Clinical Reference Systems: Pediatric Advisor 10.0

Many children have sleep problems. Examples include:

• frequent awakening during the night
• talking during sleep
• difficulty falling asleep
• waking up crying
• feeling sleepy during the day
• having nightmares
• bedwetting.

Many childhood sleep problems are related to irregular sleep habits or to anxiety about going to bed and falling asleep. Sleep problems may also be symptoms of emotional difficulties. Separation anxiety is a developmental landmark for young children. For young children, bedtime is a time of separation. Some children will do all they can to prevent separation.

To help minimize these common sleep problems, a parent can develop consistent and regular sleep routines for children.

Parents often find that feeding and rocking help an infant get to sleep. However, as the child leaves infancy, parents should encourage the child to sleep without feeding and rocking. Otherwise, the child will have a hard time learning to go to sleep alone.

Nightmares are relatively common. The child remembers nightmares, which usually involve major threats to the child's well-being. Nightmares affect girls more often than boys. For some children, nightmares are serious and frequent.

Sleep terrors, sleepwalking, and sleep talking constitute a relatively rare group of sleep disorders called parasomnias.

Sleep terrors, also called night terrors, are different from nightmares. The child with sleep terrors will scream uncontrollably and appear to be awake but is confused and can't communicate. Sleep terrors usually occur between ages 4 and 12.

Children who sleepwalk may appear to be awake as they move around but are actually asleep and in danger of hurting themselves. Sleepwalking usually occurs between ages 6 and 12. Both sleep terrors and sleepwalking run in families and affect boys more often than girls.

Most often, children with parasomnias have single or occasional episodes of these disorders. However, when episodes occur several times a night, or nightly for weeks at a time, or when they interfere with a child's daytime behavior, treatment by an expert such as a child and adolescent psychiatrist may be necessary. A range of treatments is available.

Fortunately, as they mature, children usually get over common sleep problems as well as the more serious sleep disorders. However, parents with urgent concerns should contact their child's physician.