Dyssomnias in children

Dyssomnias in children include a range of diagnoses with varying etiologies.

Most children with sleep disorders (e.g., with behavioral insomnia of childhood) do not require pharmacologic treatment, and can be managed with behavioral and environmental interventions.

Obstructive sleep apnea affects up to 4% of children. It is specifically associated with deleterious neurocognitive, developmental, and behavioral outcomes in children. Adenotonsillectomy is generally the first line of therapy and can be associated with reversal of some of these adverse sequelae.

Relevant disorders to this topic include behavioral insomnia of childhood, obstructive sleep apnea (OSA), narcolepsy, delayed sleep phase disorder/syndrome (DSPD/DSPS), and inadequate sleep hygiene.

Pediatric sleep disturbances are very common, with a prevalence of 25% to 37%.[1]Blader JC, Koplewicz HS, Abikoff H, et al. Sleep problems of elementary school children. A community study. Arch Pediatr Adolesc Med. 1997 May;151(5):473-80. http://www.ncbi.nlm.nih.gov/pubmed/9158439?tool=bestpractice.com Most involve difficulties initiating and maintaining sleep because of behavioral insomnia of childhood (sleep association and/or limit-setting disorder), insufficient sleep, poor sleep hygiene, delayed sleep phase disorder/syndrome, and other circadian rhythm disorders.[2]Owens JA, Spirito A, McGuinn M, et al. Sleep habits and sleep disturbance in elementary school aged children. Dev Behav Pediatr. 2000 Feb;21(1):27-36. http://www.ncbi.nlm.nih.gov/pubmed/10706346?tool=bestpractice.com Obstructive sleep apnea (OSA) is also a common and under-recognized problem that is present in 1% to 4% of children.[3]Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc. 2008 Feb 15;5(2):242-52. http://www.atsjournals.org/doi/full/10.1513/pats.200708-135MG http://www.ncbi.nlm.nih.gov/pubmed/18250218?tool=bestpractice.com Other sleep disorders bringing children to medical attention include hypersomnolence, movement disorders, and narcolepsy. Sleep disturbances in patients with cerebral palsy and neurodevelopmental delay are not covered in this topic.