Sleep Awareness

Introduction
Sleep is an essential part of routine and an indispensable part of a
healthy lifestyle.
Children who regularly get an adequate amount of sleep have
improved attention, behavior, learning, memory, and overall
mental and physical health.
Recommended amount of sleep

● Infants under 1 year: 12-16 hours

● Children 1-2 years old: 11-14 hours
● Children 3-5 years old: 10-13 hours
● Children 6-12 years old: 9-12 hours
● Teenagers 13-18 years old: 8-10 hours
● Adults 18+ years old 7-9hrs
Effects of poor sleep hygiene in
children

• Poor grades in school

• Poor self esteem
• Depression weight gain
• Poor appetite • Underweight
• Headaches and migraines
• Growth
• Hyperactive behavior
• Poor impulse control
• Difficulties with attention
Infant sleep routine
SIDS

The sudden death of an infant under 1 year of age, which

remains unexplained after a thorough case investigation,
including performance of a complete autopsy, examination
of the death scene, and review of the clinical history.
SIDS is a diagnosis of exclusion. This means that all other
possible causes of death are ruled out before you can call it
SIDS.
Toddler sleep routine
● 1- to 2-year-old should still sleep in a
safe, secure crib.
● Can put a light blanket or small stuffed
animal.
● Expect your toddler to drop down to
one nap a day by 18 months, typically
resulting in a slightly early bedtime.

● Separation anxiety, or FOMO (fear of

missing out!), can motivate toddlers to
stay awake. Setting a routine can really
help
Preschool Kids sleep
routine
● Regular bedtime routine and a quiet,
comfortable bedroom.
● Going to the bathroom,
● changing into pajamas,
● brushing teeth,
● reading a book.
● Turn off all screens at least 1 hour before
bedtime and keep TVs, computers, tablets,
phones, and video games out of the bedroom.
● special toy or blanket to sleep with
● Turn on a nightlight if your child is afraid of the
dark.
● plenty of exercise during the day. This can help
kids sleep better.
 School Age kids sleep routine
Homework, sports, and after-school activities, screen time (on computers, TVs,
smartphones, and other devices), and hectic family schedules all can lead to
kids not getting the sleep they need.

● Set regular bedtimes and wake-up times.

● To be sure your child gets enough sleep,
● On weekends, try to stick to the sleep schedule as close as you can.
● Aim for sleep or wake-up times no more than an hour later than on
weekdays.
● Keep the bedroom dark, cool, and quiet.
● Don't give your child foods or drinks with caffeine (found in
coffee, tea, sodas, and chocolate), especially in the late afternoon
or evening.
● Make sure your child gets plenty of exercise during the day.
Common Sleep disorders in children
Common Sleep Disorders: CHildren
Sleep-related breathing disorders: most common is obstructive sleep apnea
OSA: Clinical Features: : Snoring, Unusual sleep positions hyperextended neck, open mouth sleep,
Paradoxical breathing - gasp, MOrning headache, Nighttime enuresis, diaphoresis, excess daytime
sleep, Large tonsil/adenoids
Diagnosis: Sleep study PSG, Xray neck -adenoids
TX: Adenotonsillectomy, Positive pressure breathing

Parasomnias or Disorders of Arousals like sleep walking, sleep talking, night terrors
Clinical Features: : Intense fear perceived, scream, confusion, walking, no memory of event
Diagnosis: history
TX: Reassure, Increase total sleep time, Bedroom home safety counselling, Benzo , Sleep hygiene,
address medical conditions like GERD
Common Sleep Disorders: CHildren
Insomnia or Disorders of sleep initiation, Circadian rhythm sleep-wake disorders or Disorders of
altered sleep wake cycle:
TX: Sleep hygiene

Sleep-related movement disorders like Restless leg syndrome:

Clinical Features: Urge to move legs with associated discomfort.
Avoidance of nicotine and caffeine, Iron therapy and identify triggers- sleep hygiene,
Meds (Repinirole)
Adult Sleep
Routine
 Adult sleep Disorders
Sleep apnea, in which you experience
abnormal patterns in breathing while you
are asleep. There are several types of
sleep apnea. OSA and Central.
Clinical features: Disorder characterized by cessation
of breathing
for at least 30 episodes each lasting about 10
Seconds.
Most common frequently affects obese middle-aged
men
Associated with life-threatening arrhythmias, severe
hypoxemia during
sleep, daytime sleepiness, pulmonary
hypertension, cor pulmonale, and
systemic hypertension.
Snoring with pauses in breathing, Excessive daytime sleepiness Gasping or choking during sleep
Restless sleep, Inability to focus/memory loss, Quick to anger
Hypertension, Large neck, Morning headaches

Diagnosis
- Daytime sleepiness or fatigue
- Hx. of loud snoring with witnessed apneic episodes
- (sleep study) documenting apneic episodes
with hypoxemia

TX: Weight Loss, Nasal Continuous Positive Airway

Pressure (Nasal CPAP)
Uvulopalatopharyingoplasty (UPPP)
Insomnia
Persistent problems falling and staying asleep.
Causes
- Stress - Some psychiatric disorders (depression, manic states results in fragmented sleep)
- Excessive Alcohol Intake - Heavy Smoking
- Sedative-Hypnotic Use - Health Issues chronic pain thyroid, respiratory (SOB), urinary diseases

TX:
1. Psychological (cognitive- behavioral)
2. Pharmacologic (May Have Combination of Both)

Good Sleep Hygiene (Cognitive-Behavioral)

1. Go to bed only when sleepy
2. Use bedroom for sleeping only 3. After 20 minutes, get up
4. Get up at same time each morning 5. No caffeine or nicotine
6. Avoid alcohol
7. Establish daily exercise regimen
8. Limit fluids
9. Learn and practice relaxation
techniques
Restless legs syndrome (RLS), a type
of sleep movement disorder. It causes
an uncomfortable sensation and an
urge to move the legs while you try to
fall asleep. TX: Avoidance of nicotine and
caffeine, Iron therapy and identify triggers- sleep
hygiene,
Meds (Ropinirole)

Narcolepsy, a condition characterized

by extreme sleepiness during the day
and falling asleep suddenly during the
day.
Tx: Sleep hygiene and medications.
STimulants, Antidepressants.
Thanks

Questions