Sleep Disorders

Pediatric insomnia refers to difficulty falling to sleep, difficulty staying asleep, or waking up at night. Some children have conditioned insomnia — they may, for example, need a parent to help them fall asleep.

Pediatric Insomnia Symptoms and Effects

The most common symptoms of insomnia include:

• Daytime sleepiness
• Frequent accidents or injuries
• Hyperactivity
• Irritability, mood swings or depression
• Poor attention span or poor memory

What Causes Pediatric Insomnia?

Difficulty falling or staying asleep is often caused by:

• Changes in environment or schedule
• Chronic pain
• Depression
• Medications or other stimulants
• Medical conditions or disorders
• Stress or anxiety

Parasomnias are a group of sleep disorders in kids where unusual or atypical behavior occurs while a child is falling asleep or during sleep. Kids often don’t remember these behaviors when they wake up. Many parasomnias are common in children, but children typically outgrow them by the time they reach adulthood. Parasomnias include sleepwalking, night terrors, and other unusual behaviors (like walking or talking) while a child is falling asleep or during sleep.

Parasomnias Symptoms and Effects

Many of the symptoms related to parasomnias in children are mild, but sometimes they become bothersome enough to require medical attention. For example, unusual movements and vocal sounds may actually be nighttime seizures.

Parasomnias include the following behaviors:

• Confusion after waking
• Hallucinations
• Sleep-related eating
• Sleepwalking
• Talking or screaming
• Teeth grinding (this is called bruxism)

What Causes Parasomnias?

Parasomnias might be related to:

• Stress
• Medications
• Other disorders and medical conditions

Night terrors are a type of parasomnia. Night terrors in children include repeated episodes of intense crying, screaming and fright during sleep. Children are often confused, inconsolable, or screaming and thrashing.

Night terrors usually occur about 90 minutes after a child falls asleep. Children experiencing night terrors are difficult to wake. Once they wake up, they might not respond to attempts to provide comfort. Night terrors aren’t as common as nightmares, and children rarely remember the episodes in the morning.

Night Terrors Symptoms and Effects

Some common symptoms of night terrors include:

• Abrupt disturbances during sleep
• Sweating and increased heart rate
• Screaming
• Difficulty waking
• Confusion after waking
• Inability to remember dreams or nightmares

What Causes Night Terrors In Children?

The cause of night terrors is unknown, but they might be triggered by:

• Fever
• Lack of sleep
• Periods of emotional tension, stress or conflict

Hypersomnolence (daytime tiredness, sleepiness), which causes children to sleep too much or be sleepy most of the time. It is common in children and teens who have traumatic brain injuries or developmental disorders.

Hypersomnolence Symptoms and Effects

Symptoms of hypersomnolence usually include:

• Daytime sleepiness
• Decreased energy, slow thinking and slow speech
• Difficulty waking
• Disorientation after waking
• Increased irritation and anxiety
• Loss of appetite
• Poor memory
• Restlessness

What Causes Hypersomnolence?

Common causes of excessive sleeping or sleepiness are:

• Depression
• Medications
• Low thyroid function (hypothyroidism)
• Traumatic brain injury
• Other medical conditions or disorders

Obstructive children’s sleep apnea occurs during sleep. Throat muscles occasionally relax, blocking air flow in the nose and mouth (this is called apnea). To stop the apnea, a child briefly wakes up, which interferes with sleep. Sleep disturbances caused by sleep apnea can produce stress hormones and lead to daytime sleepiness, irritability, and changes in the ways the body uses energy.

Sleep Apnea Symptoms and Effects

Some of the most common symptoms and effects of sleep apnea in children include:

• Bed wetting (also known as enuresis)
• Pauses in breathing or gasping in sleep
• Depression, irritability, difficulty concentrating or mood swings
• Difficulty falling asleep
• Frequent waking
• Drowsiness and lethargy
• Preference for sitting up to sleep
• Headaches
• High blood pressure
• Seizures
• Snoring
• Waking up with a sore throat or dry mouth

What Causes Sleep Apnea?

There are many factors that can contribute to a child having obstructive sleep apnea.

• Children who are overweight are at an increased risk of obstructive sleep apnea because fat deposits around the throat and neck sometimes narrow the airway.
• Because children who have cerebral palsy and certain neuromuscular conditions typically have abnormal muscle tone and might be unable to reposition themselves during sleep, they are more likely to develop sleep apnea than other children are.
• Children who have craniofacial conditions (such as cleft lip and palate, craniosynostosis or Apert syndrome) have a greater risk of developing sleep apnea because their airways, jaws, and openings at the back of the throat are often small.
• Enlarged tonsils and adenoids (tissues in the back of the nasal cavity) can also cause sleep apnea.

Circadian rhythm disorders (mixed up sleep schedules, having days and nights flipped, and night-owlishness), which cause kids to sleep and wake on an unusual schedule.

Circadian Rhythm Disorders Symptoms and Effects

Typical symptoms of circadian rhythm disorders include:

• Daytime sleepiness
• Difficulty waking

What Causes Circadian Rhythm Disorders?

An out-of-sync sleep schedule is often caused by:

• Changes in routine
• Changes in time zones
• Medications

Restless leg syndrome (RLS) is a movement disorder. It often causes an irresistible urge to move the legs and unpleasant feelings when the legs are at rest. It often causes leg discomfort or the urge to move the legs when trying to go to sleep. The urge usually arises at bedtime, but it also can occur when the legs have been inactive, such as after sitting still for a long period of time.

RLS Symptoms and Effects

Typical symptoms of restless leg syndrome include:

• Crawling, burning or tingling feeling in the legs
• Daytime exhaustion, fatigue or sleepiness
• Difficulty concentrating
• Difficulty falling asleep or staying asleep
• Urge to move the legs is temporarily relieved by movement, stretching or massage

Sleep-related anxiety or nightmares includes feeling worried or stressed in the night. These worries may be related to scary TV shows — including the news — and stories that play on your child’s fears. The recent pandemic has also caused sleep changes, changes in sleep schedules or generalized anxiety regarding the changes COVID has brought upon us.

Child sleep-anxiety symptoms can include:

• Trouble going to sleep
• Frequently waking up in the night
• Resistance to going to bed
• Feelings of being overwhelmed
• Inability to concentrate
• Irritability
• Nervousness
• Restlessness
• Sense of impending danger or doom