Children’s Sleep Disorders
The article is intended to be informative not to diagnose. Please consult your physician about your child’s individual needs.
Sleepwalking: (Somnambulism)
Sleepwalking, defined as a series of complex behaviors that are initiated during slow wave sleep and result in walking during sleep, most often affect children between the ages of 6 through 12. It usually occurs during deep sleep or early in the night. Most episodes last less than 30 minutes. Sleepwalking may be related to anxiety or fatigue. It also runs in the family. It is more common in children than in adolescents or adults. Boys are more likely to sleepwalk. Approximately 16% of children age 11-12 sleepwalk.
What parents can do:
1. Sleepwalkers may do more than just walk such as change their clothes. It is not
dangerous to wake a sleepwalker, but it is best to lead them back to bed.
2. Sleepwalking can be dangerous as the child could fall down stairs or even wander
outside. You might consider using baby gates and keep doors locked.
3. Bedtime should occur at the same time every night.
4. Restrict fluids prior to bedtime as a full bladder may trigger an episode.
5. Remember that most children outgrow this by adolescence.
6. Some medications may prove helpful if determined by your physician.
Bed-wetting (Enuresis)
This sleep disorder attracts the most attention. Fortunately, most children outgrow this sleep disorder by the time they start school. Approximately, 16% of children who are 5 years old wet the bed while only 10% of 10 years old children do. Bed-wetting tends to run in families and is more common in boys.
There are some medical conditions such as diabetes, urinary tract infections, sleep apnea, or epilepsy that can also cause bed-wetting. A physical should be done to determine if a medical condition causes the bed-wetting.
Factors that contribute to bed-wetting:
1. an exceptionally small bladder
2. a delay in the maturation of the nerves that control the bladder
3. an imbalance in a hormone that reduces urine production at night
Treatments available:
1. an alarm system that wakes the child when it senses wetness seems to be the most effective
2. medications can be prescribed for short term use
3. behavior modification
What parents can do:
1. See a doctor
A visit to your doctor is essential to help stop bedwetting, if your child is over the age of 6 or 7. The physician will be able to test for any physical problems such as urinary tract infections.
2. Never punish your child
Punishing your child will not help stop bedwetting – it is just likely to cause more stress. A child has no control whatsoever of their bedwetting. The child cannot help what has happened, so punishment will only serve to lower their self esteem.
3. Respect their privacy
Children are embarrassed about bedwetting, and don’t want the whole world or even the family knowing about their problem. Be discreet about your child’s condition so not to cause extra anguish in what is already a tough time.
4. Try behavior training methods
Behavior training methods work by teaching your child’s body to either wake up when they need to urinate or by increasing their bladder size. Bedwetting alarms are useful because they teach your child to wake up at the first sign of moisture, gradually teaching the body and brain to wake up and make it to the bathroom before an accident happens. Another training method is nightlifting, where you wake your child up several times during the night and escort them to the bathroom to empty their bladder. This also teaches children to wake up.
5. Be positive and patient
One of the main aspects of your role is to be positive and remain patient. Stopping bedwetting won’t happen overnight, but it will happen.
Nightmares:
Nightmares are frightening dreams that awaken the sleeper. The symptoms are sudden awakening with feelings of fear or anxiety, immediate recall of the terrifying dream, and alertness upon awakening. Nightmares may occur after watching a scary movie or reading a scary story. Sometimes, stressful events also lead to a nightmare.
What parents can do:
Sometimes it is helpful to have you child describe the frightening nightmare. For children under 5, you might have a favorite doll or teddy bear who is assigned the job of “staying awake” and protecting the child.
Night terrors:
Night terrors are characterized by a sudden arousal from sleep with a piercing scream accompanied by behavioral manifestations of intense fear. Night terrors are very different from nightmares. Night terrors may cause the child to cry out loudly, flay about or even run around the room in an attempt to escape. Children generally are still asleep even if their eyes are open and generally will remember nothing of the episode except the fear.
Night terrors affect most often children between 3 and 5. Again, night terrors run in families and fatigue seems to play a role. Most children outgrow this disorder by the time they begin school.
What parents can do?
1. Gently restrain the child and try to return them to bed. Turning on the lights and
speaking calmly also helps.
2. As these episode return about the same time each night, you may try to wake the child
15 minutes prior to disrupt the cycle.
In summary, realize that your child cannot control these sleep disorders. Your feelings of frustration are normal, but it is important to remain calm and focused as you help your child through this difficult time.
