Sleep is an essential element in children's growth and overall development. Many children suffer from some sleep-related problems or disorders in their early stages of life, which negatively affects the comfort of both children and parents. In this article from Dalili Medical, we will review the concept of sleep disorders in children, the times when they usually appear, the symptoms associated with them, and most importantly, how to deal with this condition.

What is normal sleep?

 

Normal sleep is a special type of mental activity, an active process that involves neural interactions. There are specific areas in the brain responsible for initiating and maintaining sleep. Although sleep is important at all stages of life, it becomes more important during infancy and childhood, when brain growth and development are at their peak. The concept of normal sleep is difficult to define precisely, as sleep and wake cycles vary based on age, gender, lighting conditions, physical activity, stress levels, and diseases. Normal sleep is what makes you feel physically and mentally prepared and rested at the beginning of the day

As for sleep disorders in children and adolescents, children spend most of the day sleeping during the first years of their lives. Newborns sleep an average of 14 to 16 hours a day, sleeping both day and night, making the concept of night sleep unclear. As the child reaches his first year, the concept of night sleep begins to crystallize, and the need for daytime sleep decreases until it almost ends at the age of three. Morning sleep also does not continue after the age of one to two years. As the body ages, the body's need for sleep decreases, and sleep hours begin to decrease.

Sleep disorders are associated with many psychological illnesses such as depression, anxiety, attention deficit hyperactivity disorder, autism spectrum disorders, and others.

Even in the absence of psychological illnesses, sleep disorders are one of the most common reactions to stressful events. These disorders can also arise as a result of medical conditions such as gastroesophageal reflux, pain, allergies, asthma, and others.

Sleep disorders can negatively affect children and adolescents, leading to problems with learning, concentration, and memory, in addition to irritability and daytime sleepiness, and an increased risk of psychological illnesses, especially in cases of chronic sleep disorders. Therefore, it is essential to address these problems in childhood, when brain development is at its peak.

Sleep disorders affect about 20-30% of children and adolescents. Given the importance of sleep in supporting the healthy development of the child, it is advisable to consult a specialist when noticing any problem in this context.

What are the symptoms of sleep disorders in children?

 

Symptoms of sleep disorders in children are manifested by feeling extremely tired during the day, difficulty concentrating, increased activity, and excessive emotions. Other signs and symptoms that may indicate the presence of sleep disorders in children include:

- Snoring or gasping during sleep.

- Difficulty breathing during sleep.

- Sleeping in unusual positions.

- Feeling sleepy during the day or difficulty staying awake.

- Bedwetting.

- Difficulty falling asleep or waking up frequently during the night.

- Difficulty waking up in the morning

- Breathing loudly or intermittently.

- Constant tossing and turning throughout the night.

- Abnormal sleep behaviors, such as sleepwalking, nightmares, or waking up startled.

- Delayed growth or failure to gain weight appropriately.

- Irritability and agitation.

What are common sleep disorders?

 

**Nightmares:** Nightmares are most common among children between the ages of 3 and 5, but they can occur at any age. They usually appear late at night, increasing in the second half of sleep. They may increase in frequency during periods of stress and anxiety. There is no specific treatment for them, but it is important to search for and treat the underlying causes. For children, nightmares may increase after watching cartoons or video games that contain inappropriate scary scenes, as well as after periods of stress and anxiety.

**Night terrors:** They are common among children between the ages of 1.5 and 10, with an incidence rate of up to 40% among preschool children. This disorder occurs in the early hours of the night, that is, in the first half of sleep. The child may wake up after two to three hours of sleep, and appear frightened by screaming or crying. Their eyes are open, but their gaze is blank and dull. These episodes last from 30 seconds to 3 minutes, and the child usually does not remember what happened in the morning (if they are not awakened) because they occur during the deep sleep stage. It is sometimes recommended that the child take a nap during the day, as terror attacks may increase when the child is very tired. **Sleepwalking:** Sleepwalking is a common phenomenon in children, with an incidence rate of up to 15%. This behavior usually begins between the ages of 4 and 8, and decreases significantly during adolescence. Sleepwalking is characterized by periods of unconscious awakening and wandering, during which the person's eyes are open but their gaze is dull and motionless. The person often does not remember what happened in the morning, or remembers very little due to the depth of sleep. In addition to walking, other behaviors may occur, such as leaving the house or urinating in inappropriate places. Therefore, it is necessary to take safety precautions at home. While improving sleep habits and regulating wake-up times can be helpful, it is important to address the problem with the help of a professional.

**Psychophysiological insomnia:** Insomnia is defined as a sleep disorder that causes difficulty falling asleep or staying asleep. Psychophysiological insomnia occurs when a person is aware of the reasons that prevent him or her from sleeping, leading to anxiety about not being able toOn sleep, thus the problem worsens and sleep disorders increase.

**Sleepwalking (narcolepsy):** Sleepwalking disorder affects a person's ability to control sleep and wake cycles. A person may have difficulty sleeping well at night, but often feels sleepy during the day and may sleep at inappropriate times.

Periodic limb movement disorder: This is a condition characterized by tingling, bending of the legs, and jerking movements in the legs and arms during sleep. These movements usually occur every 20 to 40 seconds and may last for minutes or hours throughout the night.

Food allergy insomnia: Insomnia is not necessarily caused by psychological reasons. Insomnia can also be caused by changes in the body due to a certain food that has been eaten, which limits the ability to sleep.

Night eating syndrome: Night eating syndrome is represented by consuming more than a quarter of the daily nutritional intake after dinner. This means that there is an increase in appetite hours before going to bed, which leads to an inability to sleep due to the increased calories and sugar consumed.

**Central sleep apnea** Central sleep apnea is defined as the cessation of breathing without attempting to resume it. This phenomenon is common in infants and is often associated with other diseases. The duration of the apnea is usually short and not alarming, but in some cases it can lead to serious problems.

**Obstructive sleep apnea** This phenomenon commonly occurs in children between the ages of 3 and 7 years. The main cause of this condition is the obstruction of the airway in the area of ​​the posterior nose and pharynx, which occurs as a result of swelling of the tonsils or adenoids. This phenomenon is more common in infants, especially those with facial deformities.

**Sleep movement disorder** Normally, when we dream, all the muscles of the body are paralyzed except for the muscles of breathing and the eyes. However, in some individuals, this normal paralysis does not occur during dreaming, causing them to move during sleep. The person may kick or hit someone nearby or move uncontrollably. This condition can be confused with other sleep disorders or epilepsy, but treatment can be helpful.

**Obstructive sleep apnea:** Complete cessation of breathing during sleep is known as apnea, while partial cessation is called partial apnea. This condition can be caused by either the brain or the respiratory system. This condition is very serious, as prolonged cessation of breathing leads to a lack of oxygen to the brain. In general, people with the condition snore during sleep and wake up feeling tired, in addition to feeling sleepy during the day.

**Restless legs syndrome:** This syndrome is characterized by a feeling of restlessness and a desire to move, in addition to a tingling, burning, itching or pain sensation in the legs, which usually occurs during rest in the evening. In mild cases, this feeling of restlessness can go away with movement. Leg movements also occur during sleep. It is necessary to control the symptoms and treat the underlying diseases associated with them.

Narcolepsy: It is usually characterized in children and adolescents by excessive sleepiness that is difficult to control during the day. Patients may suddenly and unexpectedly fall asleep while talking or eating, and this period of sleep may last for hours. The second symptom is a sudden loss of muscle strength that occurs when experiencing strong emotions such as excitement, sadness or happiness, or even while laughing. This condition is known as "cataplexy" and occurs in 50-70% of cases of narcolepsy in children. Sometimes, cases of sleep paralysis and hallucinations can be observed during the transition to sleep, which is attributed to the lack of neurons responsible for wakefulness in the brain. The diagnosis is confirmed by special sleep tests and the analysis of a specific substance secreted by sleep cells in the cerebrospinal fluid, and patients benefit from treatment.

Sleep and wakefulness disorders associated with the circadian rhythm (24-hour cycle): The sleep-wake cycle that lasts for 24 hours is known as the "circadian rhythm". This rhythm is influenced by factors such as age, gender, light and darkness, physical activity, stress and diseases. This disorder is particularly evident in adolescents, as the physiological need for sleep increases in parallel with the demands of their academic life.

**Teeth grinding**: This is a condition that occurs when a person grinds their teeth during sleep, and it can appear at any age. This condition causes wear and tear on the jaw joint and teeth, so it is recommended to use a special device inside the mouth to protect the teeth from wear. This condition may also cause headaches due to excessive pressure. It is important to check and treat the possible causes behind teeth grinding, such as stress and tension.

**. Parasomnia** Parasomnia is a common sleep problem among children, and almost everyone suffers from it at some point in their life. This disorder includes a group of physical, motor and psychological phenomena that occur during sleep at inappropriate times, such as talking or screaming during sleep, walking, sudden movements of the legs, muscle contractions, night terrors, and nightmares.

**Sleep talking** Sleep talking is also a common sleep disorder, affecting about 10% of children, and this phenomenon often disappears on its own over time.

**Restless Legs Syndrome** Restless Legs Syndrome is a neurological condition that causes a strong feeling of wanting to move the legs, and often occurs during rest periods, especially in the evening. The cause of this syndrome may be genetic, and it can also result from low levels of iron and dopamine in the brain.

**Periodic Limb Movement Disorder**Periodic Limb Movement Disorder (PLMD) leads to aFrequent cramps in the limbs, in addition to increased movement of the legs or feet during sleep. This may wake the child from sleep and cause him to feel sleepy during the day. This disorder is often associated with low iron levels in the blood.

**Diagnosis of sleep disorders in children**

 

The doctor diagnoses sleep disorders in children by conducting a comprehensive physical examination and inquiring about the child's complete medical history. This history includes information about the child's daily activities, behavior at school, living conditions at home, as well as medications that may affect his sleep.

The doctor also requests a set of examinations and tests to confirm the final diagnosis, including:

- **Daily sleep diary**: The doctor asks the parents to follow the child's sleep times daily for a week or two and write them down in a diary. These notes help provide a comprehensive view of the child's sleep habits, including nighttime sleep times and nap duration.

- **Sleep study**: This study is conducted in specialized laboratories to measure and record the child's sleep patterns, and is usually used to diagnose multiple disorders such as sleep apnea.

- **EEG**: This test detects the electrical activity of the brain during sleep, which helps measure the stages of sleep and wakefulness in a child.

Multiple Sleep Latency Test (MSL) is a test used to diagnose narcolepsy and to determine the causes of unexplained sleepiness in children. This test measures brain activity and eye movement to determine how quickly a child falls asleep during a series of naps.

Actigraphy involves fitting a child with a watch-like device with a sensor that measures sleep and wake patterns. This test is commonly used to diagnose obstructive sleep apnea and insomnia.

Blood tests can detect iron deficiency, as low levels of iron in the blood have been linked to periodic limb movement disorder and restless legs syndrome.

**Sleep deprivation affects preschoolers**

 

Children and teens need at least 9 hours of sleep each night. However, if a child has a sleep disorder, they may not be able to get enough rest. Sleep problems and lack of sleep can have multiple negative effects on children, the most prominent of which are:

**Developmental problems:** Children's growth depends largely on regular sleep at night, as the highest level of growth hormone secretion occurs during this period. Therefore, lack of sleep or sleeping during the day can negatively affect the child's growth significantly.

**Declining learning efficiency:** Children who suffer from sleep disorders, especially after the age of two, may face difficulty learning and acquiring new skills.

**Low activity level:** You may notice that the child becomes less active and mobile after a period of irregular sleep, whether in play or daily activities, and tends to relax and rest.

Deterioration of children's social relationships: This may be due to poor mood resulting from lack of sleep, which leads to tension in relationships between the child and his surroundings.

Memory problems: Lack of sleep leads to memory difficulties, as your child may find it difficult to remember important events or quickly forget what he has learned of new words or skills.

Slow reactions: If you notice that your child's reactions are slower than usual, this may be due to lack of sleep. Where the child is not fully conscious, which makes him late in expressing his feelings and attitudes. For example, if you give him a gift, he may remain for seconds without reacting, then express his joy at the gift.

Overeating: One of the common results of lack of sleep in children is overeating. The child not getting enough sleep pushes him to eat voraciously to be able to stay active during the day.

**Treatment of sleep disorders in children**

 

Treatment of sleep disorders in children depends on identifying the main cause that leads to difficulties sleeping at night. Among the available treatment methods are:

. **Cognitive behavioral therapy**: Cognitive behavioral therapy is an effective way to deal with many sleep problems in children, such as insomnia, hypersomnia, and sleep parasomnias. This treatment aims to change negative habits associated with sleep and teach children how to sleep properly.

. **Medications**: Some stimulant medications, such as modafinil, can be useful when taken in the morning, as they help increase alertness during the day. Antidepressants taken before bedtime can also help improve a child’s sleep quality at night.

**Iron supplements:** Iron supplements help boost iron levels in the blood, especially in children with periodic limb movement disorder and restless legs syndrome.

**Continuous positive airway pressure:** This treatment is used to treat obstructive sleep apnea and improve breathing during sleep. The child wears a nasal mask connected to a device that generates positive air pressure, which helps keep the upper airway open while the child sleeps.

**Surgery:** This is the primary treatment option for children with obstructive sleep apnea. The procedure involves removing the tonsils and enlarged lymph nodes.

**Parent education:** Parents are instructed on how to manage their child’s sleep disturbances, including how to deal with nightmares.

**Light therapy for sleep disorders** Light therapy can be used to reset your child’s circadian rhythm. Specially designed artificial lights emit white or blue light. When placed near the bed, these devices can provide bright light for your baby in the early morning, helping him adjust his sleep pattern. However, bright light therapy may have some side effects.Frequent cramps in the limbs, in addition to increased movement of the legs or feet during sleep. This may wake the child from sleep and cause him to feel sleepy during the day. This disorder is often associated with low iron levels in the blood.

**Diagnosis of sleep disorders in children**

 

The doctor diagnoses sleep disorders in children by conducting a comprehensive physical examination and inquiring about the child's complete medical history. This history includes information about the child's daily activities, behavior at school, living conditions at home, as well as medications that may affect his sleep.

The doctor also requests a set of examinations and tests to confirm the final diagnosis, including:

- **Daily sleep diary**: The doctor asks the parents to follow the child's sleep times daily for a week or two and write them down in a diary. These notes help provide a comprehensive view of the child's sleep habits, including nighttime sleep times and nap duration.

- **Sleep study**: This study is conducted in specialized laboratories to measure and record the child's sleep patterns, and is usually used to diagnose multiple disorders such as sleep apnea.

- **EEG**: This test detects the electrical activity of the brain during sleep, which helps measure the stages of sleep and wakefulness in a child.

Multiple Sleep Latency Test (MSL) is a test used to diagnose narcolepsy and to determine the causes of unexplained sleepiness in children. This test measures brain activity and eye movement to determine how quickly a child falls asleep during a series of naps.

Actigraphy involves fitting a child with a watch-like device with a sensor that measures sleep and wake patterns. This test is commonly used to diagnose obstructive sleep apnea and insomnia.

Blood tests can detect iron deficiency, as low levels of iron in the blood have been linked to periodic limb movement disorder and restless legs syndrome.

**Sleep deprivation affects preschoolers**

 

Children and teens need at least 9 hours of sleep each night. However, if a child has a sleep disorder, they may not be able to get enough rest. Sleep problems and lack of sleep can have multiple negative effects on children, the most prominent of which are:

**Developmental problems:** Children's growth depends largely on regular sleep at night, as the highest level of growth hormone secretion occurs during this period. Therefore, lack of sleep or sleeping during the day can negatively affect the child's growth significantly.

**Declining learning efficiency:** Children who suffer from sleep disorders, especially after the age of two, may face difficulty learning and acquiring new skills.

**Low activity level:** You may notice that the child becomes less active and mobile after a period of irregular sleep, whether in play or daily activities, and tends to relax and rest.

Deterioration of children's social relationships: This may be due to poor mood resulting from lack of sleep, which leads to tension in relationships between the child and his surroundings.

Memory problems: Lack of sleep leads to memory difficulties, as your child may find it difficult to remember important events or quickly forget what he has learned of new words or skills.

Slow reactions: If you notice that your child's reactions are slower than usual, this may be due to lack of sleep. Where the child is not fully conscious, which makes him late in expressing his feelings and attitudes. For example, if you give him a gift, he may remain for seconds without reacting, then express his joy at the gift.

Overeating: One of the common results of lack of sleep in children is overeating. The child not getting enough sleep pushes him to eat voraciously to be able to stay active during the day.

**Treatment of sleep disorders in children**

 

Treatment of sleep disorders in children depends on identifying the main cause that leads to difficulties sleeping at night. Among the available treatment methods are:

. **Cognitive behavioral therapy**: Cognitive behavioral therapy is an effective way to deal with many sleep problems in children, such as insomnia, hypersomnia, and sleep parasomnias. This treatment aims to change negative habits associated with sleep and teach children how to sleep properly.

. **Medications**: Some stimulant medications, such as modafinil, can be useful when taken in the morning, as they help increase alertness during the day. Antidepressants taken before bedtime can also help improve a child’s sleep quality at night.

**Iron supplements:** Iron supplements help boost iron levels in the blood, especially in children with periodic limb movement disorder and restless legs syndrome.

**Continuous positive airway pressure:** This treatment is used to treat obstructive sleep apnea and improve breathing during sleep. The child wears a nasal mask connected to a device that generates positive air pressure, which helps keep the upper airway open while the child sleeps.

**Surgery:** This is the primary treatment option for children with obstructive sleep apnea. The procedure involves removing the tonsils and enlarged lymph nodes.

**Parent education:** Parents are instructed on how to manage their child’s sleep disturbances, including how to deal with nightmares.

**Light therapy for sleep disorders** Light therapy can be used to reset your child’s circadian rhythm. Specially designed artificial lights emit white or blue light. When placed near the bed, these devices can provide bright light for your baby in the early morning, helping him adjust his sleep pattern. However, bright light therapy may have some side effects.Frequent cramps in the limbs, in addition to increased movement of the legs or feet during sleep. This may wake the child from sleep and cause him to feel sleepy during the day. This disorder is often associated with low iron levels in the blood.

**Diagnosis of sleep disorders in children**

 

The doctor diagnoses sleep disorders in children by conducting a comprehensive physical examination and inquiring about the child's complete medical history. This history includes information about the child's daily activities, behavior at school, living conditions at home, as well as medications that may affect his sleep.

The doctor also requests a set of examinations and tests to confirm the final diagnosis, including:

- **Daily sleep diary**: The doctor asks the parents to follow the child's sleep times daily for a week or two and write them down in a diary. These notes help provide a comprehensive view of the child's sleep habits, including nighttime sleep times and nap duration

- **Sleep study**: This study is conducted in specialized laboratories to measure and record the child's sleep patterns, and is usually used to diagnose multiple disorders such as sleep apnea.

- **EEG**: This test detects the electrical activity of the brain during sleep, which helps measure the stages of sleep and wakefulness in a child.

Multiple Sleep Latency Test (MSL) is a test used to diagnose narcolepsy and to determine the causes of unexplained sleepiness in children. This test measures brain activity and eye movement to determine how quickly a child falls asleep during a series of naps.

Actigraphy involves fitting a child with a watch-like device with a sensor that measures sleep and wake patterns. This test is commonly used to diagnose obstructive sleep apnea and insomnia.

Blood tests can detect iron deficiency, as low levels of iron in the blood have been linked to periodic limb movement disorder and restless legs syndrome.

**Sleep deprivation affects preschoolers**

 

Children and teens need at least 9 hours of sleep each night. However, if a child has a sleep disorder, they may not be able to get enough rest. Sleep problems and lack of sleep can have multiple negative effects on children, the most prominent of which are:

**Developmental problems:** Children's growth depends largely on regular sleep at night, as the highest level of growth hormone secretion occurs during this period. Therefore, lack of sleep or sleeping during the day can negatively affect the child's growth significantly.

**Declining learning efficiency:** Children who suffer from sleep disorders, especially after the age of two, may face difficulty learning and acquiring new skills.

**Low activity level:** You may notice that the child becomes less active and mobile after a period of irregular sleep, whether in play or daily activities, and tends to relax and rest.

Deterioration of children's social relationships: This may be due to poor mood resulting from lack of sleep, which leads to tension in relationships between the child and his surroundings.

Memory problems: Lack of sleep leads to memory difficulties, as your child may find it difficult to remember important events or quickly forget what he has learned of new words or skills.

Slow reactions: If you notice that your child's reactions are slower than usual, this may be due to lack of sleep. Where the child is not fully conscious, which makes him late in expressing his feelings and attitudes. For example, if you give him a gift, he may remain for seconds without reacting, then express his joy at the gift.

Overeating: One of the common results of lack of sleep in children is overeating. The child not getting enough sleep pushes him to eat voraciously to be able to stay active during the day.

**Treatment of sleep disorders in children**

 

Treatment of sleep disorders in children depends on identifying the main cause that leads to difficulties sleeping at night. Among the available treatment methods are:

. **Cognitive behavioral therapy**: Cognitive behavioral therapy is an effective way to deal with many sleep problems in children, such as insomnia, hypersomnia, and sleep parasomnias. This treatment aims to change negative habits associated with sleep and teach children how to sleep properly.

. **Medications**: Some stimulant medications, such as modafinil, can be useful when taken in the morning, as they help increase alertness during the day. Antidepressants taken before bedtime can also help improve a child’s sleep quality at night.

**Iron supplements:** Iron supplements help boost iron levels in the blood, especially in children with periodic limb movement disorder and restless legs syndrome.

**Continuous positive airway pressure:** This treatment is used to treat obstructive sleep apnea and improve breathing during sleep. The child wears a nasal mask connected to a device that generates positive air pressure, which helps keep the upper airway open while the child sleeps.

**Surgery:** This is the primary treatment option for children with obstructive sleep apnea. The procedure involves removing the tonsils and enlarged lymph nodes.

**Parent education:** Parents are instructed on how to manage their child’s sleep disturbances, including how to deal with nightmares.

**Light therapy for sleep disorders** Light therapy can be used to reset your child’s circadian rhythm. Specially designed artificial lights emit white or blue light. When placed near the bed, these devices can provide bright light for your baby in the early morning, helping him adjust his sleep pattern. However, bright light therapy may have some side effects.

For side effects, such as dry or irritated eyes, in addition to headaches. Therefore, it is necessary for the child to be monitored during this treatment phase by a doctor.

Tips to reduce sleep disturbances in children:

1. **Monitoring sleep patterns**: It is important to maintain fixed sleep and wake-up times.

2. **Establishing a bedtime routine**: This can include wearing pajamas, washing hands and face, brushing teeth, and having short conversations.

3. **Choosing comfortable clothes**: Clothes should be comfortable, and the room temperature should be adjusted to be comfortable and quiet.

4. **Applying light therapy**: This method is easy and cost-effective.

5. **Interfering with sleep schedules**: This may require delaying or interrupting bedtime at times.

6. **Delaying bedtime**: Delaying sleep for an hour or two can help reduce daytime sleepiness.

7. **Establishing a regular routine**: It is important to stick to a fixed sleep schedule every night and avoid changing it.

8. **Avoid encouraging late sleep**: The child should not be encouraged to stay up late, especially on weekends.

9. **Encourage physical activity**: It is beneficial for the child to exercise daily.

10. **Reduce the use of screens**: It is preferable to limit the use of television, computer, mobile phone, radio, or music at least an hour before bedtime.

11. **Avoid caffeine**: Children should not be given any foods or drinks containing caffeine at least six hours before bedtime.

12. **Follow a relaxing bedtime routine**: Such as giving the child a warm bath or reading him a story.

13. **Ensure that the room is comfortable**: The sleeping environment should be well prepared to ensure the child's comfort.