Sleep Problems

A detailed history should be taken by a specialist for a child who has sleep problems. At the same time, special attention should be paid to factors such as the daily routines of the parents and other people living in the house, if any, the culture of life, the noise level, the environment in which the child sleeps, the environment and the parent-child bond. In addition, internal factors such as the child's temperament, level of resistance, reactions and the ability to self-soothe when the parent or caregiver is not present should be evaluated.

Children with sleep problems exhibit one or more of the following three symptoms:

• Difficulty falling asleep or not being able to sleep
• Daytime sleepiness or constant sleepiness
• Atypical or unwanted movements during sleep

The most common problem observed in preschool children with sleep problems is sleep disorders. Other sleep problems include difficulty falling asleep or not being able to sleep, frequent nighttime awakenings, nightmares, sleep talking, teeth grinding, sleepwalking, sleep terrors and sleep apnea (interrupted breathing during sleep).

Nighttime Wakings

Nighttime wakings in a baby or preschooler may reflect insecure attachment. Waking up in the middle of the night after falling asleep every night is like repeating the separation scene.

Difficulty Falling Asleep

If a baby or preschooler is used to falling asleep with their mother (being picked up, rocked, etc.) and/or cannot sleep without something (being wrapped in their blanket, etc.) and these behaviors have become a sleep ceremony, they may want the same ceremonies when waking up at night. In school-age children, difficulty falling asleep and sleep problems can often be related to anxiety, fear, and stress.

Nightmares

They are dreams that are usually remembered after waking up. Nightmares occur long after falling asleep, in the late hours, usually during the REM sleep period. They are seen to occur as a result of intense imagination, familial predisposition, psychological stress, insecurity, unwanted changes in life, new life stressors such as toilet training, or traumatic events. They are also frequently seen in children with febrile diseases, central nervous system diseases, mental retardation, and depression. It is often seen to start between the ages of 3-6. If nightmares continue twice a week for 6 months, it is necessary to consult a specialist.

Sleep Terror

Usually, the dream is not remembered and sleep is quickly returned to. Sleep terror is seen at the beginning of sleep (the first three hours) and since the child is asleep during sleep terror, he/she does not remember the events in the morning. The possibility of children hurting themselves during this short sleep phase, such as jumping out of the room or falling on a dangerous object, should be prevented with precautions.

Sleep Apnea

A condition in which air cannot be taken through the nose or mouth, which occurs at least 3 times during sleep. It is often seen between the ages of 4-6. Loud snoring, morning irritability and crankiness, fatigue, inattention, problems with focusing and hyperactivity-like movements are observed. It may be due to tonsils, adenoids or excessive weight. Mild developmental delay can be seen in children with sleep apnea. The reason for this is insufficient hormone secretion due to the child's inability to fall into deep sleep.

Narcolepsy

Daytime sleepiness and uncontrollable sleep attacks. It is important to monitor the child's sleeping and waking times and to determine that it is not due to insomnia.

Sleep-Wake Transition Disorders

It is seen in the transition from being awake to sleeping or from being asleep to waking. Rhythmic movements are seen especially at the beginning of sleep. It can also be seen in the form of sleep talking, leg cramps and rhythmic movement disorders (head banging, sleep jumping, and body shaking). It is important to take precautions against the possibility of the child hurting himself.

Conditions That May Cause Sleep Problems

• Children with difficult temperaments
• Children with chronic diseases (such as heart diseases, respiratory diseases, allergies, central nervous system problems, epilepsy, reflux, vision or multiple disabilities)
• Febrile diseases
• Children with separation anxiety
• Children with insecure attachment
• Children with mental retardation, Down syndrome, attention deficit and hyperactivity disorder, tic disorders, pervasive developmental disorder or other developmental delays
• Traumatic events
• Depression
• Conduct disorder
• Anxieties
• Fears
• Psychoses
• The nature of the interaction between the parent and the child
• Inadequate or problematic nutrition
• Physical conditions
• Bedtime
• Marital conflict
• Parental psychopathology
• Failure to meet physical and emotional needs
• The desire to take control in the child
• Parental Attitudes
• Inadequacy or absence of the parent
• Frequent changes in the sleep environment and/or hours