When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Dyssomnias in children

View PDF
  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Evidence last reviewed: 5 Mar 2026
Topic last updated: 05 Feb 2025

Summary

定义

病史和体格检查

关键诊断因素

  • snoring, gasping, choking while asleep (obstructive sleep apnea)
  • night sweats (obstructive sleep apnea)
  • breathing through an open mouth (obstructive sleep apnea)
  • sleeping with hyperextended neck (obstructive sleep apnea)
  • restless sleep and periodic limb movements (obstructive sleep apnea)
  • secondary nocturnal enuresis (obstructive sleep apnea)
  • hypertension (obstructive sleep apnea)
  • inability to fall asleep (sleep association disorder)
  • cataplexy (narcolepsy)
  • hypnagogic or hypnopompic hallucinations (narcolepsy)
  • sleep paralysis (narcolepsy)
  • erratic sleep schedule (delayed sleep-wake phase disorder)
完整详情

其他诊断因素

  • excessive daytime sleepiness
  • difficulty awakening in the morning
  • sleepwalking or talking (obstructive sleep apnea)
  • sleep attacks (narcolepsy)
  • refusal to sleep in own bedroom (chronic insomnia disorder)
完整详情

危险因素

  • craniofacial abnormalities (obstructive sleep apnea)
  • adenotonsillar hypertrophy (obstructive sleep apnea)
  • macroglossia (obstructive sleep apnea)
  • gastroesophageal reflux (obstructive sleep apnea)
  • allergic rhinitis (obstructive sleep apnea)
  • environmental tobacco smoke exposure (obstructive sleep apnea)
  • obesity (obstructive sleep apnea)
  • hypotonia (obstructive sleep apnea)
  • alcohol (obstructive sleep apnea)
  • medications (obstructive sleep apnea)
  • Down syndrome (obstructive sleep apnea)
  • evening light exposure (delayed sleep-wake phase disorder)
  • inconsistent parenting style or unrealistic sleep expectations (chronic insomnia disorder)
  • age <6 years (chronic insomnia disorder or obstructive sleep apnea)
  • adolescent age (delayed sleep-wake phase disorder)
  • distractions in bedroom (delayed sleep-wake phase disorder)
  • traumatic or stressful life events (chronic insomnia disorder)
完整详情

诊断性检查

首要检查

  • sleep diary
  • polysomnogram (PSG)
  • multiple sleep latency test
完整详情

需考虑的检查

  • lateral neck films
  • nasal endoscopy
  • overnight oximetry
  • actigraphy
  • audiovisual recording
  • HLA typing
完整详情

新兴检查

  • pneumogram
  • cerebrospinal fluid hypocretin levels

治疗流程

持续性治疗

obstructive sleep apnea

chronic insomnia disorder

delayed sleep-wake phase disorder

narcolepsy

撰稿人

作者

Dennis Rosen, MD

Associate Medical Director

Center for Pediatric Sleep Disorders

Boston Children's Hospital

Assistant Professor of Pediatrics

Harvard Medical School

Boston

MA

利益声明

DR declares that he has no competing interests.

同行评议者

Paul Gringras, MB, ChB, MSc, MRCPCH

Consultant in Paediatric Neurodisability

Evelina Children's Hospital

St Thomas' Hospital

London

UK

利益声明

PG is lead applicant on the ongoing MENDS trial, which is concerned with the use of melatonin in children with neurodevelopmental disorders and impaired sleep.

Leila Kheirandish Gozal, MD

Associate Professor of Pediatrics

Division of Pediatric Pulmonary & Sleep Medicine

University of Chicago

Chicago

IL

利益声明

LKG is an author of a number of references cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

American Academy of Sleep Medicine. International Classification of Sleep Disorders – third edition, text revision (ICSD-3-TR). Westchester, IL: American Academy of Sleep Medicine; 2023.

Macias MI, Malhotra S. Behavioral insomnia of childhood. Am J Respir Crit Care Med. 2021 Apr 15;203(8):P20-P21.全文  摘要

Ishman SL, Maturo S, Schwartz S, et al. Expert consensus statement: management of pediatric persistent obstructive sleep apnea after adenotonsillectomy. Otolaryngol Head Neck Surg. 2023 Feb;168(2):115-30.全文  摘要

Morgenthaler TI, Owens J, Alessi C, et al. Practice parameters for behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 2006 Oct;29(10):1277-81.全文  摘要

Marcus CL, Moore RH, Rosen CL, et al; Childhood Adenotonsillectomy Trial (CHAT). A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med. 2013 Jun 20;368(25):2366-76.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • 鉴别诊断

    • Primary snoring
    • Central sleep apnea
    • Anxiety
    更多 鉴别诊断

  • 指南

    • Management of pediatric persistent obstructive sleep apnea after adenotonsillectomy: expert consensus statement
    • Age and weight considerations for the use of continuous positive airway pressure therapy in pediatric populations: an American Academy of Sleep Medicine position statement
    更多 指南

  • 患者教育信息

    Insomnia

    Sleep apnea in adults (obstructive)

    更多 患者教育信息
  • padlock-locked登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容

内容使用需遵循免责声明