Sleep Disorders in Children
Sleep is one of the most important factors in your child’s development. Proper sleep is critical to body, brain and emotional functioning. Healthy sleep allows our children to function at their optimal level of alertness at school and play. Healthy sleep also provides the platform for growth and repair of the body, storage and consolidation of new learning and improved mood.
Unfortunately, parents are frequently confronted with a host of issues affecting their children’s (and often their own) sleep. Inconsistent sleep schedules, poor nighttime routines, and conditions that fragment a child’s sleep are some of the most common concerns among parents and pediatricians.
Signs of Sleep Problems in Children
Talk to your physician if your child exhibits any of the following signs of a sleep problem:
- Snoring (generally chronic)
- Breathing pauses during sleep
- Gasping or grunting in sleep
- Problems with sleeping through the night
- Crying or screaming in the middle of the night
- Difficulty staying awake during the day
- Unexplained decrease in daytime performance
- Unusual events during sleep
- Sleep walking
- Teeth grinding
- Bed wetting
The neuropsychology department at North Shore Pediatric Therapy is committed to helping families learn good sleep habits, identify common conditions affecting sleep and help families find the best treatment options. Please contact our office for a consultation with one of our sleep experts.
Frequently Asked Questions
At what age should a baby sleep through the night?
By 3 months of age most babies are waking only once or already have started sleeping through the night. By 4 or 5 months old 50% sleep through the night, 70% by 9 months and by 1 year 85% of children are sleeping at least 8 continuous hours each night. So, if a full-term and otherwise healthy child has reached 6 to 7 months of age and is still having problems going to sleep, or is waking up for extended or repeated periods during the night, then a consultation with a specialist may be warranted.
How do I get my baby to fall asleep without the drama and crying?
One of the most important factors in helping your baby to fall asleep and stay asleep is a schedule. Children are born with multiple daily sleep/wake cycles. As they mature, they develop the tradition single daily cycle of wakefulness during the day and sleep at night. However, in order to compensate for small stomaches and bladders they need to eat and have their diapers changed frequently. The multiple daily sleep/wake cycle allows them to get the 18+ hours of sleep they need initially for growth and development. Parents who closely adhere to feeding/play/sleep routines report better sleep cycles and less need to engage in elaborate methods to soothe their children to get them to sleep.
When does napping end?
Napping decreases from 2-3 per day in the first few months of life to one long nap around or after the first year. By age 3 or 4, only 35-40% of children are napping and few persist regularly past age 5.
How much sleep should children normally get per day?
Young infants may sleep 12 to 13 hours including day time naps. But by 6 months, most children sleep only 11 to 12 hours total, and this number changes little throughout childhood. School aged children need about 10 hours per night. New research indicates that even during adolescence the need for sleep in still close to 9-10 hours. Unfortunately puberty brings with it a phase shift leading to later sleep onset times and pressure to sleep in the next morning. This is problematic with homework, evening activities and early school times. Care should be taken to ensure children obtain reasonable total sleep times each night.
Is it OK for a child to sleep in the same bed with their parents?
Yes, but only after the first 6 months and only under certain conditions. While co-sleeping varies based on the age of the child (decrease with age) and the cultural and philosophical backgrounds of families, there are certain factors that should be considered. The task force of the American Academy of Pediatrics concluded that c0-sleeping was potentially risky for young infants, saying “that bed sharing, as practiced in the United States and other Western countries, is more hazardous than the infant sleeping on a separate sleep surface and, therefore, recommends that infants not bed share during sleep” (AAP statement, click here). What we find more important are the reasons why families choose co-sleeping arrangements and the impact it has on the health of all family members. Co-sleeping can lead to some unforeseen consequences: one parent leaving the bed, decreased sleep for all members, difficulty transitioning back to the child’s own bed, exposure to tobacco or alcohol if consumed by parents, negative impact on parental intimacy. However, in many families co-sleeping works well and in some cases may be a necessity (i.e. limited space/rooms). You and your doctor should discuss the options and cost/benefits if co-sleeping is desired in your family.
My child walks around the house in their sleep. Is this normal?
Sleepwalking does not usually occur in dream sleep; but rather at transition points from deep to lighter sleep. Children may get out of bed and move around the house. While developmental in nature, parents must often intervene to keep the environment safe. Children may navigate stairs, open doors and even leave the house on occasion. However, most often parents need do little more than lead the child back to bed. Frequent events or events where the child may harm themself require environmental precautions, including locks, alarms or gates. These events may be triggered or exacerbated by poor sleep habits, changes in schedules disordered sleep. There are a number of treatment options and consultation with a sleep specialist if often warranted.
My child snores most nights. Should I be concerned?
Yes, children should be able to breathe easily through their nose while sleeping. Allergies, colds and sinus infections may temporarily inhibit this process and should remit when the underlying issue is treated. Chronic snoring is not common in children and likely reflects an underlying sleep disorder. Children who snore most of the night (particularly in the back half of the night) require intervention. Snoring and sleep apnea are frequently related to enlarged tonsils or adenoids or an imbalance between these areas and the architecture of the throat. A sleep study will reveal the frequency, cause and impact of sleep disordered breathing and a consultation with a sleep specialist should be sought immediately.
My child complains of pain in their limbs during sleep? My child is all over the bed each night?
These are common reports from parents of children with either restless leg syndrome or periodic limb movements. These movement disorders of sleep are far more common than once thought. Both may be related to underlying chemical imbalances and several therapeutic options exist. Please consult a sleep specialist if these symptoms are present.
My child wets the bed every night. Why does this happen and what can we do about it?
Most cases of bedwetting (99%) do not involve a known medical cause. Underdevelopment of the central nervous system and the “switches” that transition children from deep sleep to REM sleep may be involved. Because children cycle through sleep stages 4-6 times per night, bedwetting can occur throughout the night. In many cases parents can treat the issue by fluid restriction in the evening; but some children will continue to wet despite very little fluid intake. In these cases, the cause is likely developmental and probably runs in families. Encouraging the child that success is around the corner and not “pathologizing” the condition is important. The vast majority of children outgrow the condition withour intervention, though sleep mats, medications and environmental changes may aid in the process
My child screams, yells and cries in the middle of the night but still seems to be asleep?
Episodes such as this likely reflect night terrors. These events occur in children who are difficult to arouse and seem to be asleep (even with eyes open). While not thought to be pathological, these events can be extremely disruptive to families. Gentle soothing is often preferable to attempts to wake the child. There are behavioral and medical interventions that can aid the family. Most children outgrow the condition by age 9.