Description

A variety of problems may disturb the sleep of young children. Identifying the problem and determining its frequency is a first step in patient evaluation.


 

Sleep problems may include:

(1) bedwetting (enuresis)

(2) nocturia

(3) teeth grinding (bruxism)

(4) sleep talking (somniloquy

(5) sleep walking (somnambulism)

(6) rhythmic movements

(7) hypnic jerks (hypnic = related to sleep)

(8) confused arousals

(9) night/sleep terrors

(10) nightmares

(11) resistance to going to bed

(12) difficulty falling asleep

(13) waking during the night

(14) early waking

(15) difficulty rising in the morning

(16) restless sleep

(17) tosses and turns during sleep

(18) snoring

(19) daytime sleepiness

(20) anxiety at bedtime

(21) fear of sleeping alone or requires someone to be present at onset of sleep

(22) comes to parent's bed or sleeps with parents during part of night

 

Sleep problems secondary to physical problems need to considered separately since they often require management of the underlying condition:

(1) growth-related bone pains

(2) other pain (stomach aches, headaches, injuries)

(3) asthma or other breathing difficulties

 

Blader et al used a frequency of >= 3 times per week to indicate a sleep disorder that is a problem (Table 2, page 475). Smedje et al (2001, Table 1, page 1459) used a frequency of >= 3 times per week for some conditions and >= 1 time per week for other disorders to indicate a problem.

 

Alternatively the conditions can be evaluated using a Likert scale (none, minimal, mild, moderate, severe) to indicated the severity of the problem for the child. It is also possible to generate a score for each condition by multiplying a frequency score by a severity score.

 


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