Sleep disorders in children and adolescents have a negative impact on their development. It is reported that sleep disorders are seen in approximately 20-30 percent of children and adolescents. The causes of sleep disorders in children and adolescents may consist of physical diseases, chronic diseases, genetic predisposition, emotional causes, environmental factors, parents' attitudes, and irregular sleep hours. The physical development process of children and adolescents with disturbed sleep patterns is negatively affected. Among the treatment methods for sleep disorders in children and adolescents, behavioral methods, which are the most widely used psychotherapy method, can be applied.
What are the Common Sleep Disorders?
Nightmares The most common age group is 3 - 5 years old. However, it can occur in any period of life. It usually occurs late at night as it is more common in the second half of sleep. It may be more frequent during periods of increased stress and anxiety. There is no specific treatment. It is important to investigate and treat the underlying causes. In children, it may increase after exposure to cartoons or video games containing inappropriate fear. It may also increase after periods of stress and anxiety.
Night-sleep terror: It is common between 1.5 - 10 years of age. The incidence in preschool children is 40%. It happens in the early hours of the night because it occurs in the first half of sleep. The child sits in bed 2 - 3 hours after going to sleep, screaming or crying in fear. The eyes are open, but the gaze is blank and dull. The duration can vary from 30 seconds to 3 minutes. Since it is during the heavy part of sleep, the child has little or no memory of it in the morning (if not woken). Daytime sleep may be recommended as it can increase when very tired. Programmed awakening can also sometimes help. Differential diagnosis is important when it starts in adolescence.
Sleepwalking: The incidence in children is 15%. It most frequently starts between the ages of 4 - 8 and decreases towards adolescence. These are recurrent periods of waking up and wandering during sleep. Eyes are still open and immobile, gaze is dull. The morning is not remembered or remembered very little as it is also a period of heavy sleep. In addition to walking, actions such as walking out the door or urinating in the wrong place may also be seen. It is very important to take safety precautions in the home. Although sleep hygiene and programmed awakening may be beneficial, the problem should be solved with professional help.
Sleep movement disorder: Normally, when we dream, all our muscles are paralyzed except respiratory and eye muscles. In these individuals, this normal paralysis does not occur during the dream. And the person moves while dreaming. He/she may kick, hit someone close to him/her or flutter. This condition can be confused with other sleep disorders or epilepsy. It can benefit from treatment.
Obstructive sleep apnea: When a person's breathing is completely interrupted during sleep, it is called apnea, and when it is partially interrupted, it is called hypopnea. It can be caused by the brain or respiratory tract. It is a very serious condition as oxygenation of the brain is impaired in prolonged apneas. Generally, individuals with this disease complain of snoring during sleep at night, waking up tired and sleepy during the day.
Restless leg syndrome: Restlessness in the legs that occurs at rest in the evening, manifested by the desire to move, tingling, tingling, burning, itching or pain. In mild cases, this feeling of restlessness disappears with movement. Leg movements also occur during sleep. It is important to control the symptoms and treat the underlying diseases.
Narcolepsy: In children and adolescents, it is usually characterized by excessive, uncontrollable daytime sleepiness. Patients suddenly fall asleep unexpectedly while talking or eating. These naps can last for hours. The second symptom is a sudden loss of muscle strength when experiencing a strong emotion (excitement, sadness, happiness) or during laughter. This condition called 'cataplexy' occurs in 50-70% of narcolepsy cases in children. In some cases, sleep paralysis and hallucinations during the transition to sleep may be observed. It is caused by a lack of nerve cells in the brain that provide wakefulness. The diagnosis is clarified by special sleep tests and analysis of a special substance produced by sleep cells in the cerebrospinal fluid. It benefits from treatment.
Sleep-wake disorders related to circadian rhythm (24-hour cycle): The 24-hour sleep-wake cycle is called "circadian rhythm". It varies according to age, gender, light and darkness, exercise, stress and diseases. It is a sleep disorder especially seen in adolescents. While the physiological need for sleep increases in parallel with academic life in adolescents, there is a change in sleep time patterns due to increased social activities. At the same time, the melatonin hormone released at the beginning of sleep starts to be released later. For all these reasons, adolescents have a phase delay in their circadian rhythm. This sleep disorder can also occur during long journeys and in shift workers.
Bruxism: It is a condition of grinding teeth during sleep. It can be seen at any age. It causes wear on the jaw joint and teeth. In order to prevent abrasion on the teeth, a personalized oral appliance should be used. It can cause headaches due to pressure. It is recommended to investigate and eliminate the underlying causes (stress etc.).
How are sleep disorders in children and adolescents treated?
Sleep disorders in children and adolescents can bring along a number of problems. The physical development process of children and adolescents with disturbed sleep patterns is negatively affected. Behavioral methods, which are a common psychotherapy method, can be applied to children and adolescents. These behavioral methods can be listed below;
- Paying attention to sleep patterns (making sure that bedtime and wake-up time are always at the same time)
- Making bedtime a routine (wearing pajamas, washing hands and face, brushing teeth, short conversations)
- Comfortable clothes should be worn before going to sleep, the room temperature and the room should be quiet.
- Light therapy can be applied (it is an easy and cost-effective method).
- It may be necessary to intervene in sleep (such as delaying sleep onset, interrupting sleep).
- Delaying bedtime by 1-2 hours will prevent daytime sleep attacks.
- The caregiver family should have a clear attitude towards the negative reactions of the child during sleep time (such as rejecting verbal or behavioral complaints, preventing the child from getting out of bed in case of crying, shouting loudly, etc.)
If sleep problems persist despite these behavioral practices, then medication should be administered by a specialist. The physical development process of children and adolescents with disturbed sleep patterns will be negatively affected. These negative effects may cause problems in daily activities, sleeping and learning.
What is Normal Sleep?
It is a special form of mental activity. It is an active and neuronal process. There are special areas in the brain involved in initiating and maintaining sleep. Although it is important in every period of life, it is especially important in infancy and childhood, when brain development and growth are the fastest. It is difficult to describe a normal sleep. This is because the sleep-wake cycle varies according to age, gender, light-darkness, exercise, stress and diseases. Sleep that makes you feel physically and mentally ready to start the day and restful is a normal sleep.
Sleep disorders in children and adolescents, in the first years of life in children, most hours of the day are spent asleep. Newborn babies sleep an average of 14 to 16 hours a day. Since they sleep both during the day and at night, the concept of night sleep is not completely absent. Around 1 year of age, the concept of night sleep starts to become clear. The need for daytime sleep decreases and ends around the age of 3. Morning sleep does not continue after 1-2 years of age. As the age increases, the body's need for sleep decreases and sleep hours close to adult (8 - 10 hours) are established during adolescence.
Sleep disorders in children and adolescents can have many different underlying causes. The most common, and the ones that can be easily corrected when help is sought, are problems arising from parental attitudes and boundary problems.
Many mental illnesses (depression, anxiety, attention deficit hyperactivity disorder, autism spectrum disorders, etc.) can also be accompanied by sleep disorders.
Even in the absence of mental illness, sleep disorders are one of the most common reactions to stressful events. Sleep disorders are also seen due to medical diseases (gastroesophageal reflux, pain, allergies, asthma, etc.).
Sleep disorders in children and adolescents can lead to learning, attention and memory problems, irritability, daytime sleepiness and mental illnesses, especially in prolonged sleep disorders. It is of great importance to eliminate these problems during childhood when brain development is very rapid.
Sleep disorders in children and adolescents are seen in approximately 20-30% of them. Since sleep is also important for the healthy development of the child, a specialist should be consulted when a problem is noticed.
