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Monday, 14 November 2011 00:00

Sleep problems in children and adolescents

Written by  Dr. Deborah G Mishek
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Up to 30% of children struggle with sleep problems.  Inadequate sleep can affect mood, cognition and attention. Children with neurodevelopmental issues and behavioral problems are at greater risk for having sleep issues.
The most common issues in children are bedtime resistance and nighttime wakings (night terrors, nightmares, sleepwalking).  Some children resist going to bed by stalling – every parent is familiar with the request for a glass of water, an extra story or an extra hug!  How can you resist?!  Some children actively refuse to go to bed and will keep coming out of their rooms.  Whatever the reason for their difficulties falling sleep, they may be difficult to wake up in the mornings or be tired the next day.  Many sleep problems can be traced back to poor sleep habits or anxiety (either separation anxiety, generalized anxiety or anxiety about sleep itself).  . Sleep can also be disturbed by mood disorders, trauma, substance abuse, and ADHD.  For more information on sleep problems look at this link .
Here are the most common sleep issues:
  • Waking up often during the night
  • Sleep talking
  • Difficulty falling asleep
  • Nightmares
  • Waking up early
How to help with sleep issues in children:
  • Establish consistent bedtime routines
  • Establish a regular bedtime
  • No naps late in the day
  • Avoid excessive sitmulation before bedtime (tv or computer/video games)
  • Avoid having your child fall asleep with you in bed - when he/she comes to a more awake state and finds you gone, he will wake and may need you to help go back to sleep.
  • If there is excessive anxiety have an evaluation for this.
The National Sleep Foundation recommends these basic daily sleep requirements for children, adolescents, pre-teens and teens:
  • Preschoolers: 11-13 hours
  • Elementary school students: 10-12 hours
  • Pre-teens: 9 - 11 hours
  • Teens 8 ½  - 9 hours
Adolescents seem to be chronically sleep deprived.  Their circadian rhythm seems to shift and they fall asleep later and yet school starts very early.  Inadequate sleep can affect all aspects of life for teenagers.  It can affect their mood, their relationships with friends, their concentration and can make them more irritable (that can sometimes be hard to assess in teenagers).  Some studies have linked weight gain with inadequate sleep.  In addition, fatigue while driving can be just as disabling as being intoxicated while driving.  One study compared the motor vehicle accidents rate of teenage drivers in two adjacent cities in Virginia in 2008.  In one city where high school classes began at 7:20 a.m., there were 65.4 automobile crashes for every 1,000 teen drivers. In the other city, where high school start times averaged 8:40 a.m., there were 46.2 crashes for every 1,000 teen drivers. Most accidents occurred in the afternoon after school let out ( ). Like younger children, anxiety and stress can make sleep more difficult.  In addition, substance use and abuse can affect the this cycle.
Here are some ideas to help teens get more sleep: 
  • Set a regular bedtime
  • Exercise regularly but not right before bed
  • Avoid stimulants after 4 pm (this includes caffeine, chocolate (yes there is caffeine in chocolate!) and nicotine)
  • Relax the mind – meditation or listening to soothing music can be helpful
  • Keep the lights low
  • Avoid napping more than 30 minutes during the day
  • Create a soothing sleep environment
  • Stay away from the computer right before bed
  • If sleep continues to be an issue, have an evaluation by a professional

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