Childhood Sleep Disorders - Frequently Asked Questions for Parents
What is Infant Sleep Apnea?
Up to what age is considered an Infant Apnea?
What are the symptoms of Sleep Apnea in children?
What is Urinary Incontinence (Enuresis)?
What causes Urinary Incontinence?
How is Urinary Incontinence diagnosed?
What types of treatments are available for urinary incontinence?
What do I need to know about sleep cycles?
What do I need to know about how babies sleep?
What do I need to know about school-age children and sleep?
How can I tell if my child is sleep-deprived? How much sleep do children need?
How are night terrors different than nightmares?
What can I do if my child sleep-walks?
Does your sleep center have a Pediatric Sleep Specialist?
What is Infant Sleep Apnea?
Infant Sleep Apnea is characterized by having episodes of either Central Apnea
or Obstructive Sleep Apnea (OSA) during sleep. An apnea is the stoppage of
airflow at the nostrils and mouth lasting at least ten (10) seconds. A Central
Apnea occurs when respiratory efforts stop for more than ten (10) seconds
(20 seconds in infancy) due to a malfunction in the part of the brainstem
that controls and regulates one’s breathing. An OSA occurs when the
upper respiratory airway becomes blocked.
Up to what age is considered an Infant Apnea?
The diagnosis of Infant Apnea is reserved for infants who are older than 37
weeks (approximately nine [9] months) at the onset of the apnea and for those
with no specific causes of Apparent Life-Threatening Event (ALTE) or apnea
can be identified.
Apnea of Prematurity is restricted to apneas in infants younger than 37 weeks
(approximately [9] months) and due to a respiratory immaturity (with no other
identifiable causes).
What are the symptoms of Sleep Apnea
in children?
• Skin color/tone change (pale or bluish in infants)
• Body limpness
• Noisy breathing during sleep.
What is Urinary Incontinence (Enuresis)?
Urinary Incontinence (Enuresis) is a medical terminology for bedwetting or
the accidental urination in children who should be otherwise be able to control
their bladders. Girls usually develop the bladder control before boys do.
The diagnosis of Enuresis is for girls over the age of five (5) and for boys
over the age of six (6). There are different types of bedwetting that can
occur including the following:
• Diurnal Enuresis - wetting during the day
• Nocturnal Enuresis - wetting during the night
• Primary Enuresis - occurs when a child has never
fully mastered the toilet training
• Secondary Enuresis - occurs when a child did have
a period of dryness but returned to having periods of incontinence.
What causes Urinary Incontinence?
There can be numerous factors for why children wet. A few possible reasons
for the problem include poor toilet training, a delay in the ability to hold
urine (this may be a factor up to about the age of five (5), small bladder,
poor sleep habits, a presence of a sleep disorder, and problems with hormones
that regulate urination.
How is Urinary Incontinence diagnosed?
Urinary Incontinence is usually diagnosed based on a complete medical history
and physical examination of the child. In addition, the child's physician
may perform the following procedures to help rule-out other causes for wetting:
• Urine test (to rule-out an infection or conditions such as diabetes)
• Blood pressure measurement
• Blood tests.
What types of treatments are available
for urinary incontinence?
A specific treatment will be determined by the child’s physician based
on the child’s age, overall health, and the medical history. Other factors
include analysis of the extent of the condition, the child’s tolerance
for specific medications, procedures or therapies.
What do I need to know about sleep
cycles?
When people sleep, they cycle between rapid eye movement (REM) sleep and non-rapid
eye movement (NREM) sleep. In REM sleep, eyes move around fast, the body doesn’t
move much, and people often dream. REM sleep is when an infant or child is
most likely to wake up. In normal sleep, a child cycles between REM and NREM
sleep stages.
What do I need to know about how babies
sleep?
Infants go through a complete sleep cycle about every 50-60 minutes, and therefore,
they can wake-up many times during the night. Newborn’s sleep is equally
divided between day and night. By age of four (4) months, the baby will probably
sleep in a 6-8 hour blocks at night, and by age of six (6) months, in a 10-12
hour blocks, but that’s not to say that they won’t wake up during
that time period. Most babies still wake-up at least once at night even at
age of nine (9) months. Some babies can get back to sleep by themselves, and
some babies need help of others to fall back asleep.
What do I need to know about school-age
children and sleep?
School-aged children still need 9-12 hours of sleep at night. At this age,
they usually start a trend toward becoming more sleep-deprived. Parents need
to figure out how much sleep the child needs. The child is getting the right
amount of sleep if they:
• Can fall asleep within 15 to 30 minutes
• Can wake up easily at the time they need to get up and don't need
others to keep bugging them to get up
• Are awake and alert all day and don't need a nap during the day. It
is a good idea to check with the child’s teacher to make sure the child
is able to stay awake and be alert during school time.
How can I tell if my child is sleep-deprived?
How much sleep do children need?
The following chart shows some averages. It gives an idea of the ballpark
figure, depending on the child’s age. Some children need more or less
sleep and differ in how they nap.
| Age | Nighttime Sleep (hrs) | Daytime Sleep (hrs) | Total Sleep (hrs) |
| 1 month 3 months 6 months 9 months 12 months 18 months 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12-13 years 14 years 15 years 16 years |
8.5 (many naps) 6-10 10-12 11 11 11 11 10.5 11.5 11 10.5-11 10.5 10-10.5 10 9.5-10 9.5 9-9.5 9 8.5-9 8.5 |
7.5 (many naps) 5-9 3-4.5 3 (2 naps) 2.5 (2 naps) 2.5 (1-2 naps) 2 (1 nap) 1.5 (1 nap) 0 0 0 0 0 0 0 0 0 0 0 0 |
16 15 14.5 14 13.5 13.5 13 12 11.5 11 10.5-11 10.5 10-10.5 10 9.5-10 9.5 9-9.5 9 8.5-9 8.5 |
How are night terrors different than nightmares?
Night Terrors are distinguished from nightmares because they usually occur during times of stress or fatigue. Night Terrors usually occur with males between the ages of three (3) to eight (8) years. They are characterized by a child bolting upright and screaming, with parents usually unable to console the child for up to 30 minutes.
What can I do if my child sleep-walks?
Common symptoms of Somnambulism (sleep-walking) and Somniloquy (sleep-talking) include a child sitting-up in bed with eyes open but "unseeing." Activities may range from a purposeless restlessness in bed to actual walking through the house. Speech is mumbled and slurred and is rarely intelligible. It is important for parents to take steps to ensure the child’s safety by placing the sleep-walker on the first floor of the home to avoid the possibility of his/her falling-down stairs and making sure that all windows and doors are securely closed. When confronting a child who is sleep-walking, parents should keep the intervention to a minimum and refrain from shaking, slapping or shouting at the child. Children usually outgrow these sleep behaviors by the adolescent age.
Does your sleep center have a Pediatric Sleep Specialist?
Yes. GWSDC is proud to announce that Dr. Robert Meny, Pediatric Sleep Specialist, is available for pediatric sleep consultations and sleep diagnostic testing at his Frederick, MD location at:
Frederick Diagnostic Sleep Disorders Center
801 Toll House Avenue
Suite H-2
Frederick, MD 21701
Dr. Meny attended Columbia University School of Medicine in New York, NY and completed his training in Pediatric Medicine at The New York Hospital. He later became the founder of the pediatric sleep program at the University of Maryland Hospital Center after completing a fellowship program in Neonatal Medicine. His special interests include neurobehavioral consequences of pediatric Sleep Apnea and the mechanism of Sudden Infant Death Syndrome (SIDS). Dr. Meny is board-certified in Pediatric Medicine and is a diplomat of the American Board of Sleep Medicine (ABSM). He is also the Chairman of the Board of the American Association of SIDS Prevention Physicians.