What Are Sleep Disorders?

Pediatric sleep disorders alter sleeping habits and change regular sleep patterns. Many sleep disorders can harm physical health and emotional well-being. Children who have a disability or complex medical condition are much more likely to experience sleep problems than typically developing children are.

Sleep disorders can be grouped into three main categories:

  • Lack of sleep.

  • Excessive sleep.

  • Problematic behaviors—such as sleepwalking, snoring or seizures—that occur during sleep.

Up to 30 percent of children and teens may have sleep disorders at some point. For children and teens who have disabilities and complex medical conditions, however, the rate might be even higher. For example, studies indicate that 50 percent of children who have cerebral palsy also have a diagnosable sleep disorder and half of children who have craniofacial conditions also have obstructive sleep apnea.

Sleep Apnea

Obstructive 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 include:

  • Bed wetting (also known as enuresis).
  • Brief periods of not breathing during sleep.
  • Depression, irritability, difficulty concentrating or mood swings.
  • Difficulty falling asleep.
  • Drowsiness and lethargy.
  • Headaches.
  • High blood pressure.
  • Seizures.
  • Snoring.
  • Sudden awakenings with shortness of breath.
  • 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.
 

Insomnia

Insomnia might involve difficulty in getting to sleep, trouble staying asleep or both. Some children have conditioned insomnia—they may, for example, need a parent to help them fall asleep.

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 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.

Hypersomnolence

Hypersomnolence occurs when a child sleeps too much or is sleepy much 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.

Circadian Rhythm Disorders

Circadian rhythm disorders cause kids to sleep at times when other people are awake (sleeping days instead of nights, for example).

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

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. 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.

Night Terrors

Night terrors usually occur about 90 minutes after a child falls asleep. They include repeated episodes of intense crying, screaming and fright during sleep. Children experiencing night terrors are difficult to wake. Once they wake up, they might not respond to attempts to provide comfort. Night terrors are not 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?

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

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

Parasomnias

Parasomnias are a group of sleep disorders in which 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 Symptoms and Effects

Many of the symptoms related to parasomnias 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.

Diagnosis and Treatment for Sleep Disorders

The first step in effectively treating sleep disorders is diagnosis. For example, nighttime seizures might appear to be a sleep disorder—it’s important to understand exactly what’s going on before proceeding with treatment.

To help make a diagnosis, tests for sleep disorders can include:

At Gillette Children’s Specialty Healthcare, your family will work with leading sleep medicine specialists for children and teens. The following are some common treatments used with sleep disorders:

Sleep Apnea Treatment

Wearing a continuous positive air pressure (CPAP) mask—a mask over the nose that releases a puff of air into the throat, relieving obstructions so the airway won’t collapse—can help. In other situations, surgery to remove the tonsils or adenoids helps to open the airway.

Insomnia Treatment

Sometimes medicines can help kids with falling and staying asleep. In other cases, behavior changes can help children fall asleep (for example, learning to sleep without a parent being in the room).

Hypersomnolence Treatment

Stimulant medicines might help a child stay awake or to feel less sleepy.

Circadian Rhythm Disorders Treatment

For some kids, light therapy, medicines or a combination of both can help to reprogram the biological clock and create new sleeping and waking schedules.

 

Integrated Care

Children who have disabilities such as cerebral palsy, craniofacial conditions, epilepsy, neuromuscular conditions, and other neurological disorders often have sleeping problems, too. A complex condition paired with a sleep disorder can affect the health—and quality of life—for your child and your family.

At Gillette, your child will benefit from one of the nation’s only sleep medicine programs designed specifically for people who have disabilities and complex conditions. In addition to sleep health services, your child might need comprehensive care that requires experts from a variety of specialties.

We’ll help you determine which specialties should be part of your child’s treatment. Gillette sleep health specialists often collaborate with: