Sleep behaviors are among the most common concerns that parents of young children bring to their doctors. These sleep problems are difficult to define because of important differences in sleep patterns that occur at different ages. For example, it is not considered abnormal when a 2-month-old infant wakes frequently during the night, but such behavior is considered abnormal in a two-year-old. There are many different kinds of sleep disorders. The two sleep disorders to be discussed here are trouble falling asleep and sleep apnea. For further information on other sleep disorders, such as sleepwalking, night terrors and  nightmares you may wish to continue your search on-line elsewhere.

Trouble Falling Asleep

It’s not just babies who wake up in the middle of the night or have trouble falling asleep. Many older kids and teens can have trouble with sleeping, too. Not getting a good night's sleep can affect your child's mood and behavior during the day, leading to school and disciplinary problems.

Symptoms

Like adults, children with insomnia either have trouble going to sleep, staying asleep or both , or are simply not well rested after what should be a normal amount of time sleeping. In addition to being sleepy during the day, symptoms of childhood insomnia can include:

• Irritability
• Mood swings
• Hyperactivity
• Depressed mood
• Aggressiveness
• Decreased attention span
• Memory problems

What to do

One common reason that many children don't get enough sleep is that they simply go to bed too late. This often happens because parents have unclear expectations for how much sleep their kids need or because their kids are over-scheduled and are participating in too many activities, or have too much homework. Or your child may simply be up late talking on the phone, playing video games, or watching TV.

Remember that children between the ages of 6 and 12 need at least 10 to 11 hours of sleep each night, and teens need at least of 9 hours of sleep each night.

If you set a realistic bedtime and your child is still not getting a good night's sleep, then common causes of insomnia can include:

• Poor sleep habits
• Caffeine
• Stress
• Obstructive sleep apnea (discussed below)
• Side effects of medications, including stimulants used to treat ADHD, antidepressants, corticosteroids, and anticonvulsants
• Asthma (coughing)
• Eczema (itching)
• Depression
• Anxiety
• Restless legs syndrome
• Nervous system disorders, such as autism, mental retardation, and Asperger's syndrome

Although parents may  want to turn to a prescription  medication to treat their child's insomnia, it is much more important to look first for any underlying medical or psychological problems that may need to be addressed.

Nondrug treatments for primary insomnia, or childhood insomnia that is not caused by another medical condition, can include:

• Restricting time spent in bed to simply sleeping, which means no reading, doing homework, or watching TV in bed
• Having a very consistent schedule of when your child goes to bed and wakes up, including weekends and holidays
• Teaching your child about relaxation techniques, including diaphragmatic breathing, progressive muscle relaxation, and visual imagery, which he or she can use when going to sleep
• Stopping stimulating activities, such as playing video games, watching TV, or talking on the phone, 30 to 60 minutes before bedtime
• Removing any distractions from their bedroom, such as a computer, television or telephone (cell phone included).
• Having your child get out of bed and do something quiet, such as reading, if she or he doesn't fall asleep within 10 to 20 minutes
• Avoiding caffeine after 3 p.m.
• Exercising regularly  but not too late in the afternoon

Finally, taking your child to a counselor or child psychologist, in addition to your pediatrician, can also be helpful for determining why your child is having problems with insomnia.

Sleep Apnea

The most common kind of sleep apnea is called Obstructive Sleep Apnea Syndrome. It is characterized by repetitive episodes of  partial or complete upper airway obstruction that occur during sleep, and might be  associated with lower blood oxygen.

Children who suffer from sleep apnea are rarely aware of having this difficulty breathing. In some cases, patients aren’t diagnosed for years because they can become conditioned to the symptoms.

Symptoms

• Frequent episodes of obstructed breathing during sleep

Associated features may include:

• Snoring—loud, squeaky, raspy
• Nocturnal snorting, gasping, choking (may wake self up)
• Restless sleep
• Heavy irregular breathing
• Excessive sweating during sleep
• Bedwetting
• Bad dreams (nightmares)
• Night terrors
• Sleeping with their mouths open, causing a dry mouth upon awakening
• Chest retraction (chest pulls in) during sleep in young children
• Sleeping in strange positions
• Confusion upon awakening
• Morning headaches
• Unrefreshing sleep
• Excessive daytime sleepiness
• Learning problems
• Excessive irritability 
• Change in personality
• Depression
• Difficulty concentrating
• Developmental problems
• Failure to thrive or grow
• Frequent upper respiratory infections
• Hyperactive behavior

What to do

Sleep apnea is a potentially life-threatening condition that requires immediate medical attention. The risks of undiagnosed obstructive sleep apnea in children include learning, developmental and behavior problems; and in some cases, failure to grow, heart  and pulmonary problems and high blood pressure. In addition, obstructive sleep apnea causes daytime sleepiness that can result in personality changes, lost productivity in school and relationship problems. A child with sleep apnea may also lag behind in many areas of development. Your child may become frustrated and depressed. The severity of the symptoms may be mild, moderate or severe. If you suspect that your child suffers from sleep apnea, you need to schedule an appointment with your pediatrician. If necessary, you may be referred to a specialist who will most likely perform sleep study. These tests can usually be performed in a sleep lab .In many cases, sleep apnea can be controlled by removing your child’s tonsils and/or adenoids.

THIS ARTICLE IS NOT INTENDED AS MEDICAL ADVICE. PLEASE BE SURE TO SEEK THE ADVICE OF A LICENSED MEDICAL PROFESSIONAL BEFORE ADMINISTERING ANY MEDICAL CARE.