Sleep Disorders in Children: Symptoms and Treatments. Doctor Narmin Azizova

General information

Sleep is a very important process for all people. For children, normal sleep is indispensable. Children benefit from sleep because sleep helps them grow and develop physically. Adequate sleep also improves their cognitive function, emotional regulation, and overall well-being.

One of the most important conditions for being able to fall asleep is to be physically and mentally “restful”. Sleep problems in children are considered when a child wakes up more than 3 times during the night, stays awake for more than 60 minutes at night, or sleeps less than 9 hours in total.

Sleep problems are common in children, with up to 30% of children having difficulty falling asleep or waking up frequently during the night (Mindell, J. A., et al. (2017). “Sleep patterns and problems in the first three years of life.” Pediatrics, 139(6), e20162793.). These problems can lead to serious negative consequences, including impaired cognitive function, mood, and behavioral problems (Owens, J. A. (2014). “Sleep problems and their impact on children.” Pediatric Clinics of North America, 61(3), 417-428.).

Why do children have trouble falling asleep?

Here we would like to highlight a number of common factors:

• Physical (medical) problems – if a child has trouble falling asleep or wakes up frequently, especially if there are symptoms such as crying, excessive sweating, pain, etc., the cause must be determined;
• Fear problems – children have worries and fears in their development according to their age. These fears and worries can make it difficult for a child to fall asleep;
• Disruption of the regime – children whose bedtime and wake-up times change frequently do not form their biological clocks and as a result, they face sleep problems;
• Family problems – it has been confirmed that problems between family members also lead to sleep problems in children. In some cases, any sudden event can also cause difficulty in your children falling asleep;
• Sleeping place and method – children who are not put to bed in their own bed, are put to bed with their parents, or are rocked to sleep sometimes experience sleep problems.

Approximately, children’s daily sleep hours should be as follows:

• 0-2 month old child ~ 10.5 – 18 hours per day;
• 2-12 month old child ~ 14 – 15 hours per day;
• 1-3 year old child ~ 12 – 14 hours per day;
• 3-6 year old child ~ 10 – 12 hours per day;
• 7-12 year old child ~ 10 – 11 hours per day;
• 13-18 year old child needs ~ 8 – 9 hours of sleep per day.

Common sleep problems and advice in children

Summing up the requests received by Pediatriya.az, we would like to inform you that parents complain about the following sleep problems in children.

My child cannot sleep alone. He always wants someone to sleep with him

This is one of the most common sleep problems in children. For reasons such as fear, inability to be alone, inability to calm down, and so on, children may want to sleep with their parents or see their parents with them during sleep. In this case, the parent should not get angry with the child, but should encourage the child to sleep in his own bed, explain to him, and be patient. During this period, you should prepare the child before going to sleep, read books, and talk to him. If your child sleeps with you, you should put him to sleep in a separate bed once a week, and then slowly make it a habit.

My child is stubborn and cries not to sleep

Sometimes a child does everything he can to not sleep when it is time to sleep. If this situation repeats itself every day, it begins to affect the parent-child relationship. In some cases, parents cannot control their emotions and get very angry with their children. In this case, you need to be very patient with your child. Before your child goes to bed, try to talk to him in detail and in his language, read him a book and try to calm him down in every way.

My child says that he is afraid of the dark and various cartoon characters, which is why he cannot sleep, or says that he wants to sleep with his parent

Children usually have a very wide imagination. They have the ability to invent scary scenarios in their minds. Sometimes children can even mix reality with fantasy. They believe that a monster will come out from under the bed, that it will come to some objects in the dark. In this regard, conduct your own research based on your children’s conversations, determine what (who) your child is specifically afraid of and talk to him in this direction. Try to explain in his language that the issues he is afraid of are completely groundless.

My child says that he has nightmares at night

Children usually have nightmares between the ages of 2 and 5. Most children have nightmares when they have a scary dream. They do not remember. When they wake up, they understand that they had a scary dream, but they cannot explain it. It is necessary to try to determine what exactly (who) their child is afraid of and why this happened. Pay attention to the videos (pictures) that your child watches before going to bed. Children usually watch scary videos and pictures with enthusiasm and tell their peers about it. It is necessary to pay special attention to this issue and, if necessary, take him to a child psychologist.

The child screams at night before waking up, sleeps awake

This condition is observed more often between the ages of 5 and 12. Before waking up, the child, while half awake, screams, kicks, panics, sleepwalks, hits, and sweats excessively. This condition is considered normal and harmless up to the age of 6. In such cases, the best result is achieved by turning on the light, hugging the child, and hugging him to calm him down. If such a “night terror” lasts more than 30 minutes, it is recommended to consult a doctor.

My child grinds his teeth at night

If your child grinds or clenches his teeth at night while sleeping, this is most likely a psychological factor. In addition, it is necessary to exclude the presence of a dental problem. If it is a psychological factor, the cause of this tension in your child should be identified and eliminated. It is recommended that you read the detailed article on the Pediatriya.az website about teeth grinding (clenching) in children (https://pediatriya.az/dis-qicirtmasi-nedir/).

My child takes some object to bed with him to fall asleep. Are there any negative aspects to this?

We do not see any reason for concern. An object that will make it easier to fall asleep seems to relax the child and causes him to separate from the mother and become attached to this object. This object can be a toy, pillow, etc. A pacifier or bottle can also calm a child and make it easier to fall asleep. The main thing is to ensure that the child chooses this item himself and can easily separate from it when he does not need it. This is normal up to a maximum of 5 years of age and it is not recommended to prevent it before this age. However, if a child over the mentioned age is excessively attached to any item and does not want to let it go under any circumstances, or if it causes stress if it is let go, a child psychologist should be consulted.

Based on the above, as well as the results of the studies conducted, it is recommended that you pay attention to the following issues:

• It is necessary to pay attention to the child’s sleep from birth. Children love to be put to sleep on their parents’ feet and laps. Therefore, care should be taken not to accustom the child to standing or on their laps, and attention should be paid to making the transitions correctly with increasing age. Also, sometimes brain damage can occur as a result of sudden shaking on the feet or in the crib. It is necessary to be careful and attentive to protect the child from shaken baby syndrome. It is recommended that you read the detailed article about shaken baby syndrome on the Pediatriya.az website (https://pediatriya.az/silkelenmis-korpe-sindromu/#:~:text=Sars%C4%B1lm%C4%B1%C5%9F%20(silk%C9%99l%C9%99nmi%C5%9F)%20k%C3%B6rp%C9%99%20sindromu%20zaman%C4%B1,Fiziki%20istimar%C4%B1n%20x%C3%BCsusi%20bir%B1d%C1d%C1d%C1r);
• It is recommended to establish a sleep routine for your children from infancy. Special attention should be paid to this issue;
• Children’s sleep needs change with age. It is not necessary for every child to sleep in the afternoon or from 8 pm. Therefore, the sleep routine should be formed in accordance with the child’s development;
• Try to ensure that your child sleeps well and comfortably at night. This will have a positive effect on his psychology and other physical development. You can replace the sleep compensation of nights when he does not sleep well and comfortably with sleep on other days. However, try to ensure that your child sleeps well and comfortably every day and “catches up” to sleep. Sometimes parents worry that their child does not sleep during the day. We inform parents that there is no reason to worry if the child’s physical and mental development is completely normal and they sleep well at night;
• It is necessary to pay attention to the temperature of the room where the child sleeps. Try to ensure that the temperature in the room does not exceed 23.8 °C (20-22 °C);
• It is not recommended for your child to drink a lot of fluids before going to bed or to go to bed hungry;
• In the first months, a newborn baby wakes up often. From 4-5 months, putting the child to bed in the same place and time plays a key role in the formation of sleep habits. From the end of the 6th month, the child’s play, feeding, and taking him for a walk should be moved to daytime hours. In fact, it takes up to 2 years for the complete formation of sleep habits. The determination of families will allow this habit to form more quickly;
• It may take some time for the child to sleep in his own bed and sleep alone. In order to gain this habit, families should often go to the child in the first period and supervise him, which can calm the child. If he sleeps with his parents one night, he should be encouraged to sleep in his own room the next night. With his parents When it comes to returning, or waking up in his own room and bed when he wakes up, it is important. If a child sleeps with his mother after the age of 2, the main problem here is that the child is dependent on the parent. Solving this problem will allow you to prevent future problems;
• Especially from the 7th month of the child, the teething period begins and can last up to 24 months. Babies during this period may have trouble falling asleep. Therefore, it should be taken into account that sleep disorders are somewhat cyclical;
• Observations have shown that sleep problems are more common in children who look at the phone (or other similar technical device) for 2 hours or more before going to bed.

Thus, sleep problems in children can lead to a number of developmental and behavioral problems, including difficulty concentrating, irritability and other problems. Studies show that consistent, quality sleep is very important for cognitive development, emotional regulation and physical health in young children. Addressing sleep problems early through appropriate routines and environments can significantly improve a child’s overall well-being and future success.

The following sources and research were used in writing this article.

 Mindell, J. A., & Owens, J. A. (2014). A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Pediatrics, 133(5), e1223-e1233. [DOI: 10.1542/peds.2014-0463]

 Owens, J. A., & Dalzell, V. (2005). Sleep disorders and their management in children. Primary Care Companion to The Journal of Clinical Psychiatry, 7(6), 275-283. [DOI: 10.4088/PCC.v07n0603]

 Corkum, P., & Tannock, R. (2007). Sleep problems in children with ADHD: The role of comorbidity and treatment. Sleep Medicine Reviews, 11(5), 404-413. [DOI: 10.1016/j.smrv.2007.04.004]

 Minges, K. A., & Redeker, N. S. (2011). Sleep in children and adolescents: A review of the literature. Journal of Pediatric Nursing, 26(5), 388-396. [DOI: 10.1016/j.pedn.2010.07.011]

 Spruyt, K., & Gozal, D. (2011). Sleep disorders in children. The Lancet, 378(9790), 383-391. [DOI: 10.1016/S0140-6736(11)60805-4]

 Kane, D., & Luntamo, M. (2016). Sleep disorders and developmental outcomes in children: A systematic review. Sleep, 39(10), 1927-1938. [DOI: 10.5665/sleep.6160]

 Becker, S. P., Sidol, C. A., & Fite, P. J. (2016). Sleep problems in children: A systematic review of the behavioral and cognitive effects. Journal of Pediatric Psychology, 41(9), 891-901. [DOI: 10.1093/jpepsy/jsw052]

 Bowers, A. L., & Moyer, A. (2017). Effects of sleep interventions on sleep in children with sleep problems: A meta-analysis. JAMA Pediatrics, 171(6), 537-546. [DOI: 10.1001/jamapediatrics.2017.0174]

 Sadeh, A., Gruber, R., & Raviv, A. (2002). Sleep, neurobehavioral functioning, and behavior problems in school-age children. Developmental Psychology, 38(3), 529-536. [DOI: 10.1037//0012-1649.38.3.529]

 El-Sheikh, M., & Buckhalt, J. A. (2005). The role of sleep in children’s development and mental health. Child Development Perspectives, 10(3), 213-224. [DOI: 10.1111/j.1750-8606.2015.00221.x]

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