Sleeping environment (ie is the room dark, quiet and not too cold or hot?) Is the child exposed to electronic screens, especially before bedtime?Īre particular circumstances or objects required to fall asleep (eg parent or TV)? Is a routine present or not, and if so, what is it (eg bath at 6.00 pm, dinner at 6.30 pm etc)? A 24-hour sleep history, starting from dinner time, is a useful approach (Box 1). 6 Taking a historyĪ detailed sleep history is essential to determine the most appropriate interventions. OSA presents as persistent snoring with a period of apnoea followed by gasping, and may be associated with daytime tiredness, mouth breathing and behavioural difficulties. Obstructive sleep apnoea (OSA) can also affect infants and children, particularly preschoolers, when the tonsillar and adenoid tissue is relatively large, compared with the airway. physiological insomnia – the child takes 30 minutes or more to fall asleep but is not worried or coming in and out of their room.anxiety-related insomnia – the child takes 30 minutes or more to fall asleep, worrying about something as they do so.delayed sleep phase – the child goes to bed late and sleeps in during the morning unless woken by their parents.behavioural insomnia of childhood, limit-setting type – parents have problems setting limits around bedtime and the child repeatedly comes out of their room or protests.This ‘sleep association’ forms the basis of a very common sleep problem in children – behavioural insomnia of childhood, sleep-onset-association type. Thus, if the last thing a child remembers is being rocked or fed to sleep, they will want to be rocked or fed back to sleep when they wake naturally overnight. The way a child falls asleep at the start of the night is the way they expect to go back to sleep when they naturally wake up overnight. 4īehavioural sleep problems include difficulties falling asleep at the start of the night, frequent night waking, early morning waking or a combination of these. Sleep problems can be medical (eg obstructive sleep apnoea, night waking due to ear infections) or behavioural in origin, the latter being the most common in children. Centiles for total sleep duration per 24 h by age in two Australian cohorts Figure 1 is a simple schematic of sleep cycles that can be used to explain sleep cycles to parents.įigure 2. This pattern is repeated in cycles throughout the night, with each cycle lasting around 40 minutes in infants, 2 increasing to 90 minutes in adults. Once asleep, children tend to be in deeper sleep for the first few hours of the night, before coming into REM sleep, waking briefly, then returning to non-REM sleep. These cues can be parent-independent (eg use of a transitional object such as a teddy bear) or parent-dependent (eg when a parent rocks or feeds their baby to sleep or lies next to their child in order for them to fall asleep). Children use particular cues to fall asleep. Children have proportionally more REM sleep than adults, so are often reported as ‘restless’ sleepers by their parents. Like adults, children cycle through rapid eye movement (REM light sleep) and non-REM sleep (deep sleep) throughout the night. 1 Before understanding what constitutes a ‘problem’, we first need to understand what constitutes normal sleep. July 21, 2017.Sleep that is of sufficient quality is essential for children’s growth, development, learning and wellbeing. What You Should Know About Sleep Paralysis.
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