Sleep Disorders In Children

Parents worry about sleep disorders in children. Sleep problems are a very common concern because of the disruption and sleep deprivation they can cause to the whole household but they are not necessarily sleep disorders in children.

For parents, it's helpful to understand what is normal and what is more unusual, or even disordered.

Sleep cycles

During sleep, we go through cycles of rapid eye movement (REM) and non-rapid eye movement (NREM) sleep. When we are in REM sleep, our eyes move quickly, our bodies are relatively still and we dream. Because REM is a lighter stage of sleep, your child is most likely to wake during this stage. NREM is deeper sleep. Normally, we move between light and deep sleep in cycles, so your child is more likely to wake up during each period of lighter sleep.

How do babies sleep?

Babies go through a full sleep cycle every 50 to 60 minutes, so they can have many periods of light sleep when they may wake up.

Newborn babies can sleep at any time, off and on. By four months of age, your baby is likely to be sleeping for six to eight hours at a stretch (hopefully overnight). By six months, this usually extends to ten to twelve hours. Most babies wake up at least once a night up till around nine months. Some babies fall back asleep by themselves, while others need help to get back to sleep.

How do older children sleep?

Children of school-age need between nine and twelve hours of sleep each night. There is a trend for children at this age to be sleep deprived, however, this is not one of the sleep disorders in children - it is a problem that can be corrected. Your child is probably getting enough sleep if he or she can go to bed, fall asleep within 15 to 30 minutes, get up easily in the morning and stay awake and alert during the day.

If your child complains that their friends have later bedtimes, you can tell them that everyone is different and has their own bedtime. Their bedtime is healthy for them.

Good sleep habits for children

• identify a time in the evening when your child tends to slow down and become tired. This is a good time to go to sleep.
• make bedtime special and enjoyable, but not stimulating. It can be a wonderful time for interacting with your child so they feel loved and secure. Don't use bed as a threat, as you want your child to know that bed is a positive place.
• Keep a regular routine of wake time, meal times, nap times. Avoid letting your child watch TV near bedtime. Watching TV has been linked to poor sleep.
• Use a basic, regular bedtime routine mainly in the place or room where your child will sleep, depending on your child's age. This can involve a few quiet activities like a small snack, bath, cuddles, a lullaby or story and saying goodnight. Don't soothe your child to sleep by letting them sleep with a bottle of milk or juice. Drinks other than water can cause baby bottle tooth decay. Feed or breastfeed our baby, then put him or her down to sleep.
• Some babies and younger children sleep better when there is low level noise like a fan, radio or vaporizer. These can block out distractions.
• Keep your child's bed clutter-free. Lots of toys can be distracting and stimulating. One or two comfort toys can help with separation, but babies under four months should have an empty crib to avoid suffocation.
• Keep lights low in the evening as bedtime gets closer - this helps the brain to slow down. In the morning, expose your child to light to signal the brain to wake up - open the curtains or blinds.

Common sleep problems

Sleep problems aren't necessarily sleep disorders in children. Sleep problems are sometimes learned, or sometimes normal behaviour that is considered a problem by parents.

Sleep deprivation is a common problem among children and adults and can have serious consequences. Here are some average sleeping hours to give you an idea of whether your child might be experiencing sleep deprivation. Keep in mind that averages include children who sleep less and more than the average. Ultimately your guide is your child and how easily they fall asleep, wake up and how alert they are between sleeps. Teen sleep deprivation is of particular concern.

Night waking

Parents of babies are often asked whether their child is sleeping through the night and parents frequently discuss sleeping patterns. You may know someone whose baby sleeps for long stretches from an early age. If yours doesn't, please don't feel bad. It is entirely normal for babies to wake up at night. Breastfed babies wake more often than bottle-fed babies because breast milk is more quickly and easily digested - it is designed for your baby. This can be frustrating when your nursed baby wakes hungry every couple of hours or so and needs a tummy-fill to get back to sleep, but remember that breastfeeding is so good for your baby and by six to eight months your baby will be able to sleep much longer without nursing.

Before 4-6 months, babies have to feed at night, but older babies may get into the habit of feeding at night, when they don't need it for survival and growth.

When you comfort your baby in the night, don't stimulate your child...don't play or turn up lights. You want to make it as easy as possible to re-settle your child and signal that it is still sleep time.

Causes of night waking

• Being premature
• Difficult temperament
• Depressed mothers
• Live in a stressed household
• Sleeping with parents
• Separation anxiety
• Breastfeeding

Separation Anxiety

By the time children are 8-9 months old, they aware aware that you exist even if they can't see you. They may not, however, feel secure about you not being visible. Children can lack this security until 3-4 years of age when night waking usually diminishes. You will know if your child wakes due to separation anxiety because they will settle back to sleep when you are there to reassure them.

Some ways to help your child feel more secure may be to let them sleep with a comfort object like a doll, soft toy or blanket. When he or she sees this object during the night. it is easier to relax and get back to sleep.

If this is not enough, and your child needs your presence to settle, you can put a foam mattress and blankets next to your bed on the floor where they can come in during the night and sleep if they need reassurance.

Sleep disorders in children

Sleep disorders in children are unusual but can be very distressing. Learn more about the following sleep disorders in children:

• Sleep apnea in children
• Bedwetting

These are known as parasomnias, rather than sleep disorders in children. Parasomnias are disruptive but are not considered a serious health concern:

• Night terrors in children
• Sleepwalking in children

Source: University of Michigan Health System

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