A Review on Sleep-disorders in Children and Adolescents

Abstract

Introduction: A considerable amount of knowledge has accumulated in recent years regarding the pediatric aspects of sleep with its associated disorders being understood. Health education for parents and prospective-parents frequently pay little attention to sleep. In addition medical students and specialist-trainers receive little instruction about sleep disorders despite the fact that many of them have contact with children and adolescents who have sleep disturbances. The ICSD-2 describes nearly 100 sleep-disorders many of which are seen among children and adolescents. Aim: The aim of this Article is to review sleep-disorders in children and adolescents, in the clinical-aspect beside epidemiology and disease-burden. Methodology: Literature retrieved through Google Scholar, EMBASE, Medline and PubMed were reviewed independently by the authors towards a consensus. Results: Sleep-disorders treatable, yet a large proportion remains of cases remain undiagnosed. Sleep-disorders are not uncommon among children and adolescents. Factors which contribute to sleep-disorders include extensive television viewing increased social recreational activities as well as academic demands all of which may contribute to sleep deprivation and sleep problems. Patterns of sleep behaviours and disorders differ between children and adults. Additionally some sleep-disorders previously thought to be seen mainly or exclusively in adults are now being recognized in children. Explanations of the causes of sleep-problems at any age, both physical and psychological possibilities should be considered whilst at the same acknowledging that parenting practices play a major role part in children's sleep-problems. This is important because persistent sleep disturbance can have harmful outcomes which can impact on mood, behavior, performance, social-function and physical health. The treatment of most sleep disorders in children is, in principle, straight-forward and is more likely to be effective if it is appropriate and carefully implemented. Medication should not be the first line treatment for a sleep disorder but instead should be used as a last resort. Behavioual methods such as sleep hygiene and counselling is preferable. There is evidence to suggest that insufficient sleep might impair motor skills and reaction time as well as decision making and general concentration levels leading to an impact on academic achievement. Persistent sleep-loss is becoming increasingly associated with an adult’s physical health The authors mainly discuss: • Insomnia of childhood • Obstructive sleep apnea • Parasomnias • Sleep-related movement disorders: Restless legs syndrome/periodic limb movement       disorder and rhythmic movements • Narcolepsy • Delayed sleep phase disorder Conclusion and Recommendations: In view of the morbidity, mortality, loss of Quality of Life, and the disease burden including the economic cost of sleep-disorders, cost-effective Prevention Programs are needed. Such Programs should educate parents, parents-to-be, teachers and healthcare professionals.