Pediatric Sleep Problems
There are differences between adult sleep apnea and pediatric sleep apnea. Adults usually have daytime sleepiness, while children are more likely to have behavioral problems. The underlying cause in adults is often obesity; in children, the most common underlying condition is enlargement of the adenoids and tonsils. However, obesity also plays a role in children. Other underlying factors can be craniofacial anomalies and neuromuscular disorders.
Pediatric sleep disorders increasingly interfere with daily patient and family functioning. Interest in and treatment of sleep disturbances in youth continues to grow, but research lags. One survey indicated that pediatricians were more likely to prescribe antidepressant medications for insomnia than psychiatrists. Further investigation is needed to develop fact-based diagnosis and treatment of pediatric sleep disorders.
The consequences of untreated sleep problems may include significant emotional, behavioral and cognitive dysfunction. The magnitude of these events is inversely proportional to the child’s overall ability to adapt and develop in spite of the sleep disturbance. Sleep regulation remains a critical part of health for youths. Elevated rates of sleep problems exist among children and adolescents with neurodevelopmental, non-psychiatric medical conditions and psychiatric disorders.
Factors such as increased societal demands, academic pressures, family related stressors (e.g., parental discord) and onset of puberty heighten the risk of sleep problems in adolescents.
Early diagnosis and treatment are important to prevent complications that can impact children’s growth, cognitive development and behavior. Pediatric sleep disorders require careful and extended evaluations that include interviewing the parents, child and teachers, as well as assigning and reviewing sleep diaries. Parents should be encouraged to record their child’s sleep-wake habits over a 24-hour period using sleep diaries for at least two continuous weeks prior to the initial visit. This can be useful to support the reported sleep-related complaints as well as guide routine history taking. Sleep diaries also assist in detecting day-to-day variability in sleep patterns that can often be missed during routine history and physical exams.
For an extensive review of pediatric sleep read the entire article in the Q4 issue of A2Zzz.