Sleep Disorders in Children Tips

Sleepwalking in Children

Sleepwalking is a disorder in which a child partly, but not completely, awakens during the night. The child may walk or do other things without any memory of doing so.

More children than adults sleepwalk, most often between the ages of 3 and 7. According to the National Sleep Foundation's 2004 Sleep in America Poll, 1 percent of pre-school children and 2 percent of school-aged children walk in their sleep at least a few nights per week. Sleepwalking occurs more often in children with obstructive sleep apnea. There is also a higher instance of sleepwalking among children who wet the bed. Sleep terrors are a related disorder and both tend to run in families.

The child may sit up in bed and repeat certain movements, such as rubbing his or her eyes or fumbling with clothes. The child may get out of bed and walk around the room, look dazed, have clumsy movements. When talking to the child, he or she usually will not answer.

It is important to keep children safe during sleepwalking. Some tips for keeping sleepwalking children safe:

- Experts say to gently guide the child back to bed.
- Don't yell or make a loud noise.
- Remove dangerous objects from areas where the child might reach.
- Keep doors and windows closed and locked. This is especially important if you live in an apartment. If necessary, the child may have to sleep on the ground floor of a home.
- Don't shake the child.
- Use toddler gates on staircases.
- Don't use bunk beds.
- Never make your child feel ashamed about sleepwalking.

Most children who sleepwalk don't have emotional problems. So experts say not to worry too much if it happens. Most children outgrow sleepwalking. If your child sleepwalks for a long time, talk to your doctor. Your doctor may want to look at the problem more closely. Some medicines can be used to treat sleepwalking.

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Treatments for Sleepwalking

There is no specific treatment for sleepwalking. However, one study shows a method used by parents that was highly effective - quickly stopping 80 percent of sleepwalking children.

These parents used scheduled awakenings. Parents kept a diary of the time of sleepwalking over several nights and then began to waken the child 15 minutes before the sleepwalking had been occurring, making sure the child was fully awake for at least 5 minutes. If the child continues to sleepwalk throughout adolescence, the child's doctor or pediatrician should be consulted.

Treating sleepwalking in children can include discussing possible contributing factors such as fatigue or stress, which may all trigger symptoms.

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The Difference Between Nightmares and Night Terrors

When your child wakes you up in the middle of the night, crying over a bad dream, it is important to know if the child is having nightmares or night terrors. Here are the differences between the two, courtesy of the American Academy of Family Physicians.

Nightmares in children are basically scary dreams. Most children have them from time to time. The child may wake up and turn to a parent or caregiver for comfort. Usually, he or she will be able to say what happened in the dream and why it was scary. The child may then have trouble going back to sleep and may have the same dream again on other nights.

Night terrors in children, on the other hand, are a different kind of scary dream. Night terrors happen during deep sleep and a child having a night terror will often wake up screaming. He or she may be sweating and breathing fast. The child's pupils may look larger than normal. At this point, the child may still be asleep, but with open eyes. He or she will be confused and might not answer when asked what's wrong. The child may be difficult to wake. When the child wakes, he or she usually won't remember what happened.

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Helping Kids and Teens Sleep

If you are a parent exasperated by your child's sleeping patterns, here are some guidelines for helping kids get to sleep at night - and stay asleep:

- Have them go to bed at the same time every night; this helps the body get into a routine.
- Follow a bedtime routine that is calming, such as taking a warm bath or reading.
- Limit foods and drinks that contain caffeine. These include sodas, chocolate, and coffee-flavored ice cream.
- Do not allow a TV in the child's room. Research shows that kids who have one in their rooms sleep less. If they do have a TV, turn it off when it's time to sleep.
- Don't let them watch scary TV shows or movies close to bedtime because these can sometimes make it hard to fall asleep.
- Don't let them run around and get excited just before going to bed.
- Use their bed just for sleeping - not homework, reading, playing games, or talking on the phone. That way, you'll train them to associate their bed with sleep.

Teenagers need more sleep than adults. Teenagers need eight and a half to nine and a half hours of sleep per night, compared to the eight hours adults need.

Helping teenagers get to sleep:
To increase nighttime sleep for your teen, follow these guidelines by the National Sleep Foundation:

- Cut out television, video games and Internet access within two hours of bedtime
- Cut out all caffeinated beverages and foods after lunch.
- Assessment and changes in sleep schedules and sleep habits are often required as well, with the help of the family physician or a sleep doctor.

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About Night Terrors in Children

Night terrors, frequent recurrent episodes of intense crying and fear during a child's sleep, typically occur in children aged 3 to 12 years old, with a peak onset in children aged 3 1/2 years old.

Children who experience night terrors experience an increased heart rate and breathing rate and sweating during episodes. An estimated 1 to 6 percent of children experience night terrors. Boys and girls are equally affected. Children of all races also seem to be affected equally. The disorder usually resolves during adolescence.

The typical night terror episode usually begins approximately 90 minutes after falling asleep. The child sits up in bed and screams, appearing awake but is confused, disoriented, and unresponsive to parents or caregivers. Most episodes last 1 to 2 minutes, but they may last up to 30 minutes before the child relaxes and returns to normal sleep.

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What Time You Should Send Your Children to Bed

Children benefit from routine. That means regular bedtime and sleep schedules with clear limits set by parents are key to helping kids get to sleep.

If you are wondering when you should set your child's bedtime, here are the guidelines set forth by the National Sleep Foundation.

- Children up to age 6 should be able to fall asleep between 7 and 8:30 pm.
- Six to 11 year olds may fall asleep between 7:30 and 9 pm
- Teenagers should be able to fall asleep between 9 and 10:30 pm.

Most kids between age 5 and 12 get about 9.5 hours a night, but experts agree that most need 10 or 11 hours each night.

Anxious and depressed children sometimes need special support to fall asleep at night, and teenagers have a biological propensity to fall asleep later and wake up later. These are factors that should be considered when setting the right bedtime for your child. Researchers believe too little sleep can affect a child's growth and immune system.

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Sleep Disorders in Children

Sleep problems and sleep disorders in children range from nightmares to night terrors to bedwetting.

Examples of sleep disorders in children can include:

- Frequent awakening during the night
- Talking during sleep
- Difficulty falling asleep
- Waking up crying
- Feeling sleepy during the day
- Nightmares
- Night terrors
- Bedwetting
- Teeth grinding and clenching
- Waking early

Many childhood sleep problems are simply related to poor sleep habits or to anxiety about going to bed and falling asleep. To help minimize common sleep problems, a parent should develop consistent bedtime and regular bedtime and sleep routines for children. Help can be sought at a sleep clinic if you think your child has a more serious sleep disorder.

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Bedtime Problems

First, determine an appropriate time based on the child's sleep requirements and the parents needs for some time without children. Once this time is established, parents need to develop a bedtime ritual for their child that runs a half hour or so. This ritual helps make the transition from day to night and associates bedtime with something routine and good. Fixed bedtime rituals include taking a bath, changing into pajamas, brushing the teeth, reading a story, doing a puzzle, or just talking about their day. Most children feel that bedtime is their best time to talk to their parents, and a conversation with your youngster is always worthwhile. Tussling, tickling, or other stimulation horse play needs to be avoided at this time. When possible, most of the bedtime ritual should take place in the child's bedroom so that when the ritual is over the parent leaves the bedroom instead of the child leaving the family room. Both parents should take turns with this special time and never cancel the ritual as punishment for misbehavior earlier in the day.

* Source: Bruce A. Epstein, M.D., All Children's Hospital

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Sleep Statistics in Children and a New Program Designed to Help

The 2006 Sleep in America Poll discovered that just one in five adolescents get the nine hours of sleep they need on school nights. In fact, 45 percent of them sleep less than eight hours on school nights. Furthermore, over the course of a week, the average high school senior misses 12 hours of sleep.

Here is how our kids are sleeping, according to that study. You may be surprised at some of the results.

- More than half of adolescents report feeling tired and sleepy during the day.
- At least one day a week, one quarter of high school students actually fall asleep at school.
- Among adolescents who say they're unhappy, 73 percent of them aren't getting enough sleep.
- Fifteen percent of high schoolers between sophomore and senior year report driving drowsy at least once a week.
- Nine out of 10 parents believe their child is getting enough sleep most of the week, which means there is a miscommunication in the home over sleep.

The National Sleep Foundation has launched a program to help educate kids about sleep. The foundation is hoping the awareness week will motivate parents and educators to invite a sleep specialist from their community into schools to educate parents, teachers and students about sleep and common child sleep disorders.

The program is called "Adopt A School ... For Sleep Education." This program brings sleep specialists into schools to educate about sleep. The forum can be set up for an entire school assembly, an entire grade, or just one class.

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Nightmares in Children

For kids, stresses they encounter during their days at school and at home can manifest as nightmares.

The cause of nightmares in children range from problems at home, problems at school, and stress from sports or schoolwork. Sometimes major changes, such as moving or the illness or death of a loved one, can cause stress that leads to nightmares. Watching scary movies or reading scary books before bed can also bring nightmares on.

Sick kids with a high fever may have nightmares. Parents should let the pediatrician know if the onset of nightmares coincided with the start of a new medication for their child.

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Sleeping With Parents

Some children seem to fall asleep okay, but at two or three o'clock in the morning they wake up and crawl into bed with their parents. Children like sleeping with their parents- they know that in the parents bedroom they are safe and nothing can go wrong. Allowing the child to continue this practice, however, will prevent the child from learning how to cope on their own at night and will infringe on the parents' privacy. Therefore, when children come into their parents bedroom at night they should be returned to their bed as soon as their presence is discovered. There may be protests and tears, but it is important that parents remain adamant that the child stay in their own room at night (after all, instead of coming into your room, they could wander around the house at night and hurt themselves, even going outside!) If parents are deep sleepers, they should use some warning device (such as a cow bell on the child's door) that will signal the parents that their night wanderer is leaving the room. Consistently tell the child that if they wake at night and cannot go back to sleep, they can read or color quietly in their room, but they are not to come out of their bedroom. It is important to praise the child every morning when they stayed in their bedroom throughout the night. Remember, while the youngster may tell you that they "are afraid" or "had a bad dream." they are also being manipulative and testing the limits placed upon them. Dr. Goldstein says: "When the child leaves their bedroom at night, they have lost the limits parents placed on them. It stands to reason that by returning the child to their bed at night, parents are taking another important step in teaching their child how to control themselves."

* Source: Bruce A. Epstein, M.D., All Children's Hospital

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Causes of EDS In Adolescents

The most common causes of excessive daytime sleepiness in adolescents are:

1. Poor Sleep Hygiene: Insufficient sleep, irregular bedtime and rising time; pushing back bedtime to socialize, watch TV or play computer games, etc. Other problems are vigorous exercise just before bed, smoking, alcohol at bedtime, watching TV in bed.
2. Phase Delay Syndrome: inability to fall asleep until late, sometimes after 3 A.M. Such adolescents have trouble getting up in the morning and tend to build up a sleep deficit which they try to make up on the weekend. Adolescents normally require more sleep (9 hours) than children and adults.
3. Narcolepsy: Although relatively uncommon, the symptoms are regularly misinterpreted. These adolescents tend to fall asleep while doing routine activities, like eating, playing or working in class. These attacks are uncontrolled and may be frequent. When awakened they can be aggressive, confused or verbally abusive. They may experience sudden muscle weakness, particularly when surprised, excited or laughing. Their academic performance is usually affected and they are often labelled as inattentive, lazy or dull.
4. Sleep Apnea: Not uncommon in children, they may snore loudly, drool on the pillow, or have morning headaches. Daytime sleepiness is due to disturbed sleep. These children may exhibit signs of Attention Deficit Hyperactivity Disorder (ADHD).
5. Movement Disorders in Sleep: Restless Legs Syndrome (RLS), Periodic Limb Movements in Sleep (PLMS). These leg twitches are repetitive and may last several seconds. At night they are not recognized by the child but cause fragmented, unrefreshing sleep. They can also occur during the day, leading to a restless child who can't sit still. These children may also have signs of ADHD.
6. Asthma: Asthma can be predominantly sleep-related. Attacks disrupt sleep leading to daytime fatigue and less frequently daytime sleepiness.
7. Depression: Adolescents may suffer from unrecognized depression which often affects their academic performance. Depressed mood - especially in the morning, daytime sleepiness, lethargy, loss of appetite, poor concentration and irritability may also be signs of depression.
8. Shift Work: Disrupted biological rhythms can affect the quality and duration of sleep. Students who work afternoon or evening shifts can be excessively sleepy during classes, develop mood changes or have cognitive difficulties.

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