Sleep Disorders Affect Children Too: What You Can Do

Many sleep disorders that keep adults up at night and dragging during the day can have the same effect on children and teens.

Pediatric sleep expert Sally Ibrahim, MD, says these sleep disorders can affect your children’s health — and yours, since you care for them. She offers facts on some common childhood sleep disorders and the steps you can take to overcome them.

Common sleep disorders in children

Many sleep disorders that trouble adults can affect children too, but they need to be addressed a little differently. Here are some common sleep disorders that children may develop:

Children’s insomnia

Insomnia affects children in much the same way it affects adults. “Insomnia means that someone is having trouble falling, staying asleep or both,” Dr. Vaishal explains.

Certainly, you can note this behavior at night. But the first signs of insomnia could also be seen in how your child acts when they’re awake. Irritability, excessive tiredness or sleepiness during the day could also be signs that your child is experiencing insomnia.

Other signs of insomnia include:

• Early morning awakenings
• Frequent wakings at night
• Resistance to bedtime
• Excessive daytime sleepiness
• Lack of energy (seemingly out of nowhere)
• Difficulty falling asleep independently

If cases of acute insomnia, symptoms occur more suddenly and may clear up just as quickly. Temporary bouts of insomnia can be brought on by illness, stress or a change in the environment.

If the insomnia lasts longer than a few months, it is considered chronic (or ongoing).

Parasomnia

Parasomnia is a type of sleep disorder that causes abnormal behavior while you’re sleeping. As an example, your child crying, screaming or talking without responding in their sleep could be a sign of parasomnia.

Some other forms of parasomnia include:

• Night terrors. These are exactly what they sound like — sudden arousals from a deep sleep with features similar to intense fear such as crying, sweating, screaming and confusion. Your child often will not remember the episode the next day.
• Sleepwalking. Here, your child may walk or perform complex activities while still asleep. It’s like their mind is still asleep but their body is going through the motions anyway.
• Nightmares. Is your child running to your bedroom in the middle of the night more than usual? Nightmares or vivid, disturbing dreams can cause your child to wake up feeling scared. Unlike night terrors, children often remember their nightmares.

“I sometimes call this ‘like paranormal activities at night,’ which are some kind of abnormal movements such as screaming, crying and so forth,” Dr. Vaishal explains. “That’s usually a good signal of parasomnia.”

Parasomnia is often more common in children than adults.

Restless sleep

Restless sleep and restless legs are often described as a feeling of unease and restlessness in the body and legs when awake in bed and can reflect a lack of quality sleep. Some of the signs include:

• Trouble staying still
• Feeling constantly tired
• Having trouble focusing
• Being irritable

“It’s common to see this run in the family,” Dr. Vaishal says.

Iron deficiency and your dopamine functioning can play a role in restless sleep and restless legs. “Our brains need a chemical called dopamine to function properly,” notes Dr. Vaishal. “So if you're deficient in iron and dopamine doesn't function well, that can lead to restless sleep and restless legs.”

In children, this may lead to:

1. Daytime sleepiness
2. Frequent leg and body movement
3. Difficulty waking up
4. Problems focusing
5. Behavioral issues

Other contributing factors in restless sleep are things like stress, certain medications and poor sleep habits. In some cases, conditions like asthma or sleep apnea can also play a role.

[H3]: Delayed sleep phase syndrome

If you’ve ever called your teenager a night owl, they may be dealing with their sleep-wake cycle being off.

“A lot of times if you notice your child unable to fall asleep, you automatically think it's insomnia — but that's not always true,” says Dr. Vaishal. “There could be another set of disorders, what we call circadian rhythm disorder.”

The most common type of circadian rhythm disorder in adolescents is delayed sleep phase syndrome. It means their biological clock causes their sleep schedule to be delayed in comparison to social needs — late to bed and late to rise.

For kids, delayed sleep phase syndrome can have signs like:

• Difficulty falling asleep and difficulty waking up
• Mood changes
• Missing school (particularly in the morning)
• Poor academic performance
• Extended weekend sleep

Sleep apnea

Obstructive sleep apnea (one type of sleep-related breathing disorder) is one of the most common sleep disorders seen in children, says Dr. Vaishal. Symptoms include snoring, fragmented sleep and pauses in breathing while asleep.

The number of children experiencing sleep apnea is increasing, too.

“It used to be about 1% to 4% of children in the United States had it,” explains Dr. Vaishal. “But with the obesity epidemic in children, we're seeing a variety of literature showing that almost 20 to 70% of children with obesity have obstructive sleep apnea.”

Aside from snoring and pauses in breathing, other signs of sleep apnea include:

• Mouth breathing while asleep
• Heavy breathing while asleep
• Attention problems and hyperactivity
• Excessive daytime sleepiness
• Bedwetting
• Night sweats

Obstructive sleep apnea also may cause mood changes, daytime fatigue and high blood pressure. Other indicators could resemble attention-deficit hyperactivity disorder (ADHD) and include trouble concentrating, poor grades and behavioral issues.

If you suspect your child experiences sleep apnea, talk to your pediatrician about ordering a sleep study. It’s the gold standard for diagnosing sleep apnea and determining how severe it is.

If your child has sleep apnea, your provider may recommend removing their tonsils and adenoids or other treatments.

Tips for helping your child

Of course, it can be easier said than done to get your kids on the right track with bedtime. Certain sleep disorders will require treatment from a specialist. But good bedtime habits and techniques can help a child who’s having trouble with sleep:

Teach good sleep hygiene

Good sleep hygiene is necessary. And depending on how severe your child’s sleeping disorder is, improving their sleep hygiene may be enough to manage the condition as well.

“We talk a lot about the importance of personal hygiene like brushing our teeth, showering and so forth. But it’s also important to follow good sleep hygiene too,” Dr. Vaishal highlights.

Do things like:

Instill a regular bedtime routine

This is going to look a little different for every child. “It’s good for them to have a consistent bedtime and wake-up time,” Dr. Vaishal explains. If you’re a parent, you know this can be a struggle, especially if your child is going through a change in their routine or having trouble winding down before bed.

But here are a couple of ways to instill a good bedtime routine for your child:

1. Set a consistent bedtime: Choose a bedtime that allows your child to get the recommended amount of sleep for their age. For example, according to the National Sleep Foundation, young children (ages 3-5) should get about 10-13 hours of sleep. Stick to the same bedtime every night, even on weekends. If this is a change for your kiddo, ease them into it and don’t expect them to settle into the new routine overnight.
2. Create a wind-down routine: Establish a calming pre-bedtime routine that lasts 20-30 minutes. Activities can include reading a book, taking a warm bath or listening to soft music. Show your child simple relaxation techniques to help them calm down if they are anxious or excited at bedtime (more on that in a moment).
3. Bedtime bonding: Spend quality time with your child before bed. This can make bedtime feel special and something to look forward to. Anything to get them to associate bedtime as a good and positive thing!
4. Set clear expectations: Let your child know what you expect regarding bedtime. Be clear about the rules and follow through consistently.

Create a good sleep environment

Keep the bedroom quiet, cool and dark. Having a calming, sleep-inducing environment for bedtime is a key factor for improving sleep. Especially for children, their bedrooms should be as quiet and dark as possible. Plus, make sure it’s not too hot, as heightened temperatures often cause sleep disruptions as well.

Limit electronics at night

Let’s be honest, this is a tip we should all follow. But especially for kids, it’s important to avoid that glowing rectangle before bed (at least 1 to 2 hours before their head hits the pillow). Light can further delay your biological clock so artificial light exposure at night should be avoided. Conversely, having light in the morning helps regulate our internal clocks to ‘wake up,’ and helps keep our biological rhythm in check.

Utilize relaxation techniques

It’s important for your child to associate bedtime with calming down and unwinding. Especially if they’ve been a ball of energy all day, it’s good to set about 10-20 minutes before bedtime to practice some relaxed breathing or meditation. Another option is reading before bed or listening to calming music or an audiobook.

Try keeping a sleep log

Another good way to encourage your child to get on a better sleep schedule is to help them be more intentional around it. This can be as simple as keeping a sleep log, Dr. Vaishal suggests. Here, they can record their sleep patterns, the number of hours they get each night and any other factors that help or deter their sleep quality.

Some of the things you can keep in your child’s sleep diary include:

• Day of the week
• Date
• Average hours of sleep per night
• Any needs that your child has to help them sleep (I.e., a specific toy, blanket, sound machine, etc.)
• Noting what disrupts your child’s sleep (certain noises, smells, situations, etc) and how often these happen
• Certain food or drinks that improve or hurt your child’s sleep
• Timing and length of any nap

Try melatonin (in small doses)

Before even looking at melatonin dosage, you should talk to your child’s pediatrician first. A low dosage of melatonin has been shown to help regulate sleep patterns for children diagnosed with specific sleep disorders, particularly circadian rhythm disorders. Melatonin should not be utilized as just sleep aid to help fall asleep without guidance on appropriate dosage and timing from medical provider.

In some cases, the supplement can have adverse side effects like drowsiness or grogginess in the morning – which could make your child’s sleep situation worse.

Consider therapy

Cognitive behavioral therapy addresses some of the thought processes and behaviors around sleep. “That's essentially the most effective way to improve sleep long term in children with insomnia,” explains Dr. Vaishal.

Sleep disorders in children can sometimes be tied to mental health disorders like depression or anxiety. In this situation, children may need therapy as well as further help from a mental health provider.

When to see a doctor

For difficult cases, talk with your pediatrician. For some children, a consult with a sleep doctor may help. Sometimes a behavioral sleep psychologist is available to help guide insomnia with cognitive behavioral therapy. The important thing is to address sleep issues as early as you can for your child so they can develop positive sleep habits for life.