gland in the brain that varies in 24-hour cycles and is controlled by our personal body clock. Often referred to as the “hormone of darkness”, its function is to help us get to sleep at the hours closer to nighttime. Melatonin is also used to treat children’s difficulties with falling asleep or remaining asleep. It has shown to benefit children with normal development as well as children with ADHD, autism and other developmental disabilities. The root cause of a child’s sleep disorder, however, should be investigated and diagnosed properly before melatonin dosage is considered. For example, a child’s inability to achieve a whole night’s sleep may be due to disruption by apnoea or anxiety, not to behavioural disorders. Parents and carers must take into account the range of sleeping disorders for children in relation to their daily activity, diet, moods and general health. ADHD in Children and Sleep Up to 70% of children with ADHD experience difficulty with sleep, which may be either behaviourally or medically based. Generally children with ADHD are unwilling to go to bed or fall asleep, experience anxiousness prior to bedtime, have Delayed Sleep Phrase Syndrome whereby they fall asleep and wake up later, or have insomnia. The presence of someone else, like a sibling, adult or a favourite movie, may be required to ease the child into sleep. Sleeping difficulty may be a side effect of ADHD medication or due to depression, anxiety or behavioural issues. Behavioural Sleep Issues in School Aged Children These include the common bedtime struggles that parents and carers experience when that particular hour arrives, including refusal to get into and stay in bed, not settling into sleep, not staying in their own bed, waking up during the night and getting up early. All of these generally equate to the child not experiencing enough nightly sleep. Childhood Snoring and Apnoea Sleep apnoea is a condition that causes breathing to stop for a few moments while sleeping. Generally children who experience sleep apnoea will snore, but not all little snorers have the condition. Children with apnoea may struggle to breathe and have restless sleep, often awaking suddenly and frequently with gasping or loud choking noises. As a result, children may sleep in odd, uncomfortable positions, sweat a lot during sleep or wake up with confusion and/ or a headache. Nightmares Nightmares are more commonly experienced among children and stop between the ages of More than one third of school aged kids experience sleep problems. Children ’s Health nine to ten. They occur during the sleep stage or REM (Rapid Eye Movement) sleep, in which dreams and nightmares often reflect information attained that day. REM is often more intense among children, meaning their nightmares are more vivid, which can lead to higher levels of fear, discomfort and disturbance of sleep. 10% to 15% of children have nightmares. Narcolepsy This is a neurological sleep problem that disables the brain’s control over a person’s desire to sleep. Its main symptoms are feeling very drowsy throughout the day and random attacks of sleep. Periodic Limb Movements (PLMS) These are the movements of a child’s limbs during sleep and often are disruptive to sleeping patterns. The limb often jerks continuously, stopping periodically, and then continues moving again until the child awakens. It is often sleep depriving and affects the child’s behaviour and learning ability during the day. Good Sleeping Habits Toddlers • Determine and maintain a daily sleep schedule and bedtime routine • Maintain the sleep environment consistent every night, throughout the night (lighting, bedding, etc.) • Establish limits for bedtime and enforce through explanation and negotiation • Provide a security object such as a blanket or toy Preschoolers • Maintain a regular and consistent sleep schedule • End the bedtime routine with the child in bed. The use of bedtime stories is a successful technique in this context • Avoid using the television as a means to put the child to sleep School Aged Children • Teach school aged children about the health benefits of sleep • Reward good sleeping behaviour • Separate the area of television watching from the bedroom • Avoid caffeine Child Sleep Units Around the country, there is a number of Children’s Sleep Units that specialise in children’s sleep and assess and diagnose behavioural and medical sleep disorders. Experts in children’s sleeping behaviours will undertake overnight sleep study and daytime nap studies to determine a child’s disorder and treatment necessary, including sleep training and management, and/or medication. pm Pindara M 50 agazine Summer | 2014/15
Pindara Private Hospital Magazine - Issue Three
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