If you’re like most parents, you know that when your child doesn’t sleep, neither do you. Understanding why our kids have sleep problems and acting on them can help you (and the rest of the family) get the sleep you need.
Dr. Shalini Paruthi, a sleep specialist at Cardinal Glennon Children’s Hospital, says the fact that children do have sleep disorders is not widely recognized. “Most children really do not get enough sleep, and many sleep disorders are age-related,” she says. “Starting with toddlers up until about 8 to 10 years old, there may be a lot of resistance to going to bed, with frequent ‘curtain calls.’ Bedtime routines and consistency are very important in changing that behavior.”
Paruthi says many younger kids’ night fear stems from something they heard or saw on TV. Teenagers, on the other hand, have a shift in their circadian rhythms so that they get sleepy much later—but still have to get up early for school. A good rule of thumb, she says, is that children up to the age of 5 need between 11 to 14 hours of sleep, 5 to 13-year-olds, 10 hours, and high-schoolers, 8 to 9 1/2 hours.
Curtain calls and sleeplessness aside, it may be behaviors during sleep that are most distressing to parents. Paruthi says the most common are sleepwalking, sleep talking, sleep terrors, bed wetting, sleep apnea, and restless leg syndrome. She says handling sleepwalking is mostly about safety. “It’s important to make sure they can’t run into something sharp, fall down the stairs, or go outside,” she explains. “If you catch them roaming, just turn them around calmly and lead them back to bed.”
Night terrors are a different story. “These kids are more out of control,” Paruthi says. “They have a rapid heartbeat, may be sweating, and they are running through the house asleep—and screaming. If you try to corner them, they can get aggressive.” She says the best thing is to provide for their safety and wait for them to come out of it.
“We know that something arouses them and stimulates it, so we try to determine why arousal is happening, and deal with the underlying cause,” she explains, adding that sleep deprivation is a major trigger. She also screens for sleep apnea and restless leg syndrome or anything in the child’s history that can interrupt sleep. In the meantime, if night terrors persist, Paruthi advises parents to wake the child gently about a half hour before the terrors typically occur, then let them fall back to sleep. “A few nights of doing that usually breaks the cycle,” she says.
Dr. Amy Licis, a pediatric neurologist with Washington University Sleep Center at St. Louis Children’s Hospital, deals with many children with sleep disorders. She says parents concerned about their child’s sleep habits should discuss the problem with their pediatrician, who in turn, will refer the child to a sleep center if the issue persists.
When a child spends the night at a sleep center, specialists look for specific things, like how the child breathes and whether he/she snores. Some children, especially those with overgrown tonsils or adenoids, may have obstructive sleep apnea that causes frequent awakening. In some children, apnea (stopping breathing periodically) may be caused by faulty neurologic control, and is referred to as central sleep apnea. “We also look for frequent awakening, how long the child actually sleeps in total, and how long he stays in the different stages of sleep, as well as any unusual movements,” Licis says.
Sleep studies can get at the underlying cause of other problems, like sleepwalking or night terrors. Rather than needing any medication, most children grow out of them and just have to be managed, Licis says. And parents should realize that bedtime resistance in children is part of their development of autonomy, while sleep deprivation is a very real problem. “Try to have the same bedtimes all week,” Licis says. “Make the room conducive to sleep: only very dim night lights, and no TV or roughhousing right before bedtime.”