Prevalence rates of insomnia follow a developmental course in which persons in early childhood and older adulthood are more likely to experience this problem

Sleep has a broad effect across many of the day-to-day aspects of an individual’s life.

Poor sleep is associated with irritability, mood, concentration, memory, and learning problems.

Sleep problems may be the result of a medical condition, side effect of medication, poor sleep hygiene, or a psychological disorder.

Many medications will impact sleep

– Blood pressure medications

  • Clonidine, propranolol, atenolol, methyldopa

–Hormonal

  • Thyroid, cortisone, progesterone

– Long-term use of antihistamines

–Asthma

  • Theophylline, albuterol, salmeterol

– SSRI antidepressants

  • Fluoxetine, paroxetine

–Steroids

  • Prednisone

–Stimulants

  • Methylphenidate, amphetamines

 

Children also suffer from insomnia, though rarely from the same primary causes. The root causes behind child or pediatric insomnia are very different from those of adult insomnia and can be very difficult to identify, diagnose, and treat.

When your child doesn’t sleep well, nobody sleeps well!

Challenges with Pediatric Insomnia

Since insomnia is a symptom for something else most doctors have the job of eliciting information from their patients relative to sleep cycles, sleep disturbances, medical conditions and psychological stressors. Children have few conditions in their lives that might set off insomnia as it can in adults—there are no stressful jobs, no messy divorces, no menopause or other age-related hormonal changes, and no night shift work. To complicate the issue, most children’s insomnia symptoms must be reported by parents or guardians. Few small children have the communication capacity to relate the necessary nuances of their insomnia or sleep disturbances and may not even recognize their symptoms as such.

Types of insomnia problems:

– Sleep onset

– Length of sleep

– Early morning wakening

– Irregular sleep-wake cycle

– Poor sleep routines

Non-Behavioral Causes

– Gastrointestinal Problems

  • GI problems can be painful – May lead to night awakenings and fragmented sleep

– Anxiety & Depression, etc.

Circadian Rhythm Dysfunction Causes

– Melatonin, naturally occurring hormone which regulates circadian rhythm

– Seasons (10% of children with ASD show some sign of seasonal sleep)

Breathing-Related Sleep Disorder

  • Apneas (breathing cessation)
  • Hypopneas (slow or shallow breathing)
  • Hypoventilation (low oxygen blood levels)

Sleep Terror Disorder

Showing signs of acute terror: screaming, crying, shouting; Not related to psychopathology; Unknown cause;  May be genetic+

Symptoms of Pediatric Insomnia

In order to identify childhood insomnia you must be willing to observe children and listen to them closely. Symptoms include:

  • They report difficulty falling asleep after they’ve been put to bed, relate episodes of waking up in the night, inability to go back to sleep once they’ve woken up, or waking up early in the morning while it’s still dark out and before anyone else is awake.
  • Children may be chronically tired, complain of being tired, may visibly seem groggy and distracted.
  • In combination with the above, observed behavior could become more erratic, even moody.
  • Behavior could initially resemble ADHD, with hyperactive components.

Again, the challenge for childhood insomnia is in identifying unusual behavior and recognizing that it’s a problem.