Sleep Disorders in Children and Adolescents

Many people battle the obstacle of having a sleep disorder. In fact, some don’t even know that they are suffering from one, or just think they are a restless or very late sleeper; it could  be something as little as very bad snoring. But, what they probably realize is that these sleep struggles and habits which could potentially be a serious matter, taking a toll on their level of functioning throughout their lives and their daytime sleepiness. While some may think sleep disorders mainly occur in adulthood, it is also common in children and adolescents; additionally it can be caused by unhealthy environments, poor sleep hygiene, or subtle or very physical abnormalities; ultimately, leading to negative impacts on children’s and adolescent’s emotional health and performance throughout the day.

Assessing for Sleeps Disorders

There is a long list of sleep disorders that fall under the categories of insomnia, hypersomnia, parasomnias, restless legs syndrome (an uncomfortable feeling while sleeping) and sleep apnea. To determine if one is struggling with one of these, it is important to look for symptoms, and there are many ways to do this. For example, patients can obtain witness reports from housemates, parents, or “a collateral history from a bed partner” (Rourke, Anderson, 2014). They would report signs of sleep apnea (excessive snoring) or parasomnias such as walking, restlessness driving, talking, texting, violent actions, acting out dreams, eating, all while being asleep, and not being able to react to stimuli (Rourke, Anderson, 2014).Other ways of determining symptoms is logging  sleep habits, including how many times one wakes up through the night, what time one goes to sleep, if one is up all night and can’t fall asleep (insomnia), tiredness during the day (hypersomnia), or following a sleep scale known as the Epworth Sleep Scale, rating how likely one is  to fall asleep in certain situations (Rourke, Anderson, 2014). Further, a person can probably undergo a sleep study in  a laboratory. Taking note of  histories of sleep habits can, in the long run, help a patient by allowing them to act early on their potential sleep habit.

There are many causes of sleep disorders and ways they can be treated. Some of these causes include poor sleep hygiene. Rourke and Anderson (2014) lists some reasons such as drinking, eating late meals, smoking, and late night exercising. Adjusting these habits can help better sleep problems. Additionally, for sleep apnea patients,  treatments include using a mask that fits over the patient’s mouth and nose, and “blows a constant stream of air to splint open the airway, and prevent the collapse that causes apnea;” and for other types of disorders, drugs such as hypnotics like temazepam and zopiclone, and cognitive behavioral can also help a patient. therapy (Rourke, Anderson, 2014). Ultimately, looking out for sleeping problems, and maintaining proper sleep hygiene, and getting proper treatment can all be of benefit to a person. 

Children and Adolescents with Sleep Disorders

Not only adults are affected with sleep disorders, children are too. Kotagal and Pianosi( 2006) states that one fifth of children and adolescents are affected by sleep disorders, and that the most common types of sleep disorders in children and adolescents are obstructive sleep apnea, which can be caused by bodily and facial anomalies, restless leg syndrome, narcolepsy and parasomnias as mentions by Rourke and Anderson as well . 

Unfortunately, these disorders can have a negative impact on young people. It can result in daytime sleepiness (hypersomnia) and “impair concentration,  attention span, memory, and behavior”  (Kotagal;Pianosi, 2006). Similarly  said by Rourke and Anderson, these problems in young people can be caused by  poor sleep hygiene. Kotagal and Pianosi( 2006) states that late night exercising, improper bedtime schedules, caffeine and substance abuse can all contribute to sleep disorders; additionally, central nervous system disorders such as narcolepsy, and psychiatric disorders such as depression can also contribute to sleep disorders and worsen them. Kotagal and Pianosi present many solutions and treatments to childhood sleep disorders acknowledging Rourke’s and Anderson’s point about maintaining good sleep hygiene and using treatments. Going to bed early, avoiding drugs, and not using technological devices can help, as well as using prescribed drugs, and having a pediatrician refer the child to a specialist if ongoing symptoms such as falling asleep in school occurs frequently (Kotagal;Pianosi 2006).

Impacts of sleep disorders on Children and How Their Environment Affects Them

There is a correlation between a child’s environment and having a sleep disorder. Specifically, being a victim of second hand smoke can lead to a child having a potential sleep disorder.  The study ran by Montaldo, L., Montaldo, P., Caredda, and D’Arco (2012) investigated the relationship between second hand smoke, which as stated before by Rourke and Anderson (2014), and Kotagal and Pianosi (2006) is a poor hygiene that can affect sleep disorders, and sleep bruxism (“teeth grinding or clenching movements during sleep”)(Montaldo, L., Montaldo, Caredda, D’Arco 2012). This investigation was done on children by interviewing families about whether or not they smoked around their children, and dividing the  children into groups of those who have been exposed to smoke within 6 months and those who have not and rating their exposure with “heavily, moderately, lightly, and occasionally exposed.” (Montaldo, L., Montaldo, Caredda, D’Arco 2012).The results of the study showed a strong correlation between secondhand smoke and sleep bruxism in children as 31% of the children suffered from sleep bruxism, and of that group, 76% of children were exposed to secondhand smoke (Montaldo, L., Montaldo, P., Caredda, D’Arco 2012). Therefore, clearly smoking in a household should be made aware of and limited as it has a negative impact on children in general, but also contributes to sleep problems that can negatively affect them throughout their day.

Sleep bruxism and other sleep disorders affect children poorly in regards to their daily functioning. A study on Chinese children done by Jianghong Liu and colleagues (2016) interviewed 3979 children who completed  questionnaires on emotional problems and sleep behavior, and their parents of four elementary schools who completed a child’s sleep habit  questionnaire while teachers rated school performances (Jianghong, 2016). The study showed that sleep disorders were more common in boys, putting kids at “risk for depression, loneliness, and poor school performance,” as well as daytime sleepiness which as stated before is a common result of poor sleep habits and disorders. (Jianghong, 2016).  Jianghong Liu and colleagues (2016) suggest earlier child screening to intervene with sleep disorders. As noted by Kotagal and Pianosi( 2006), depression in children can contribute to worsening sleeping disorders, and similarly stated before, sleep disorders can cause low daytime functioning, so tackling these symptoms, and getting treatment  quickly can allow kids to function better and have better school performances.

Knowing about Childhood Sleep Disorders is Important. 

The previously stated articles all tie into togething by education on sleep disorders especially in pinpointing causes of sleep disorders such as depression, smoking, and other methods of poor sleep hygiene. Further studies for showing how prominent potentially causes sleep disorders can be done by surveying schools about how many children fall asleep or are getting sleepy during school. This can be an indication of poor sleep habits at night which could potentially lead to a sleep disorder. Additionally, ways to help children with this can be by allowing more or longer breaks during school, maintaining a daily schedule to follow, and decreasing workloads so that children and adolescents  are not overwhelmed, and have more time for themselves, and are not going to bed late. Sleep disorders are emphasized as something that is clearly common in children. It is important to pay attention to symptoms in children, promote healthy sleep hygiene, caring for mental health, and  jumping on childhood screening in order to to help and treat childhood sleep disorders. It will help children to function better throughout the day even emotionally; and not only that, being aware of child sleep disorders or poor habits will help them in the future as childhood sleep problems can take a huge toll eventually in adulthood. The sleep issue may not be a disorder now, but can potentially turn into one in the future if it is not acted upon.

Kotagal, S., & Pianosi, P. (2006). Sleep disorders in children and adolescents. BMJ (Clinical 

research ed.), 332(7545), 828–832. https://doi.org/10.1136/bmj.332.7545.828

Liu, J., Liu, X., Ji, X., Wang, Y., Zhou, G., & Chen, X. (2016). Sleep disordered breathing 

symptoms and daytime sleepiness are associated with emotional problems and poor school performance in children. Psychiatry research, 242, 218–225. https://doi.org/10.1016/j.psychres.2016.05.017

Montaldo, L., Montaldo, P., Caredda, E., & D’Arco, A. (2012). Association between exposure to 

secondhand smoke and sleep bruxism in children: a randomised control study. Tobacco control, 21(4), 392–395. 

https://doi.org/10.1136/tobaccocontrol-2011-050217

Rourke, E., Anderson, K. N (2014) Sleep disorders. BMJ: British Medical Journal, 349. https://doi.org/10.1136/sbmj.g3818