Sleep Problems in Kids

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Waking Up to Sleep Problems in Kids: Nearly 40 percent suffer sleep

deprivation

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SATURDAY, Dec. 2 (HealthScout) -- Tuck your child into bed, read a few

lines from a favorite book and creep out of the room. Then, minutes

later: " Mommy! " Or, in the middle of the night, you're awakened by a

tiny figure wanting to crawl into bed with you.

All a normal part of childhood development? Not if it happens night

after night, sleep experts say. Commonly thought of as adult problems,

sleep disorders affect children, too, and at surprisingly high rates. A

recent Brown University study claims that 37 percent of children in

kindergarten through the fourth grade suffer from at least one

sleep-related problem.

" The results underscore the importance of screening school-aged children

for sleep problems and the need for pediatricians to understand the

possible consequences of disordered sleep on children's daily lives, "

says Dr. Judith Owens, lead author of the study published in the

journal, Developmental and Behavioral Pediatrics.

" Health-care providers often assume that grade-school youngsters get

adequate sleep... but that is not the case, " she says. Owens and her

colleagues questioned 494 youths, plus their parents and teachers, in a

suburban school district in Rhode Island. They uncovered a host of

sleep-related problems -- from bedtime resistance, sleep-time anxiety

and difficulty falling or remaining asleep to bedwetting, snoring or

gasping during sleep and daytime sleepiness.

Teachers reported that at least 10 percent of the students struggled to

stay awake during class. " I think that is just the tip of the iceberg, "

says Owens, an assistant professor of pediatrics at Brown. " This is an

age range that should be normally physiologically alert during the day, "

she says. " If teachers knew what to look for beyond yawning, dozing off

and not paying attention, we'd probably find a lot more kids in school

with sleep problems. "

An underdiagnosed problem

Children who are chronically sleep-deprived sometimes are misdiagnosed

as having attention deficit hyperactivity disorder because they don't

pay attention in class or misbehave, Owens says.

Dr. Sung Min Park, director of the sleep lab at San Diego Children's

Hospital, says sleep problems in children are more widespread than you'd

think. " Overall, sleep problems are underdiagnosed, " Park says. " Parents

don't recognize it as a problem, just as years ago it was not seen as a

problem in adults. Parents put up with it, thinking it's a part of

normal childhood development -- and it's not. "

The roots of sleep problems in children go back to infancy, Park says.

At 6 months, a baby should sleep through the night. By letting the child

cry instead of jumping up for a midnight feeding, parents quickly can

condition the child to go back to sleep, he says. If not, parents run

the risk of having children who never learn good sleeping habits, he

says. And poor habits can carry over into later childhood.

Common problems in children include:

Sleep association disorder: This occurs when a child needs a particular

object -- like a television or a parent -- to fall asleep. When the

child wakes up in the middle of the night and the television is turned

off or the parent is no longer in the room, he or she can't fall back

asleep. Parents can alleviate this by using what Owens calls a

" transitional object, " like a blanket or a stuffed toy for younger

children, or soft music for older ones.

Anxiety disorder: Kids may worry about school or family problems.

Talking with them about what's bothering them, or trying to comfort them

during the day, can help.

Snoring. Heavy snoring in children is relatively uncommon. Parents

should tell a pediatrician if their child snores, especially if it's

heavy, Park says, because it could be a sign of a breathing difficulty

known as sleep apnea. " Breathing becomes a struggle, " he says. " Instead

of sleep being refreshing, you wake up tired. "

Today's lifestyles also can contribute to children not getting adequate

sleep, says Suzan Jaffe, a nurse practitioner who runs a sleep clinic in

Aventura, Fla. Children often are shuttled between two households

because of divorce or other circumstances. And parents who work late

sometimes keep the kids up late with them because it's the only time

they have together. But it's important for parents to make sure children

are in bed by 9 p.m., Jaffe says, and that the bedtime remains the same

each night, even if children split time between households. " It's kind

of sad, " she says. " Kids end up fitting into the parents' schedule.

Because of these blended family situations, kids are sleeping in

different beds, and there's no consistency. "

How much sleep does a child need? Generally speaking, a 5-year-old

should get about 10 hours a night, Jaffe says. By age 8 or 9, a child

needs about 8½ to 9 hours of sleep, but when kids hit adolescence, the

amount of sleep they need goes up again, she says.

What To Do

Sleep experts say practicing " good sleep hygiene " can prevent or solve

many sleep problems. That means limiting caffeine, avoiding heavy meals

and vigorous exercise before bedtime, making sure the sleeping

environment is quiet, dark and comfortable, keeping a regular sleep-wake

schedule and not having a television set in the bedroom.

For more information on sleep and children, visit the American Academy

of Pediatrics or the American Academy of Children and Adolescent

Psychiatry. For information on sleep disorders in general, check out the

Web site of the American Academy of Sleep Medicine.

SOURCES: Interviews with Judith Owens, M.D., assistant professor of

pediatrics, School of Medicine, Brown University, Providence, R.I.; Sung

Min Park, M.D., director, sleep laboratory, Children's Hospital and

Health Center, San Diego; Suzan Jaffe, Ph.D., nurse practitioner,

Aventura, Fla.; February 2000 Developmental and Behavioral Pediatrics

Copyright © 2000 Rx Remedy, Inc.