Regardless of age, adequate sleep enhances cognitive function, promotes mood regulation, and improves overall health. However, many children today face challenges that disrupt their sleep patterns, potentially leading to a range of sleep disorders. The consequences of untreated sleep disorders in children can be profound, impacting their academic performance, behavior, and quality of life. Assessing sleep disorders in children is a complex task that involves the identification of insomnia and other sleep-related problems. Professionals in the field carry out several studies, from clinical evaluations and questionnaires to advanced studies conducted in specialized sleep laboratories. Let’s look at the different types of insomnia that can be experienced during childhood and explore the assessment methods used by sleep professionals to identify pediatric sleep conditions.
Types of Insomnia in Children
Behavioral Insomnia of Childhood Behavioral insomnia in children involves sleep problems like resisting bedtime, taking a long time to fall asleep, or waking up during the night. t's most common in kids aged zero to five but can continue as they grow older. One of the primary causes of behavioral insomnia includes maladaptive sleep associations. When a child associates certain situations like being rocked or fed with falling asleep and they wake up during the night, they can't go back to bed without those same conditions. Another common source of this sleep disorder is parents setting inconsistent bedtime rules, preventing children from having a consistent sleep schedule. In order to differentiate regular sleep resistance from behavioral insomnia, issues must occur at least three times per week, persist for at least three months, and result in significant impairment of functioning in the child, parents, or caretakers. Insomnia Related to Excessive "Time in Bed" While professionals don’t consider it an official insomnia classification, this idea by Dr. Richard Ferber is widely used in clinical practice. Some children face difficulties like long bedtime struggles, waking up at night, or getting up too early when their designated sleep time set by parents is longer than their actual sleep requirements. This mismatch can disrupt their sleep patterns and affect their overall sleep quality. Conditioned Insomnia Conditioned insomnia, often seen in older children and adolescents, involves cognitive and behavioral responses that disrupt the ability to fall or stay asleep. It's marked by heightened anxiety related to sleep and the sleep environment, where patients dwell on past events or future worries and can’t quiet their minds. Multiple factors contribute to this type of insomnia, such as:
- Acute stress
- Caffeine consumption
- Genetic predispositions
- Medical disorders and psychiatric conditions
- Poor sleep habits
- Daytime napping
Assessment Methods for Sleep Disorders in Children Routine Screening In some cases, parents don’t readily offer details about their child's sleep, or they don’t grasp the potential connection between sleep issues and daytime behavior. Hence, professionals need to perform a screening to get sleep-related information and have a more detailed patient history. The BEARS acronym can be a useful tool, prompting clinicians to ask about five critical sleep areas:
- B (bedtime issues)
- E (excessive daytime sleepiness)
- A (awakenings during the night)
- R (regularity and duration of sleep)
- S (sleep-disordered breathing or snoring).
Chief Sleep Complaint During this process, sleep professionals ask the main sleep-related complaint, reported by either the parent or the child. Most sleep complaints in children can be categorized into four primary areas:
- Struggles with falling asleep or staying asleep
- Feeling excessively sleepy during the day
- Snoring or experiencing breathing issues while asleep
- Unusual movements or behaviors before or during sleep
The healthcare professional will investigate the identified sleep complaint more thoroughly and make it the focus of the sleep history. Additional Sleep History After identifying the chief complaint, the assessment explores specific details that differentiate disorders in that category. The additional sleep history should include the sleeping schedule, the pattern and timing of the symptoms, and the duration and frequency of the problem. It should also cover previous interventions that the patient tried to stop the problem, as well as daytime symptoms related to sleep issues, such as sleepiness, hyperactivity, inattentiveness, or irritability. General Physical Examination In the course of the physical examination, sleep professionals assess the child's alertness level, monitoring for potential indicators of excessive sleepiness like frequent yawning, drooping eyelids, or restlessness. Signs of nasal obstruction, such as persistent mouth breathing or noisy respiration, are also noted. Moreover, conditions like excessive weight gain, obesity, or insufficient growth may raise concerns about underlying sleep disorders, including obstructive sleep apnea (OSA).
Worried About Your Children Facing Sleep Disorders?
To take proactive steps towards better sleep and overall well-being for your child, don't hesitate to get in touch with us at Sunrise Orthodontics and Airway & Sleep Group. Our team of experts is here to provide the guidance and solutions you need. Contact us today to schedule a consultation and start improving your child's sleep quality.
