Behavioral Sleep Disorders in Children and Adolescents
Section snippets
Assessment of sleep disorders
In children and adolescents, not all sleep problems meet criteria for a disorder based on diagnostic criteria of the International Classification of Sleep Disorders, 2nd Edition (ICSD-2) [2] or the Diagnostic and Statistical Manual, 4th Edition[3]; however, they are of significance and should always be considered as part of any medical or psychiatric evaluation. It is important for all health care specialists who regularly interact with children and adolescents (eg, pediatricians,
Behavioral sleep disorders
In general, behavioral sleep disorders present with at least one of the following complaints: (1) bedtime problems, including bedtime stalling or resistance; (2) difficulties falling asleep; (3) frequent or prolonged night wakings; (4) early morning wakings; or (5) excessive daytime sleepiness. Despite these common symptoms, the causes, diagnoses, and treatments for behavioral sleep disorders vary depending on the nature of the disorder and the child's age. The next section reviews the
Sleep and psychiatric disorders in children and adolescents
There is a complex and bidirectional relationship between sleep disturbances and psychiatric disorders in children and adolescents. For example, insomnia and hypersomnia can be signs of depression, and sleep disturbances can be a sign of anxiety [3]. Conversely, sleep disturbances can cause or exacerbate negative mood and psychiatric problems. Studies of patients referred to pediatric sleep clinics have found that 31% to 50% of children and adolescents have a diagnosed psychiatric disorder [48]
Summary
Behavioral sleep disorders are common, and if left untreated can have a significant impact on the cognitive, social, and emotional functioning of children and adolescents. A complete assessment of sleep patterns, sleep disruptions, psychosocial factors, and psychiatric disorders is essential to disentangle the complex and often comorbid presentation of behavioral sleep disorders. In addition, age and developmental stage need to be considered when weighing different diagnoses, and when selecting
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