As many as 30% of children have a sleep disorder at some time in their childhood and the impact on patients and families can be enormous. Thorough history taking is the single most important step in identifying the type and source of the problem. Common problems include difficulty getting the child to fall asleep or night time awakening.
A nonthreatening, parent-cued way to uncover events that can affect sleep is to complete a sleep-history questionnaire. Parents are asked to start with the evening meal and describe what happens during the next 24 hours. The bedtime routine is brimming with important details. It is not unusual to hear accounts of struggles or tensions, vigorous sports practices, or viewing of energizing or scary TV shows or videos before bedtime.
The American Academy of Sleep Medicine has recommendations to help your child sleep soundly:
- Follow a consistent routine.
- Establish a relaxing setting at bedtime.
- Don’t substitute television watching or videos for personal interaction at bedtime.
- Screen television programs, videos, and computer games for age-appropriate material.
- Avoid letting your child fall asleep with a bottle, while nursing, being held, or rocked.
- Avoid giving your child food and drinks containing caffeine (chocolate, soda, etc.) and other stimulants (over the counter cough medicines and decongestants).
Snoring may be a symptom of sleep apnea which when undiagnosed can lead to problems in school, delayed growth or even heart failure. Some common symptoms of obstructive sleep apnea in children include:
- Sleep in an abnormal position, with head off the bed or propped up with many pillows
- Snore loudly and often
- Stop breathing during the night for a short period – followed by snoring or gasping or completely waking up
- Sweat heavily during sleep
- Have school or other behavioral problems
- Sleep restlessly
- Are difficult to wake up, even though sleep should have been long enough
- Have headaches during the day, particularly in the morning
- Are irritable, aggressive, or simply “cranky”
- Fall asleep or daydream in school or at home
- Have attention deficit disorder with hyperactivity (ADHD)
- Bedwetting (enuresis) that isn’t outgrown at a typical age (especially if snoring is present)