More than two-thirds of children younger than 10 years old have experienced some type of sleep-related problem. While most children will outgrow these issues, some are left with symptoms that last for years and disrupt their daily lives. Pediatric sleep disorders are very common and linked to a number of behavioral, academic, social, and developmental difficulties. Some children may experience frequent night wakings due to sleep apnea or have problems falling and staying asleep because of night terrors, bed-wetting, restless leg syndrome, or sleepwalking. Children with sleep disorders are usually excessively tired during the day and have trouble concentrating in school. If you suspect your child may have a sleep disorder, make an appointment with your pediatrician. The problem might have a simple solution or require a more thorough investigation.
Q: Does my child have a sleep disorder, or are they just not getting enough sleep?
A: It depends on the age of the child. Newborns to four-month-olds will sleep about 16 to 17 hours a day, with newborns waking every one to three hours. Between the ages of four months and a year, babies sleep about 14 to 15 hours a night and begin to regulate their sleep cycles, meaning they usually start to sleep through the night. Toddlers sleep about 12 to 14 hours a night with one or two naps during the day, while children ages 3 to 6 need 11 to 12 hours each night with a short daytime nap. Kids 7 to 10 years old need about 10 to 12 hours, and teenagers need around 8 hours of sleep to feel rested.
If your child has difficulty waking up in the morning, is school-aged but needs an afternoon nap, is tired during the day, or needs to sleep late on weekends to feel refreshed, they might not be getting enough sleep at night.
Q: Are nightmares, night terrors, sleepwalking, and/or bed-wetting normal?
A: Sleepwalking, night terrors/nightmares, and bed-wetting are common problems for many children. Although it can be alarming to witness, sleepwalking is common and usually outgrown by the time your child becomes a teenager. Sleepwalking is not inherently dangerous, but certain factors in the home can pose a risk to the child. If your child is prone to sleepwalking, make sure the front and back doors are locked at night and heavy, sharp, and dangerous objects are kept out of reach. If sleepwalking is accompanied by other factors (such as night terrors and bed-wetting), it might be cause for concern.
Night terrors are also common in children and usually occur a few hours after falling asleep. A night terror differs from a nightmare because the child will usually not respond to comfort measures and probably won’t remember the episode in the morning. Common reasons for night terrors are stress, sleeping in a new environment, or being overtired. If your child is having frequent nightmares or night terrors that are affecting their quality of sleep, see your pediatrician for advice.
Bed-wetting is also normal for children but becomes worrisome after age 7. Bladder control is usually established by this age, and frequent bed-wetting in older children is often a sign of a sleep disorder or other underlying problem.
Q: My child wakes up several times during the night. Is this normal?
A: There are many reasons for night waking in children. Grade-school kids usually wake up because of a nightmare and have trouble going back to sleep because they are afraid. Toddlers or preschoolers might have their sleep disrupted because of a recent life change (such as a move) or other stress factors. Babies wake up frequently for comfort or because of teething pain or side effects from food/environmental allergies.
If your child wakes up frequently throughout the night, is excessively sleepy during the day, and has risk factors such as snoring and being overweight, they might have sleep apnea or another common sleep disorder. Sleep apnea is when a person wakes up dozens or hundreds of times throughout the night because their airway has closed up. A sleep study is the best way to diagnose sleep apnea.
Q: How do I know when its time to take my child to a sleep specialist?
A: If your child experiences risk factors such as frequent night terrors, poor concentration, excessive daytime sleepiness, or breathing interruptions at night, they might need to see a sleep specialist. If you suspect that your child has a sleep disorder, you should first consult your pediatrician. Your pediatrician will be able to tell you if your experience is normal or cause for concern. If your pediatrician suspects that your child has a sleep disorder, you will likely be referred to a specialist. A specialist will perform a sleep study called a polysomnogram on your child to determine the underlying cause of their sleep problem. During the night, your child’s brain waves, muscle function, and vital signs will be monitored. At the end of the sleep study, you will likely have answers that can help you move forward with improving your child’s quality of sleep.