Things you should know:
- More than a third of school aged children may have sleep problems.
- Disturbed sleep at night makes it harder to function during the day. It raises the risk of problems with how a child behaves and learns.
- Sleep problems might not be noticed for some time because they are not easy for parents to detect.
- Most problems and disorders can be treated and cured. Some can't be cured but can be managed.
- There are units that specialise in treatment of children's sleep problems.
There are a number of common sleep problems and sleep disorders that are known to affect children.
You find it hard to get your child to settle into sleep at a reasonable time in the evening or your child wakes you more than once at night.
Your child might have a behavioural sleep problem
These tend to be linked with some inappropriate behaviours around the time your child goes to bed. It means it is hard to get them to go to bed, go to sleep and stay asleep. See Behavioural Sleep Problems in Children. For information on hours of sleep you could expect at different ages see How much sleep do you really need?
You notice that your child snores at night, has very restless sleep and wakes in the morning but does not look refreshed.
Your child may have Obstructive Sleep Apnoea Syndrome. They will need to see a paediatric sleep specialist. This is to look at your child's breathing and sleep
Obstructive Sleep Apnoea Syndrome (OSAS) is a breathing problem during sleep. There are many things that may give clues that your child has OSAS, e.g., loud snoring, noisy breathing, having to make more of an effort to breathe, or not breathing consistently with pauses and gasps every now and then. OSAS causes a restless sleep pattern. In turn, this leads to poor quality sleep. OSAS can also be linked with night sweats, mouth breathing, sleeping in strange positions and morning headaches. A young child with OSAS might grow and gain weight slowly. When children with OSAS wake up, they don't look refreshed. They may have behaviour and learning problems during the day and perform poorly at school. OSAS in children tends to be caused by large tonsils and / or adenoids. A sleep study in a children’s sleep unit can work out how bad the OSAS is. This is done overnight. Surgery is a common way to treat OSAS in children. The tonsils and adenoids are taken out. Some children have a higher risk of OSAS. Risk factors are if he or she is obese, has narrow bone structure in their face, Down Syndrome, neurological problems, weak muscles or has had cleft palate. See also Snoring and Obstructive Sleep Apnoea in Children.
Your child may have Restless Legs Syndrome (RLS)
This is a movement disorder. It causes strange feelings in the legs. These come when the legs are at rest, or when your child is lying down ready for sleep. These feelings make the child want to move the legs or walk around. When they move their legs, they will feel better for a short time. But the feelings will come back after a short time. These tend to occur in the time before sleep. This means RLS can make it hard to get to sleep and stay asleep. It can make their sleep worse. This can lead to behaviour and learning problems during the day. A paediatric sleep specialist can tell if your child has RLS and if so how bad it is. They can then arrange to treat it, if your child needs it.
Your child may have Periodic Limb Movements (PLMS) during sleep
These are when your child moves a body part during sleep. It is most common in the legs. The limb moves or jerks over and over, then stays still for a time. After a while, the limb starts moving again. This can disturb their sleep. They might wake up at night. This can cause daytime problems with behaviour, learning and sleepiness. A paediatric sleep specialist needs to look at your child to be sure if they have PLMS or not. They will need to do an overnight sleep study. The sleep study can see how much of an impact the PLMS is having on sleep as well. There are a number of ways to treat PLMS, e.g., iron supplements, exercise and /or medications. PLMS may occur together with Restless Legs Syndrome.
This may be due to a parasomnia
Parasomnias are a group of nighttime sleep problems. They are most common from 2 to 8 years of age. Common types are sleep terrors, confusional arousals, sleepwalking, sleep talking and nightmares. Risk factors include if the child doesn't get enough sleep or feels stressed. It can also run in families: a child has a higher risk if a parent had a parasomnia as a child. Parasomnias are usually thought of as normal in children. They do not normally need treatment, except if they are frequent or there is a risk that the child might hurt themselves. Parents should find out about these parasomnias. They should learn how to help their child during and after one. See Sleep Terrors, Sleep Walking and/or Nightmares.
Your child may have nocturnal seizures
These can occur as the child goes to sleep, during sleep or just after waking in the morning. They can happen even if the child has never had a seizure during the day. They are much rarer than night terrors. The child may move in the same way over and over. They may jerk and shake. They may or may not wake up. However, they tend to get in the way of a good night's sleep. This leads to daytime problems in behaviour and learning skills. If you suspect nocturnal seizures discuss this with your GP. They may refer your child to a paediatric sleep specialist or Neurologist.
Your child may have insomnia
This is a sleep problem where it is hard to go to sleep and stay asleep. The cause is often behavioural sleep problems, anxiety, depression or stress. Or it could be that they cannot switch off the brain from thinking and let go of the day. This can cause daytime problems with behaviour and learning. Good sleep habits before and at the time they go to bed can make things better. See Sleep Tips for Children and/or Sleep Hygiene: Good Sleep Habits and/or Insomnia. This will fix the issue for most children. But if not then they should see your family doctor who may arrange a referral to a paediatric sleep specialist. They will look for more ways to improve your child’s sleep.
Your child is most likely suffering from Delayed Sleep-Wake Phase Disorder (DSWPD)
DSPS is a sleep problem with the internal body clock. This is also known as the circadian rhythm. It controls the sleep times of the body. With DSPS, the body clock has been trained to go to sleep later through habit. But you can retrain it so your child can go to sleep earlier. To do this, get them to go to bed 15 minutes earlier each night for a week. Changing things step by step is easier than a sudden change. Be sure they get plenty of bright light (e.g., outdoor) as soon as they need to wake up. See Delayed Sleep-Wake Phase Disorder. If this doesn't work then they should see a paediatric sleep specialist.
Your child may be suffering from Narcolepsy
This is a neurological sleep problem. The brain can't control the desire to sleep while it’s awake. If your child has it, they may feel very sleepy during the day. It may be linked with other symptoms such as cataplexy (sudden loss of muscle strength). In some people, it causes sudden sleep attacks during the day too. To work out if your child has it or not, they will need to visit a Children’s Sleep Unit. Here they will do an overnight sleep study and daytime nap studies. A paediatric sleep specialist needs to do this. If they do turn out to have it, a management plan will be developed. Plans to manage behaviour and maybe some medication will be a part of this. See also Narcolepsy.
There are a lot of things that could cause this. See Excessive Daytime Sleepiness. You may need to discuss this with your family doctor.
Your child may have a sleep problem or sleep disorder
A child can have a sleep problem and a sleep disorder for some time before it is noticed. You need to look at your child’s sleep. Also look at how they function during the day. You need to see if you can find any clues that there may be a sleep problem. If you do suspect they have one, keep a diary of what you see and when you see it. You should see your family doctor to discuss your concerns. A referral to a paediatric sleep specialist may be needed.
Other useful links:
- Behavioural Sleep Problems in Children
- How much sleep do you really need?
- Childhood Snoring and Sleep Apnoea
- Obstructive Sleep Apnoea (OSA)
- Sleep Study
- Restless Legs Syndrome (RLS)
- Periodic Limb Movements of Sleep (PLMS)
- Sleep/Night Terrors
- Sleep Walking
- Anxiety and Sleep
- Depression and Sleep
- Sleep Hygiene: Good Sleep Habits
- Sleep Tips for Children
- Delayed Sleep-Wake Phase Disorder (DSWPD)
- Excessive Daytime Sleepiness