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When kids and teens don’t sleep

February 17, 2014

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We spend one-third of our lives sleeping to help us be alert and active during the other two-thirds. People who sleep less may be suffering a range of issues, and that’s especially true in children.

“Inadequate sleep can lead to problems with learning, behavior, mood, and overall health,” says Sujay Kansagra, MD, director of Duke's Pediatric Neurology Sleep Medicine program. “Poor sleep can worsen just about any health condition.” In kids, poor sleep can cause irritability, behavioral problems, attention problems, and hyperactivity that can mimic attention deficit/hyperactivity disorder. A child’s sleeplessness can lead to loss of sleep for parents and may even affect the family dynamic.

Maintain consistent bedtime routines

When adults have trouble sleeping, we typically think stress is the culprit. But in children, the most common sleep problems are actually related to behavior. “Children often test their limits by making multiple requests at nighttime,” Kansagra says. Nearly every parent is familiar with the expert stalling tactics employed by children. “Please? Just one more story?” may be tempting. Your kid loves reading, and that’s a good thing, right? Not so fast. “This is a behavioral problem, and it requires parents setting firm limits,” Kansagra says. Having consistent bedtime routines is important at any age.
 

Understand shifting sleep patterns

By the time children become teenagers, they may experience changes in their natural body clock, known as the circadian rhythm. Most adolescents naturally shift their internal clock to go to sleep later and wake later the next day. “Delayed sleep phase syndrome” will be familiar to any parent who has ever wondered how a teenager can sleep until noon. Exposure to light late at night can worsen this otherwise normal shift, so adolescents using electronics at night are at risk of getting inadequate sleep. Avoiding late-night light and maintaining the same wake time on weekends and weekdays can help. White-noise machines and fans might help soothe teens to sleep, too.

Quiet the worries

Some adolescents have a very adult problem: insomnia. Just as in adults, the source is often related to excessive worry about the inability to transition to sleep.

“Even though they are tired, some teens just can’t seem to shut their minds down to go to bed,” Kansagra says. He and his team work with patients to reverse this negative thought process at night to treat the insomnia.

Consider a sleep study

Although it seems normal, snoring should not be ignored in children. It can be a sign of a serious problem. “About 25 percent of children who snore actually have sleep apnea,” Kansagra says. Sleep apnea is often due to large tonsils or nasal congestion. If a child has sleep apnea, he’s not getting good sleep—even if it looks as though he is sleeping for eight or more hours.

Kansagra recommends a sleep study for children who snore and have a daytime manifestation of sleep apnea, such as attention problems, behavioral difficulties, and poor school performance. Duke has sleep clinics especially for children at Duke Children's and WakeMed Children’s Specialty Services in Raleigh and Lenox Baker Children’s Hospital and Duke Children’s Hospital in Durham. “Although the study is not painful, there are a variety of wires and sensors that are placed onto a child to determine how well they are sleeping,” Kansagra says. So, parents should plan to be with their children through the night.

Start tonight

A good night’s sleep is crucial for good health. Help ensure your child makes the most of one-third of her life by enforcing bedtime rules and seeking help for chronic sleep problems. Your “baby”—even if he is 16 or 17—is never too old to be told, “Sweet dreams.”

Learn more about treatment for pediatric sleep disorders

Duke Children's sleep disorders
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