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Sleep Disorders in Children

Sleep in children is important for normal physical and mental development.

Adequate sleep leads to improved attention, behavior, learning, memory, quality of life, and mental and physical health. Inadequate sleep is associated with an increase in injuries, hypertension, obesity and depression, especially for teens who may experience increased risk of self-harm or suicidal thoughts.

Abnormal breathing at night can cause children to become tired or hyperactive.

It is suggested that all screens be turned off 30 minutes before bedtime and that TV, computers and other screens not be allowed in children's bedrooms. Establishing a bedtime routine is important to ensuring children get adequate sleep each night. It is important to have a consistent sleep schedule, and bedrooms need to be comfortable, cool, dark and quiet.

Caffeine should be avoided late in the day. Remember that caffeine can be hidden- read labels to be sure you are not giving your children caffeine that may impair sleep.

How Much Sleep Does Your Child Need?

Signs of chronic sleep deprivation are irritability, difficulty concentrating or making decisions, poor school performance, loss of short term memory or becoming overly aggressive. In fact, sleep deprivation is often misdiagnosed as Attention Deficit Hyperactivity Disorder (ADHD).

  • Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. (Recommendations for babies less than 4 months are not included because there is a wide range of what is normal when it comes to sleep in newborns.)
  • Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health.
  • Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health.
  • Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health.
  • Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health.

Children, Obesity and Sleep:

Some 13 percent of children ages 6 to 11 and 14 percent of adolescents ages 12 to 19 are overweight. The ever-increasing waistlines put children at risk for heart disease, type 2 diabetes and high blood pressure. But there is another problem, often overlooked, accompanying the grim statistics from the U.S. Surgeon General’s office. Those extra pounds also put children at risk for sleep apnea, a serious, debilitating and potentially life threatening sleep disorder, according to the National Sleep Foundation.


BEARS Sleep Sceening Algorithm

The "BEARS" instrument is divided into five major sleep domains, providing a comprehensive scree for the major sleep disorders affecting children in the 2- to 18-year old range. Each sleep domain has a set of age-appropriate "trigger questions" for use in the clinical interview.

B = bedtime problems
E = excessive daytime sleepiness
A = awakenings during the night
R = regularity and duration of sleep
S = snoring

Examples of developmentally appropriate trigger questions:
   
Toddler/preschool
(2-5 years)
 
School-aged
(6-12 years)
 
Adolescent
(13-18 years)
   
1. Bedtime problems   Does your child have any problems going to bed? Falling asleep?   Does your child have any problems at bedtime? (P) Do you have any problems going to bed? (C)   Do you have any problems falling asleep at bedtime? (C)
 
2. Excessive daytime sleepiness   Does your child seem overtired or sleepy a lot during the day? Does she still take naps?   Does your child have trouble waking in the morning, seem sleepy during the day or take naps? (P) Do you feel tired a lot? (C)   Do you feel sleepy a lot during the day? In school? While driving? (C)
 
3. Awakenings during the night   Does your child wake up a lot at night?   Does your chld seem to wake up a lot at night? Any sleepwalking or nightmares? (P) Do you wake up a lot at night? Have trouble getting back to sleep? (C)   Do you wake up a lot at night? Have trouble getting back to sleep? (C)
 
4. Regularity and duration of sleep   Does your child have a regular bedtime and wake time? What are they?   What times does your child go to bed and get up on school days? Weekends? Do you think he/she is getting enough sleep? (P)   What time do you usually go to bed on school nights? Weekends? How much sleep do you usually get? (C)
 
5. Snoring   Does your child snore a lot or have difficulty breathing at night?   Does your child have loud or nightly snoring or any breathing difficulties at night? (P)   Does your teenager snore loudly or nightly? (P)
 
 
(P) Parent-directed question
(C) Child-directed question