Sleep Problems in Children

About 25% of all children experience some type of sleep problem at some point during childhood. Despite this high number, sleep disorders in children often go unrecognized.

Normal sleep is necessary for a child’s optimal functioning. During childhood and adolescence, sleep accounts for about 40% of an average day.

Primary medical or psychiatric disorders are likely to be worsened by sleep problems. As any parent with a sleepless child can attest, this causes increased stress for parents and can lead to marital discord. This is also a major public health issue, since children with obstructive sleep apnea often need more medical care and because teens are at risk for motor vehicle accidents from drowsy driving.

In adults, insufficient or poor quality sleep due to any sleep disorder usually causes sleepiness. However, children with sleep disorders may not seem overly sleepy but may have other symptoms.

Children may seem irritable, moody, or not in control of their emotions. They may have problems with cognitive function such as inattention, poor concentration, and problem-solving. They also may exhibit behaviors such as overactivity, oppositional behavior, and poor impulse control.

These symptoms can be very similar to symptoms of ADHD. In fact, children are often misdiagnosed as having ADHD and put on stimulants instead of getting a sleep evaluation. These children then suffer consequences from misdiagnosis for many years, sometimes decades.

Common Sleep Disorders in Children

The most common sleep disorders in children are:

  • Insufficient sleep due to poor habits. Increased use of electronic devices in the bedroom, caffeinated beverages, and poor sleep practices are all too common.
  • Obstructive sleep apnea. Conservatives estimates are that it affects 1% to 3% of toddlers and preschoolers
  • Parasomnias. This is a type of sleep disorder that includes confusional arousals (mental confusion upon awakening), sleepwalking, night terrors, nightmares, REM sleep behavior disorder (acting out vivid dreams while sleeping), and bedwetting.
  • Restless leg syndrome. This involves uncomfortable feelings in the legs that can interfere with a child’s ability to fall asleep or stay asleep
  • Circadian rhythm disorders. This describes interruptions in a person’s “internal body clock.” Delayed sleep phase syndrome, in which a person’s “internal clock” is delayed by several hours, is the most common sleep disorder in adolescents.
  • Insomnia. This is defined as a child’s inability to fall asleep or to stay asleep throughout the night.
  • Narcolepsy. With this condition, a child has sudden attacks of sleepiness throughout the day and night that can’t be controlled.

What Parents Can Do

If you think your child may have a sleep disorder, there are some key screening questions.

Does your child:

  • Have problems going to bed?
  • Have problems falling asleep?
  • Maintain regular sleep schedule?
  • Seem sleepy during the day or difficult to awaken in the morning?
  • Wake up during the night?
  • Have any unusual behaviors during the night?
  • Snore or have problems breathing at night?

The rising prevalence of childhood obesity implies that obstructive sleep apnea is also increasing in children. However, even children without obesity can be at risk for sleep apnea if they have enlarged tonsils or adenoids, or have certain facial features.

The first line of treatment for obstructive sleep apnea in children is to remove their tonsils and adenoids. If their symptoms persist, a C-PAP (continuous positive airway pressure device, which blows air into the nose through a mask worn while sleeping) or an oral appliance would then be pursued.

Sleep disorders in children for the most part are easily treatable, and in some cases they can be prevented. A well-rested child is a happier and smarter child.

Frequently Asked Questions About Pediatric Sleep Studies