Sleep is a state of reduced response and interaction with the environment that is reversible and takes place quickly. The amount and length of sleep varies according to the age of the baby and child. The older the child, the less need for sleep. Sleep consists of two components, namely rapid eye movement (REM) and non-rapid eye movement (non-REM) which occur alternately which form a sleep cycle. Sleep has several functions, including energy storage, adaptation, and memory consolidation. Research also states that sleep is beneficial in emotion regulation. Sleep disturbances are related to emotional status and behavior in children and adolescents.
Sleep disorders in children are rarely diagnosed early due to a lack of understanding by parents about a child's sleep needs. Research in Beijing states the prevalence of sleep disorders in children aged 2-6 years is 23.5%. Significant physiological and social changes occur during childhood and adolescence including changes in the sleep cycle system that regulates sleep duration and timing. Sleep duration decreases as development progresses, from about 14.5 hours at 6 months of age to 8 hours at 16 years of age. These changes in sleep patterns throughout development, especially in the context of mental health issues, can be difficult for some teens.
Potential effects on physical health are also deleterious, including cardiovascular risk, impaired immune function and metabolic changes such as insulin resistance, which can persist into adulthood without treatment.
The majority of adolescents presenting with a chief complaint of insomnia (defined as difficulty initiating/maintaining sleep) meet criteria for a mental health diagnosis. Many adult psychiatric patients report that their sleep problems originate in childhood.
In general, many nonclinical childhood fears (eg, monsters under the bed, the dark) are associated with the presence of transient sleep disturbances. These problems are mostly developmental and occur in most of the children.
The associations and relationships between sleep regulation, emotion and behavior during early development are striking and complex. Taken together, these interrelationships suggest that:
- Childhood psychiatric disorders can cause or worsen sleep problems
- Insufficient or disturbed sleep can impair a child's ability to regulate emotions and behavior and lead to mental health problems and disorders
Assessments should incorporate the use of multiple informants (children, parents, pediatricians) and methods (clinical interviews, sleep diaries, questionnaires) and consider the interrelationships between nighttime and daytime behaviors. In some cases, sleep may improve with adequate psychiatric treatment, whereas in others, sleep disturbances may persist even in the presence of other improvements.
Based on research in China, it is stated that the risk factors that significantly influence sleep disorders in children are exposure to electronics, such as television, computers or the internet, parents' short sleep hours and not implementing good sleep hygiene in children.. Sleep hygiene includes the application of children's sleeping hours, the use of shady lights when sleeping at night, keeping the bed clean and not placing electronic items in the room.
Sleep disturbances are related to emotional status and behavior in children and adolescents. Parents must maintain adequate and quality sleep for their children to increase concentration and productivity. Not surprisingly, people with poor sleep quality tend to be less productive and have poorer memory than people who get enough sleep. Sleep quality can be obtained by paying attention to the way of sleeping, the sleeping environment, as well as comfort and sleep patterns. Short sleep duration was also associated with an increased risk of weight gain and obesity in both children and adults.
Amin RS, Kimball TR, Bean JA, Jeffries JL, Willging JP, Cotton RT, et al. Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine
Ivanenko A, Barnes M, Crabtree V, Gozal D. Psychiatric symptoms in children with insomnia referred to a pediatric sleep medicine center. Sleep Medicine
Kahn A, Van de Merckt C, Rebuffat E, Mozin MJ, Sottiaux M, Blum D, et al. Sleep problems in healthy preadolescents. Pediatrics
McLaughlin-Crabtree, V.; Witcher, LA. Impact of sleep loss on children and adolescents. In: Ivanenko, A., editor. Sleep and Psychiatric Disorders in Children and Adolescents. New York, NY: Informa Healthcare