Doc Talk: Ways to treat sleep disturbances in children

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Wednesday, February 6, 2019
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Doc Talk

In our weekly feature, 'Doc Talk' pediatric emergency doctor, Clint Pollack from Valley Children's Hospital talks about sleep disturbances in children and how you can treat them once they occur.

Doctor Pollack says parasomnia is very common in younger children, affecting more than half of all children at some point.

He says it most commonly occurs in preschool-aged children and often decrease by 10 years-old.

Usually seen in normal healthy children, but may be associated with other neurologic, psychiatric, or medical issues.

Most likely to occur during the first few hours of sleep.

Sleep terrors: Most common between 4-12 years-old. Occurs during the first third of sleep. Children usually wake up screaming, agitated, flushed, sweaty, and heart pounding.

Confusional arousal: Most common in toddlers. Occurs during the first few hours of sleep. Milder than sleep terrors, with distress and confusion but no physical symptoms.

Usually lasts five to 30 minutes.

Sleepwalking: Most common between 8-12 years-old. Can be calm or agitated.

There is a genetic component. Parasomnias are more likely if a sibling or parent had them.

They can be triggered by fever, URI, sleep deprivation, or any other condition that may impair healthy sleep, such as obstructive sleep apnea or restless leg syndrome.

Attempting to interrupt the behavior may cause more agitation and is discouraged unless safety/injury is a concern.

Milder ones that occur 1one to two times per month generally do not require treatment.

"Anticipatory awakening" can be used to help prevent parasomnias.

Gentle, brief awakening of the child 15-20 minutes before the parasomnias usually occur has been shown to be very effective.

Melatonin is safe for children and may be helpful. Lower doses of 1-3mg have been used in smaller children. Higher doses of 6-18mg can be used in older, adult-sized adolescents.

More severe, persistent parasomnias may be treated with a low-dose benzodiazepine (sedative) at bedtime.

Parasomnias usually resolve within one to two years.

Regular naps (for toddlers) and healthy sleep habits are very important, as sleep deprivation can trigger parasomnias.