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Sleep problems in children (Pathophysiology (Waking at night Difficulty…
Sleep problems
in children
Management
Conservative
Information, advice, support
Sleep diary
Safe environment (in case of night terrors/sleepwalking
e.g. gates, locks to kitchen)
Psychological
Sleep hygeine
No screens, quiet, adequate temperature, dark,
tell child to lie with eyes closed until they fall asleep
Lengthening periods
Putting to bed then visiting to check, slowing increasing
time period to allow to fall asleep alone
Prognosis
Often self resolve over time
Definition
Problems getting to sleep
or staying asleep in children
Epidemiology
Common in preschool children
Pathophysiology
Waking at night
Difficulty self settling
Nightmares
Bad dreams that can be recalled
Difficulty settling
Normal expression of separation anxiety
Too much sleep during the day
Disrupted sleep/wake cycle
Overstimulation in the evening
Noisy surroundings
Lack of routine
Dislike of the dark/silence
Night terrors
Occur during sleep, child appears awake, disoreintated and distressed, unresponsive
Child settles to sleep and unable to recall
Type of parasomnia (distubed structure of sleep)
Clinical
presentation
Difficulty getting to sleep
Waking up and unable
to self settle
Nightmares
Night terrors
Diagnosis
Examination
Nil
History
Difficulty getting to sleep, waking up,
nightmares, night terrors, bedtime routines,
bedtime surroundings, sleep hygeine