sleep disruption. Parental characteristics,
personality, psychosocial influences, education, parenting skills, stress, trauma, school, culture and
personal health can all bring about sleeping disorders in young to middle-aged children.

Some parents find that there children sleep too much, while others don't sleep enough. Some fall
asleep at the wrong times while others cant ever even get to sleep. There are about 100 different
sleep disorders being researched currently. Although sleep is a basic behaviour in animals as well as
humans, researchers still do not completely understand all of its functions and maintenance. In
order to cure the child's sleep problem, you have to find the root of it. Unfortunately all sleep
disorders are not caused by the same condition. There are several types or disorders and several
conditions that can produce them. (Fritz p82).

The first and most researched sleep disorder is sleep apnea. Sleep apnea does not affect children as
often as it affects adults, but it is still a rising concern. Sleep apnea occurs in about 2 per cent of
children, mainly between the ages of one through eight. But it can also show up in older children
and even infants. (Klein). Research says that young blacks are more at risk than young whites. (Fritz p
83). Children with sleep apnea briefly stop breathing many times during the night due to an
obstruction in the respiratory tract. Most of the time it is related to enlarged tonsils, adenoids or to
obesity. As the child will gasp for there breath during sleep, they awaken for a few moments to
regain there normal breathing and then they immediately return back to sleep. Because the child
will be awoken by this many times during the night, these causes sleep deprivation. (Common Sleep
Problems AA). The physical symptoms of sleep apnea are excessive daytime sleepiness, snoring,
restless sleep, heavy and irregular breathing, excessive perspiring during the night, bad dreams,
sleeping with there mouth open, sleeps in strange positions, morning headaches, learning problems,
excessive irritability, depression, changes in personality, difficulty concentrating, hyperactive
behaviour, and upper respiratory infections are only some of the immediate signs. Sleep apnea is a
potentially life-threatening condition that does require immediate medical attention. Not catching
sleep apnea at an early stage may bring about long-term side effects later in the child's life. A sleep
test called polysomnography is usually conducted to diagnose sleep apnea. In most cases involving
children, sleep apnea will be treated by removing the child's tonsils or adenoids. Or it can be treated
through a machine that opens up the child's airways. (Kryger Childhood). It is one of the most
dangerous of the sleep disorders but when found early it can normally be treated completely.

The next and most common disorder in children is nightmares. For most kids, dreams are pleasant
experiences of everyday events. For other kids dreams are not dreams, they are nightmares that
cause a child to have fear and dwell upon them which eventually can lead up to the fear of falling
asleep at all. Nightmares seem to become more serious when parents neglect to talk to there
children about there worries. (Horne). Nightmares usually begin when a child is about three years
old. They are most common between the ages of three and eight. (Sleep Problems). They usually
occur in the second half of the night when dreaming is most intense. (Epstein). This is normally the
age when there fantasy level is most active. Most of the time a child will be wide awake after a
nightmare and they will be able to recall the events that occurred the next morning. Occasional
nightmares are perfectly normal but an increased number of nightmares can be a response to
excessive stress and anxiety in a child's life. Changes in a child's normal routine can also bring about
nightmares. Also watching a violent or scary movie can cause a child to have nightmares. (Sleep
Problems). When a child awakes from a nightmare, they need physical contact, comfort, and
reassurance. Parents should stay with the child until they are ready to go back to sleep. (Epstein).

Another disorder often confused with nightmares is night terrors. Night terrors are cauterized by a
sudden arousal from slow wave sleep with a piercing scream or cry, followed by autonomic and
behavior malfunctions of intense fear. Night terrors are defined as episodes of sudden, intense
terror in the night. These episodes usually occur in the first third of the night. (Night Terrors in
Children). They are more common in boys than in girls. (Sleep Tight Video). Most of the time the
child will have no recollection of the event once it has occurred. Some children have these
occurrences less than once per month while some experience night terrors almost once per week
and some experience them every night. Children who have night terrors once a week or month
usually will have no harm done to themselves or others but children with episodes occurring almost
every night will normally result in accidental physical injury to the child or others. (Kryger Night
Terrors). Differentiating a night terror from a nightmare depends on a few things. One is the time of
the attack. This is because night terrors occur in the first part of sleep while nightmares occur in the
third part of sleep. When a child experiences a night terror, he or she may have there eyes wide
open and look alert when they in fact are not alert or comprehensive at all. Night terrors are
referred to as "disorder of incomplete arousal from deep sleep". Most of the child's brain is shut
down during an episode. A child will yell, walk around, scream, and thrash around during a night
terror. A child is not dreaming during an episode, they are in deep sleep. It is suggested that a parent
should not discuss a child's night terrors with him or her because they will have no recollection of it
occurring at all. A parent should not try to awaken a child during a night terror. They should just hold
the child close to them until the spell passes. To prevent a night terror, it is said that parents should
awaken there child gently about 1 hour after they fall asleep. Jostling the sleep system in the brain
can prevent an attack to occur. Medication is also available in some serious cases. (Sleep Tight
Video).

The next disorder to touch on is sleepwalking. Sleepwalking is a series of complex behaviors that are
initiated during slow wave sleep and result in walking during sleep. It typically occurs in prepubertal
children. Eighteen percent of the population is prone to sleepwalking. It is most common in children.
Boys are more likely to do it than girls. Sleepwalking can have something to do with a child's
genetics. Episodes of sleepwalking usually occur around when nightmares occur which is toward the
end of sleep. Sleep talking usually will occur with sleepwalking. The range of episodes consists of
sitting up in bed, walking around the room, or even running and screaming. (Kryger Sleepwalking). A
child might unlock doors, eat or prepare food or even go outside during a case. (Tipsheet). In some
cases the child will use the restroom in inappropriate places during sleepwalking. The child may also
use obscene words and gestures. They also are at risk greatly to fall and injure them. For some kids
episodes only occur about once a month and don't result in any harm. Some though have episodes
nightly and often physically harm themselves every night. A child normally has no recollection of the
occurrence. A routine sleep schedule can help reduce a child's sleepwalking. Also a full bladder can
trigger it so a child should use the restroom before bedtime every night. A child who is common to
sleepwalking should not have a bedroom on the second floor to reduce the risks of injury. Also a
parent should "childproof" the room the child sleeps in so the child cannot trip or harm him or her
self. Medicine can treat severe cases and also hypnosis has been said to cure it as well. (Kryger
Sleepwalking). Sleep walking can be as short as 5 minutes and last up to 30 minutes. (Tipsheet).

Paralysis can occur in children when they wake up suddenly out of a nightmare and find that they
cannot move or call out for there parents. This is called sleep paralysis. The motor part of REM sleep
is still active but all the child can do is breath, move there eyes, and possibly moan. True sleep
paralysis is very, very rare and may be a symptom of narcolepsy. Sleep paralysis can be stopped by
sustained voluntary eye movement or touch from someone else. (Horne).

Bedwetting is yet another common sleep problem with children. Children are not born with bladder
control so this becomes a problem at night. Children should have full control of there bladders by
age 4. Bedwetting occurs in about fifteen percent of children aged five to six. If a parent of the child
suffered this disorder, the child is three to five times more likely to have it as well. Bedwetting can
be a sign of urinary tract infection, diabetes, epilepsy, and even sleep apnea. Bedwetting occurs in all
stages of sleep. Inappropriate toilet training, excessive teasing about the problem by siblings, or a
parent who kept there children in diapers to long can all psychologically bring on bedwetting.
Bladder training exercises can help cure bedwetting. Positive encouragement and sometimes even
medication can treat the problem. Reassurance is the best medicine though. (Horne).

The most minor sleep disorder is sleep talking. It is mental events of sleep and is a muttering of
jumbled words or phrases with no real content, occurring in light sleep and usually has nothing to do
with dreaming. Sleep talking is more common in children as well. In fact, almost all children will do
this if they are talked to during light sleep. If two or more kids share a room and one starts sleep
talking, often others will join in on the talking. A sleep talker does not listen to those around them.
They are in a world of there own. Sleep talking is not a serious disorder and normally a child will
grow out of excessive sleep talking. (Horne).

Tooth grinding is a minor disorder usually found in stages one and two of sleep. It has a tendency to
be related to stress. It can occur in children soon after the first developments have come about and
can result in tooth damage and misalignment. A night-time rubber mouth guard can be purchased
and used for a child with a severe case of tooth grinding. If anxiety is a factor, therapy or relaxation
treatments are suggested. (Horne).

There are five different stages in the sleep cycle and each disorder will take place in various stages of
sleep. Four stages have non-rapid eye movement (known as NREM). Dreaming occurs in the fifth
stage which is during rapid eye movement (REM) sleep. Stage one occurs while a person is falling
asleep. It takes up about five per cent of the average night. Stage two is the beginning of true sleep.
About fifty per cent of the night occurs during stage two. Stages three and four are also known as
the delta or slow wave sleep. These stages are the deepest levels of human sleep and they represent
ten to twenty per cent of the night. The last stage which is the REM stage usually begins about
ninety minutes after a person falls asleep and then alternates with the NREM sleep about every hour
and a half. Sleep cycles vary with a persons age. Children have longer periods of stages three and
four. Most people sleep an average of seven to nine hours a night. (Frey). Newborn babies average
sixteen to eighteen hours of sleep each day. (Fritz p 37).

Pediatricians estimate that twenty to thirty per cent of all children have some type of sleep disorder.
(Frey). Sleep disorders affect both the child and the parent. The child will suffer in there ability to go
to sleep, stay asleep and wake up from sleep all due to sleep disorders. They also will have a harder
time concentrating in school and participate in sports and other everyday activities. Bad grades at a
young age can also be the result of a sleep disruption. Sleep disorders also can bring out family
eruptions if the disorder is serious enough to disrupt the whole family. (Burcum).

Researchers are still very hard at work with trying to develop solutions to these disorders. It is said
that children who consistently wake and disrupt during sleep should seek medical attention. It is
suggested that a parent should seek pediatric help if they spend a lot of time coaxing the child into
bed or there child has bad mood swings due to lack of sleep. Most pediatricians will refer the family
to a sleep specialist. For severe problems, anti-anxiety drugs or other medications may be
prescribed. Most of the time though medication is not prescribed. Most often, physicians and
families can solve the sleep problem by discovering a child's natural sleep pattern. A very important
key in resolving sleep disorders is the keep a routine time in putting a child to bed, eating snacks
before bed, and reading stories. Also minimizing physical activities before bed. Avoiding caffeine and
scary movies before or close to bedtime can help prevent problems as well. For disorders like sleep
apnea, surgeries to remove the tonsils can cure the problem. Also psychology for the child can held
reduce anxiety and stress which are both cause of sleep disorders. Most of the time, a parent or
pediatrician can cure a child's sleep problem. (Burcum).

It is important that parents remember that just because a child wakes often in the night and is
restless that doesn't mean he or she has a sleep disorder. Each child has different sleep patterns.
Observing each individuals traits and then adjusting bedtime schedules accordingly may be all that is
need to help the child's sleep problems. (Burcum).

Works Cited

Bantam. "Caring for Your School-Age Child: Ages 5 to 12". American Academy of Pediatrics. June
1999. 12 Sept 2001. http://www.medem.com/MedLB/articledetail.com

Burcum, Jill. "While Most Kids Occasionally Have Problems Getting to Sleep". Minneapolis Star
Tribune. 18 July 2000. 19 Sept 2001. http://www.elibrary.com/s/edumark/getdoc.com

Epstein, Bruce. "Nightmares, Night terrors Can Disturb a Child's Sleep". St. Petersburg Times. 1 Nov
1993. 3D. 12 Sept 2001. http://inforweb3.newsbank.com

Frey, Rebecca. "Sleep Disorders". Goal Encyclopedia of Medicine. April 1999. P 265-267. 1 Oct 2001.
http://web6.infotrac.galegroup.com

Fritz, Roger. Sleep Disorders: Americas Hidden Nightmare. Naperville, IL: National Sleep Alert Inc.,
1993.

Horne, Jim. "Sleep and It's Disorders in Children". Journal of Child Psychology and Psychiatry. (1992).

12 Sept 2001. http://www.Ilboro.ac.uk/departments/hu/groups/sleep.com

Klein, Hanne. "Troubled Nights". The Dallas Morning News. 1 March 1999. 19 Sept 2001.
http://www.elibrary.com/s/edumark/getdoc.com

Kryger, Meir. "Childhood Sleep Apnea". Online Posting. 24 Mar 1999. 19 Sept 2001.
http://www.stanford.edu

Kryger, Meir. "Children and Sleepwalking". Online Posting. 15 April 1998. 19 Sept 2001.
http://www.standford.edu/slpwalking.html