What sleep problems can children have?

Sleep problems are common in children. Up to 30% of children less than 3 years old at some stage will have a sleeping difficulty. These can be divided into two categories: problems getting to sleep or problems staying asleep.

What causes these problems?

  • Behavioural issues: Most of these are due to behavioural issues around going to bed. This can also lead to problems falling back to sleep when the child wakes in the middle of the night causing disrupted sleep to parents.
  • Parasomnias: These include sleep walking/talking, bed rocking, night terrors and confusional arousals. They occur in deep sleep and the child will have no memory of the event.
  • Medical causes: These can be varied from skin irritation and gastric reflux to sleep disordered breathing and obstructive sleep apnea. Untreated sleep apnea can lead to a number of issues including behavioural difficulties at school and poor learning.

How can this be managed?

Behavioural issues are managed by educating parents after a full assessment has been made by a physician. A careful history and sleep diary will be helpful in managing the issue. Involving the help and expertise of a specialist sleep unit may be needed for some children and their families.

The Parasomnias are best managed with education and reassurance. Over-tiredness may contribute to an increased frequency of these events. Ensuring that the child has enough sleep is important. Addressing any safety issues around the home is also important.

Medical conditions need to be managed after consultation with your physician. Medications may be appropriate in some instances to manage chronic skin irritation or gastric reflux. Noisy breathing or snoring may indicate the presence of sleep apnea. An overnight sleep study is required for an accurate diagnosis. Unlike adults, surgery in children will often treat the condition. Some children may also need orthodontic treatment. In some instances CPAP (continuous positive airway pressure) may be required.

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