As many parents would agree it is apparent that Shakespeare had children when you read the following quote about sleep: “Sleep that knits up the raveled sleave of care, the death of each day’s life…chief nourisher in life’s feast.” Children, mostly infants, are infamous for keeping parents awake.
Healthy sleep patterns in infants begins to develop at about 6 weeks and most have a regular pattern by 3-6 months. An important part of a child’s healthy sleep is a steady bedtime routine. This routine helps the body and mind to wind down, relax, and prepare physically and mentally for sleep. This is true for children and adults.
While the majority of children develop healthy sleep patterns it is becoming more and more common for parents to report that their children are having problems with sleep bothering everyone in the household.
If a parent notices any of the following, they should discuss these symptoms with their health care provider: Your child is extremely and consistently fussy, having problems breathing, has loud snoring, unusual awakenings or difficulty falling asleep or staying asleep. It is important to notice if they have daytime sleepiness or behavioral problems.
Some sleep problems in children are called parasomnias which are a group of abnormal sleep behaviors which can be measure in a sleep study. Parasomnias may be abnormal movements, behaviors, emotions, perceptions or dreams. During these events the child is likely to stay asleep and often have no memory that it has occurred. These disorders include sleep walking, sleep terrors, sleep eating, sleep paralysis and REM sleep behavior disorder.
Nightmares occur late at night during REM (rapid eye movement) sleep and awaken the child. Sleep or night terrors occur early in the night as the child may scream and be distress although they are not awake. Sleep talking is when the child talks, laughs or cries out in their sleep but are unaware and have no memory of it the next day. Sleep walking occurs in approximately 40% of children, usually between ages 3 and 7. Snoring occurs when there is a partial blockage in the airway that causes the back of the throat to vibrate causing the familiar noise.
Sleep apnea (obstructive sleep apnea OSA)) occurs when the snoring is loud and the child is having trouble breathing. Symptoms include pauses in breathing during sleep which can wake the child repeatedly. Some consequences of untreated OSA include inattention/behavioral problems (ADHD), failure to thrive, hypertension and an enlarged heart. Concerns about OSA usually are referred to an Ear-Nose and Throat doctor. Treatments might be intranasal steroids, removal of tonsils and adenoids or devices to create positive airway pressure. Some children with oral malformations may require orthodontic or plastic surgery.
Obesity contributes to the increased upper airway resistance and weight loss is recommended. Obesity associated with OSA is much more common in adults.
As stated above lack of sleep has been linked to serious health issues in all ages and concerns should be expressed to the doctor.
by Sally Robinson, MD Clinical Professor
Keeping Kids Healthy