My child may have trouble sleeping, sleepwalking, waking up several times during the night ... But, for all families or children certain attitudes during sleep are inconvenient nor is it easy to determine when there is a true sleep disorder in a child.
According to the Clinical Practice Guideline on Sleep Disorders in Children and Adolescents in Primary Care, the prevalence of sleep disorders varies depending on the definition used and the type of problem being studied. But the definition of childhood sleep disorders is complicated.
It is true that there are often sleep problems instead of true sleep disorders. Sleep problems are sleep patterns that are unsatisfactory for the parents, the child or the pediatrician (because having more information, for example, detects something problematic that happens to parents unnoticed).
These problems may be related to the welfare of the child or family; but not all sleep problems are abnormalities nor do they all require treatment. An “inconvenience” can be only for the parents and not for the child and the same inconvenience can be problematic for some families and not for others.
On the contrary, sleep disorder is defined as a real alteration, not a variation, of a physiological function that controls sleep and operates during it. But we must also bear in mind that the differences between the "normal" and the "abnormal" are often defined according to age and not according to the pattern of sleep.
The same symptoms can have very different meanings according to the age of the child, for example that a baby wakes up many times at night is normal (and healthy) but that doing so a school-age child can negatively affect his health.
If we focus on children under five years of age, it is estimated that approximately 30% have problems and / or alterations in different types of sleep.
A review of the different studies shows that between 13% and 27% of parents of children four to 12 years of age, refer to the presence of sleep difficulties that include from what we have defined as "problems" (some of which personally I find the most normal and less worrisome) to true disorders.
These are: resistance to bedtime, anxiety at bedtime, delayed onset of sleep, reactive pigtail (when it is not the decision of the parents but they are “accepted” from the child's behavior), snoring, bedwetting, night waking , nightmares, sleep terrors, sleepwalking, early morning awakening and excessive daytime sleepiness.
What can be said is that If a child has certain problems of small sleep, these are usually stable throughout childhood.
According to different studies, a child with sleep difficulties at eight months will probably continue to show difficulties at three years of age and those with problems at two years will continue at 12 years of age (although we do not know if they are same problems or dreams related to sleep).
In a recent study conducted in the American context, it is seen that between 6% and 11% of parents or caregivers of children from zero to ten years think that the child has sleep problems.
However, in another study the incidence figures for sleep disorders are reduced: a global prevalence of 3.7% according to the international classification of diseases in children from zero to 18 years. That is, when we focus on the “true” recognized disorders, we see that very few children suffer from them. But what are these disorders?
Recognized disorders
Several groups of sleep disorders are included in the International Classification of Sleep Disorders. Recall that these are disorders in children, not babies, because especially newborns do not have any habitual sleep pattern in adults. Does your child suffer any of these disorders?
- Insomnia, when the child presents difficulties for the onset or maintenance of sleep and that may be due to different factors.
- Movement disorders related to sleep, including periodic limb movements and restless legs syndrome.
- Circadian rhythm disorders, when the quantity and quality of sleep are normal, but occur at an incorrect time according to the "usual" schedules (it is rare in children and more in adolescents).
- Respiratory disorders related to sleep, including habitual snoring, the syndrome of increased resistance of the upper airway, obstructive hypopnea, obstructive sleep apnea-hypopnea syndrome, night involvement of asthma and other chronic respiratory disorders.
- Childhood parasomnias (sleepwalking, night terrors, nightmares).
- Excessive daytime sleepiness or hypersomnia
Other problems at bedtime may be normal for the child's age, but if you are worried about what is happening (if repeated for several nights) or think it affects the child's health, consult the pediatrician.
It is also not good for the family that we remain with the doubt of whether our child suffers from a sleep disorder or not, and on this issue there are many popular "myths" and advice they give sometimes without asking them that they can lead to confusion and, worse, for the child to have a worse time.
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More information | AEPAP
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