Gina Johnson
Sleep is an essential building block for a child's mental and physical health. However, it can be challenging for parents to know whether their child is simply going through a phase or experiencing a sleep disorder. Sleep disorders are defined as problems with sleep quality, timing, and duration, and they can lead to distress and a reduced ability to function. A child's sleep disorder can affect the whole family, and there are several ways to help improve their sleep.
| Characteristics | Values |
|---|---|
| Daytime sleepiness | Excessive daytime sleepiness is usually the first sign of narcolepsy in children. |
| Nighttime sleep disturbances | Waking up often during the night (disturbed sleep). |
| Sudden muscle weakness | Cataplexy is a sudden, brief loss of muscle tone or strength. |
| Hallucinations | Vivid, dream-like/nightmare events that are difficult to distinguish from reality. |
| Sleep duration | A child under the age of 5 should get adequate sleep of 16-17 hours per day. |
| Sleep quality | Quality sleep is important for a child's mental and physical health. |
| Sleep timing | A consistent bedtime routine is helpful for making sure your child gets enough sleep. |
| Sleep duration | Lack of sleep can cause trouble controlling emotions, poor problem-solving skills, and irritability in children. |
| Sleep environment | A calming, warm bath, meditation, and relaxation techniques can help improve sleep quality. |
| Sleep schedule | A posted sleep schedule with a consistent, predictable routine will help children stay on track. |
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What You'll Learn
Your daughter may have narcolepsy
There are two types of narcolepsy: Type 1 (previously called narcolepsy with cataplexy) and Type 2 (previously called narcolepsy without cataplexy). Type 1 is characterised by excessive daytime sleepiness and cataplexy (sudden muscle weakness), and it can also lead to rapid weight gain. Type 2 also involves excessive daytime sleepiness, but without the presence of cataplexy, and it doesn't affect hypocretin levels. Hypocretin is a brain chemical that promotes wakefulness.
The first sign of narcolepsy is usually excessive daytime sleepiness, which can interfere with your child's daily activities, including learning, playing, and socialising. They may feel extremely tired all day, even when inactive, and may experience sleep attacks where they fall asleep suddenly. They may also nap longer than usual or feel tired shortly after waking up. Other symptoms include mental fog, forgetfulness, irritability, and difficulty concentrating.
Narcolepsy can also cause sleep disturbances at night, with your child waking up frequently. They may experience sleep paralysis, where they feel unable to move or speak just before falling asleep or upon waking up. Sleep paralysis can be terrifying for children, and it often occurs alongside hallucinations. Hallucinations are vivid dream-like experiences that are difficult to distinguish from reality and can be extremely frightening.
Narcolepsy is often underdiagnosed and misdiagnosed in children. It can be mistaken for other conditions or behavioural problems. However, it is important to seek medical advice if you suspect your child may have narcolepsy. Treatment options include medications and behaviour changes, such as maintaining a strict sleep-wake schedule, taking short naps, increasing physical activity, and avoiding caffeine.
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She may be experiencing night terrors
Night terrors are a common sleep disorder that affects around 1 to 6.5 percent of children. They are more common in children than in adults and typically occur during non-REM sleep, about 90 minutes after a child falls asleep. During a night terror, your daughter might suddenly bolt upright in bed, appearing intensely scared or agitated, and she may cry, yell, or even sleepwalk. Usually, she won't be truly awake, and most children don't remember the episode in the morning.
If your daughter is experiencing night terrors, there are a few things you can do to help minimize their occurrence. Firstly, try to stick to a consistent sleep schedule and reduce nighttime disturbances as much as possible. A calming bedtime routine, such as a warm bath or quiet reading, can help relax your daughter before bed. Keep the bedroom lights dim during this time, and ensure the room is dark and at a comfortable temperature when it's time to sleep.
You can also try emphasizing time spent together before bed. Spend a few minutes talking to your daughter about her day and encourage her to share her thoughts and feelings. This can help reduce restlessness and make it easier for her to fall asleep. Additionally, it's important to unplug electronics and create an electronics-free zone in the bedroom. Start the bedtime routine early enough so that your daughter is away from screens at least an hour before bedtime.
If your daughter's night terrors persist or interfere with her daily life, it's important to talk to her pediatrician or a pediatric sleep specialist. They can help create a plan to improve her sleep and determine if there are any underlying medical issues, such as obstructive sleep apnea, that need to be addressed.
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She could be sleepwalking
Sleepwalking, or somnambulism, is a behaviour in which a person gets up during the night and walks or does other activities. If your daughter is sleepwalking, her body will be awake but her mind will be asleep. This means she won't respond normally to you or anything around her, and she won't remember the sleepwalking in the morning.
Sleepwalking behaviours can range from harmless, like sitting up, to potentially dangerous, such as wandering outside, turning on power tools, or driving. Sleepwalkers might also try to exit the house or urinate in an inappropriate place. Sleepwalking can be upsetting for parents to witness, but it is quite common, especially in children aged 4-12. It is also more common in children whose parents also sleepwalked or used to sleepwalk.
If your daughter is sleepwalking, there are a few things you can do to manage the situation:
- Ensure your daughter is getting enough sleep. An earlier bedtime or a regular bedtime might reduce sleepwalking.
- Make sure her environment is safe. Check that all doors and windows are securely locked, and remove any tripping hazards from her room and hallway.
- Set up an alert to wake you when your daughter sleepwalks, such as a bell on her door, a baby monitor, or a motion-activated light or buzzer.
- If your daughter is going away overnight, inform the caregivers about the sleepwalking so they can keep her safe.
Sleepwalking is usually not a cause for concern, and most children grow out of it when they reach puberty. However, if your daughter is sleepwalking at least once every night, or if you are worried she might hurt herself, it is best to consult a doctor.
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She could be suffering from anxiety or depression
If your daughter is sleeping all day, she could be suffering from anxiety or depression. Sleep is essential for children's mental and physical health, and a lack of sleep can have several negative consequences. According to the American Academy of Pediatrics, a quarter of children under the age of five do not get adequate sleep, and this has been linked to anxiety and depression.
If your daughter is struggling with anxiety or depression, it is important to address these issues to improve her sleep. Here are some steps you can take:
- Identify the cause of her anxiety or depression: Understanding the underlying cause of your daughter's mental health struggles is crucial. Is she dealing with school-related stress, conflicts with friends, or family issues? By identifying the specific triggers, you can better support her and create an environment that promotes healthy sleep.
- Encourage open communication: Create a safe and non-judgmental space for your daughter to express her thoughts and emotions. Let her know that you are there to listen and support her. Open communication can help you understand her anxieties and fears, and together, you can work on addressing them.
- Seek professional help: If your daughter is experiencing anxiety or depression, consider consulting a mental health professional. A therapist or counsellor can provide her with additional tools and strategies to manage her mental health and improve her sleep.
- Establish a bedtime routine: A consistent bedtime routine can be calming and help your daughter's body and mind prepare for sleep. This routine can include activities such as reading a book, taking a warm bath, or listening to calming music. Stick to a regular sleep schedule, including wake-up times, to regulate her body's internal clock.
- Create a sleep-conducive environment: Make sure her bedroom is quiet, comfortable, and screen-free. Consider using dark curtains, eye masks, or noise-cancelling headphones to minimise distractions and create a relaxing atmosphere.
- Promote relaxation techniques: Teach your daughter relaxation techniques such as meditation or deep breathing exercises. These practices can help her manage anxiety and calm her mind before bed, making it easier to fall asleep.
- Emphasise quality time and open conversation: Spend time talking with your daughter before bed. Ask her about her day, listen to her concerns, and encourage her to share her thoughts. This can help her feel more connected and supported, reducing anxiety and improving her overall mental well-being.
- Address any underlying medical conditions: If your daughter is experiencing physical discomfort or medical issues, such as asthma, sleep apnea, or allergies, ensure that these are properly addressed. Consult your paediatrician or a sleep specialist to rule out any underlying medical conditions that may be disrupting her sleep.
Remember, it is important to be patient and understanding throughout this process. Every person's journey with anxiety and depression is unique, and healing takes time. By providing support, creating a calming environment, and seeking professional help when needed, you can help your daughter improve her sleep and overall well-being.
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She may have restless leg syndrome
Restless leg syndrome (RLS) is a sleep disorder that affects around 2% of children. It was previously thought to be an adult problem, but research has shown that it can start in childhood.
RLS can be difficult to identify. Your daughter may complain of having "the wiggles" or an itchy or crawling sensation in her legs. She may frequently change positions in bed to try to find relief. Some children don't notice these uncomfortable sensations, but they may still experience poor sleep as a result of RLS.
There are several treatments for RLS, although many of them have not been extensively studied in children. These include vitamin supplements and medication. Talk to your daughter's doctor about the best course of treatment.
In the meantime, there are some things you can do to help improve your daughter's sleep:
- Promote relaxation before bed. A warm bath or quiet reading can help your daughter unwind and prepare for sleep. Keep the bedroom lights dim during this time, and ensure the room is dark and at a comfortable temperature when it's time to sleep.
- Set a bedtime routine. Performing the same steps every night will help your daughter get used to a consistent sleep routine. Post the plan in her room, for example, "Brush teeth, read books, lights out."
- Spend time together before bed. Spend a few minutes talking to your daughter about her day and encourage her to share her thoughts and feelings. This can help reduce restlessness and make it easier for her to fall asleep.
- Unplug electronics. Make your daughter's bedroom an electronics-free zone. Start the sleep routine early enough so that she is away from screens at least one hour before bedtime.
- Create a positive association with bedtime. Instead of scolding your daughter for getting up during the night, consider a reward system for staying in bed and going to sleep at the preferred time.
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Frequently asked questions
There are many reasons why your daughter might be sleeping all day. It could be due to a change in her environment, a new mattress, or a new sibling. It could also be due to a more serious issue such as narcolepsy, sleep apnea, or restless leg syndrome.
There are several things you can do to help your daughter sleep better at night. Firstly, try to establish a consistent bedtime routine and stick to it as much as possible. This could include brushing teeth, reading a book, and turning off the lights at the same time every night. Additionally, make sure her bedroom is quiet, cool, and free of electronic devices and bright lights. You should also ensure she is getting regular exercise during the day and eating a healthy diet.
If your daughter's sleeping issues are interfering with her daily life, causing mood changes or academic performance issues, or if you suspect she may have a sleep disorder, it is important to seek professional help. A healthcare provider can evaluate her for any underlying medical or psychiatric conditions that may be contributing to her sleeping issues and provide treatment or referrals to specialists if needed.
