Sleep Disorders

Sleep disorders manifest themselves differently in the infant, the toddler, the schoolchild and the adolescent. Newborn and premature babies wake throughout the night in need of feed, change or comfort. Most by the age of three months will have established a sleep pattern which may allow them (and their parents) five hours of unbroken sleep at night. An infant that is hungry, cold or wet will wake more frequently. While there is no doubt that for infant feeding breast is best, it sometimes is not enough - in which case it isn’t the best. It should be recognised that fervently following rules drawn in dogma (for fear of appearing a failure) by a mother whose milk production does not meet the needs of a lusty infant, can cause starvation for the baby (and sleep starvation for the parents). If the infant wakes ravenous in the night, the breast-feeding mother might consider providing a bottle before bed - and should be praised for so doing.

Toddlers may have problems in settling to sleep, either through fears of separation from the parent, of the dark, or nameless terrors of the night. It is important to establish a routine with which the child is comfortable, and rituals that they come to enjoy - the bedtime story, and light by the door, are found helpful by many. The persistently insomniac toddler may, however, need a very short course of sedative anti-histamine medication in order to establish a sleep pattern.

Nightmares are bad dreams which wake the child and often cause them to seek the comfort and safety of the parental bed: they are of no consequence unless they are repetitive and cause the child sufficient distress that they fear going to sleep in the first place, when they may be the outward sign of a deep-seated anxiety, and psychological support may be helpful. They may be precipitated by stimulants such as caffeine or drugs used to treat diseases such as asthma. Night terrors are different from nightmares - they affect pre-school children who'll sit up screaming an hour or so after falling asleep. The child cannot be comforted because they are not, in fact, awake - they are unaware of their surroundings, and quickly return to sleep. Unlike nightmares, the child has no memory of the event. This is actually a condition called a parasomnia, where there is a disturbance of the normal structure of sleep pattern with rapid arousal from the first stage of deep sleep. They are more frightening for the parent than the child, and are usually a passing phenomenon.

The schoolchild may experience sleep disturbance as a result of underlying anxiety - often ill-articulated. Small things can loom large in little minds - overheard parental disharmony, worries about school or schooling (it may be the first sign of bullying) or concerns regarding their own performance with respect to their peers. Reassurance and a sympathetic ear may resolve problems: any evidence of bullying must be pursued.

Early adolescence is a time when sleepwalking quite commonly occurs. This, like night terrors in the toddler, is a parasomnia, with abrupt arousal from the stage of deep sleep to the state where there is purposeful movement though the child is asleep. Gentle guidance back to the bedroom and a return to bed usually produces a well rested teenager with no memory of the night's events. They are of no sinister significance. It might be wise to avoid stimulants such as caffeine before bed.

Sleep apnoea is a condition where the sufferer snores, and then stops breathing for a variable length of time before starting to breathe again, usually with a violent snort. Because there is disturbance of sleep, there is often daytime sleepiness. In children it is commonly a consequence of large tonsils and adenoids, often complicated by allergic rhinitis causing congestion of the nose and throat, and is worse if the child is obese. Besides decongestants and anti-histamines, those with very large tonsils and adenoids (see nose and throat in the head section) may benefit from the attentions of an Ear nose and throat (ENT) surgeon.
 
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The information provided by WIS is for guidance only. Whilst it is based upon the expert advice of leading professionals, and extensive research, it is not a substitute for diagnosis by a qualified professional. Always consult your doctor, pharmacist or qualified practitioner before making any changes or additions to prescribed medication.