Insomnia in Children

Insomnia is simply the condition wherein you experience difficulty in falling asleep, or maintaining your sleep due to frequent awakenings or you wake up too early in the morning. Insomnia is a quite common occurrence in the adults and is regularly witnessed in children too.

Before proceeding any further, I would like to make a small point in the context of this article that when I mention children, it will encompass infants, toddlers, growing children and teenagers. Wherever the observation in this article is related to a particular group of children, I will mention the same specifically.

We, as parents, often ponder over the amount of sleep required by our kids. Sleep experts suggest that children between six and ten need 10 to 11 hours of sleep every night while teens require around 9 hours of sleep every night.

Insomnia in Children

Insomnia in children could loosely be defined as a sleeping disorder whose features resemble the condition of primary insomnia, which is faced by adults. A child suffering from insomnia would find it difficult to either fall asleep or maintaining it. Insomnia in children also affects the parents indirectly as most of the time due to their parental love and concern they too find their sleep disturbed.

However, insomnia in children in very different than insomnia in adults. Although both conditions involve sleeplessness, the causes vary quite considerably and due to this reason the definition of insomnia in children is very different from that for the adults. Sleeplessness in childhood could range from a normal developmental phenomenon to a severe condition in falling or staying asleep.

Insomnia in children could result due to a number of environmental factors and also due to some underlying medical and psychiatric disorders.

If your child is suffering from insomnia he / she will also face difficulties during the daytime. The regular disturbance in sleep would adversely affect the child’s behavior, mood and performance during the day.

While dealing with the problem of insomnia in children you have to keep in mind that frequent awakenings and urination are part of a normal development phenomenon in infants and toddlers. Also, waking many times during night hours as well as sleeping many times during the day is also normal for this group. So, no need to worry about it as things will smoothen out themselves as time progress and your child grows. On the contrary, during this period it will be you, as parents, who will be more troubled by insufficient sleep. There are many ways to take care of your sleeplessness in such conditions like taking turns to care for the baby etc. but I will not dwell on it further as this article focuses on the sleeplessness of children and hence seek your excuse!

In real terms the problem of sleeplessness during childhood starts when it (sleeplessness) results in distress in the child, the parents or both. Too much of sleeplessness results in profound behavioral changes, mood swings, learning difficulties, headaches and many other complaints which can make things gloomy for the child as well as the parents.

Insomnia in Children

To understand the reason for insomnia in a child it is important that you first understand the manner in which a child, and for that matter even adults, fall asleep. Sleep occurs to a child through a complex interaction between behavioral and psychological factors. Initially the body clock (circadian rhythm) has to enter the sleep phase which makes the body ready to go to bed.

Then the child’s daily routine of the activities before actually falling asleep has to start. Now this routine could depend on child to child and family to family, and could include placing the pillow, the quilt, wearing a night suit etc.

Certain environmental factors too are repeated every night like signing of a lullaby while rocking the child or carrying the child in your arms, or playing some soft music, using pacifiers while sleeping etc. Growing children might like to sleep in a particular bedroom, like to lie in a certain way on the bed, or hold on to their favorite stuffed toy. Children particularly also look for a safe environment to sleep.

So, when the combination of these environmental and behavioral factors takes places it onsets sleep in the child. Also, if on any particular night any one or a combination of such used to factors is found absent, the child may find it difficult to sleep.

Some of these factors like the room, the toy, the dimmed light would be present all through the night. But many other factors like rocking the child, or carrying the child in your arms etc. would not be available regularly. Therefore, when the child awakes during the night and does not find these missing factors, he/she and even you might find it hard to go back to sleep again unless the missing factors are brought back.

Such disorders of sleep onset are more common in older infants and toddlers. As the child gets older he/she has more control over her environment and is less likely to require associations with such external factors.

On these factors, now I will tell you something really out of my own personal experience, totally true. When I was blessed with a sweet daughter our whole family and even the extended family were very happy. This was because my daughter was the first girl child in seventy years in the complete family tree. So it was all natural to shower our wholehearted love for my daughter. During infancy she used to sleep through the day and the night getting up for her routine activities of excretion and taking milk. Both I and my wife used to take turns to attend to her thinking that she would start sleeping through the night once she is passed her first birthday.

Insomnia in ChildrenBut we were proved wrong by our daughter. When she used to wake up during the night, out of pure parental love I used to make her go back to sleep by taking her in my arms and singing something for her while her mother used to prepare her milk in a bottle. During this she used to keep staring at a particular ceiling night lamp and then sleep away sipping her milk. She kept this habit of hers of all through her third birthday! It was only after she started going to playschool that she started sleeping directly on her bed. She is seven now, and still to this day she finds sleep only when anyone of us (mom / dad) is sleeping besides her, and her favorite baby pillow is with her, and she also needs to listen to some music on my cell phone to doze away.

During all this period I and my wife witnessed a lot of sleeplessness, but we compensated all of it by sleeping whenever we got time during our holidays and sometimes even took short naps in our offices too!

As you see such kind of sleeplessness is not really that worrying although it could be annoying sometimes. However, if your child is well into the growing years or is in the teens and is still experiencing difficulty in falling asleep, then you definitely should consider it seriously. Less sleep during the night means more behavioral problems during the day.

Sleep problems in children are also classified into two major categories:

Dyssomnias : These may include sleep onset difficulties; inadequate sleep hygiene; insufficient sleep syndrome; snoring and obstructive sleep apnea. Snoring is a common occurrence with one in every ten children doing it habitually. Snoring can be harmless but it results in poor sleep quality.

Obstructive sleep apnea is the most common type of apnea in children. It is caused due to an obstruction caused in the airway (the region from the mouth or nose through the wind pipe and into the lungs, through which our breathing action takes place). This obstruction is caused due to the enlarged tonsils (lymph nodes at the back of our throats), which is a common occurrence in growing children and it happens during sleep since that is when the soft tissue at the back of the throat is most relaxed. This condition usually goes off once the tonsils recover.

Parasomnias: These may include sleepwalking; bedwetting; teeth grinding; night terrors; nightmares and rhythmic movement disorders like head banging or rocking. Bedwetting and teeth grinding are a common part of childhood. Nightmares and night terrors are quite common among children and they are a result of an immature central nervous system. If your child faces such difficulties you should talk to them and assure them that such episodes are totally non harmful.

To correct the sleeplessness in your child you could start with instituting good sleep habits in your child like going to bed only when feeling sleepy; using the bed only for sleeping and not for doing homework or playing video games. The bedroom should be quiet, calm and comfortable. You can also teach certain relaxing techniques like deep breathing and positive mental imagery to your child. In these fast paced and competitive times these techniques really help in taking off the tensions. Everyday sleeping and waking time should be maintained.

It is always better to look for the underlying psychological or medical condition being faced by your child which is resulting in the sleep disorder and then take positive and corrective action.

Medications are usually not recommended for children and adolescents for treatment of sleep disorders and they are used in only certain very crucial circumstances and that too under the guidance of a qualified doctor. Another fact to be kept in mind is that most of the medications and aids related to insomnia have not been approved by the FDA for use in children.

Hence it is always better to speak to your child if he/she is facing any difficulty in school or studies; or the child might be nurturing some unwarranted fears like demons etc. If you are able to generate confidence in your child and make him / her understand that such fears are totally unfounded and nothing will happen, then your child would be able to overcome the sleep disorder much quicker and without any medical intervention.

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