When to see a specialist when there are infantile sleep disorders?
It would be advisable to see a specialist when we observe the following warning signs: sleep disorders due to educational cause, fear of sleeping, insomnia, hypersomnia or obstructive apnea. Also when the child presents night terrors, sleepwalking and bruxism. And finally when there is somniloquy, offense capitis and narcolepsy.
We explain them:
Sleep disorders of educational cause.
The cause that originates this problem is the deficient acquisition of the habit of sleep, that is to say, there is a distortion and destructuring by inadequate associations that the child makes with his sleep, normally due to changes that the parents make to try that the child falls asleep or educational guidelines for the sleep, disruptive for the child. They are children with a very alert attitude, who capture with great intensity the stimuli that exist around them, usually with anxiety and insecurity. They usually have a superficial sleep during which they are restless, like vigilant, and any noise wakes them up.
They can be irritable children during the day, with great dependence on the person who takes care of them. On the other hand, it is very important to establish a bedtime routine, such as setting a specific time or making a ritual for the child to go to sleep, and to keep the child calm when the time for sleep is approaching. There are a number of individual differences that can influence a child’s sleep, in addition to those mentioned above, such as nutrition, physical and mental fatigue and other external factors.
Finally, it is important for parents to be aware of their role as sleep educators as well. They have to set the guidelines for going to sleep, especially in the face of the child’s refusal to go to bed and the demand for attention to them at bedtime. To have hourly guidelines and to sleep a minimum of hours, has repercussions in a better consolidation of learning and in an adequate growth.
Fear of sleeping
A child may resist going to sleep for various reasons. They may be afraid of the dark or of not waking up, they may also feel insecure when they are alone, so they may be unable to sleep without the presence of an adult, so if they wake up, they usually go to bed with their parents. It is common for children to develop feelings of worry about being physically separated from their parents, sleeping alone, fear of the dark, noise or burglars.
It is important to talk to children about their fears to help them overcome them. What should not be done in these cases is to laugh about it or minimize it, as this does not help to overcome fears, and instead, causes children to lose confidence in sharing their insecurity with their parents and feeds their fears. If instead, it is convenient for them to learn to face their fears, it is necessary to listen to them and explain to them that they have the strength to overcome their fears without saying that they do not exist.
It should also be clear that there is a normal stage of the child in which evolutionary fears appear. Finally, one way of not supporting the child’s fear is to facilitate his independence, taking him out of the parents’ room or out of the parents’ bed before the age of one year.
Insomnia, hypersomnia and obstructive apnea
In infantile insomnia, parents usually explain that the child has never slept well. The symptom that characterizes this type of disturbance is the difficulty to initiate sleep without help or collaboration. At night these children may also have nocturnal awakenings, i.e. they tend to interrupt their sleep many times and have difficulty falling back to sleep spontaneously and without help.
Hypersomnia is an excessive amount of sleep with increased daytime sleepiness and prolonged episodes of nocturnal sleep. It is very rare in children and is usually found as a symptom of other disorders in the adolescent period. It should be taken into account that this syndrome is less important when the child is young, since it is normal for him/her to sleep more hours.
The infantile sleep apnea syndrome is characterized by the presence of episodes of partial or total obstruction of the upper airways that appear during sleep, at times of respiratory effort. As a result, frequent awakenings occur, breaking the sleep cycle and causing daytime sleepiness. In this case it is always necessary to consult with the pediatrician.
Do not forget that all of the above mentioned disorders can lead to other problems, such as increased irritability, attention disorders or developmental difficulties, and also that the above mentioned disorders can be a consequence of other developmental alterations.
Night terrors, sleepwalking and bruxism
In episodes of night terrors it is common for the child to sit up abruptly in bed and start screaming and crying with a terrified facial expression and signs of intense anxiety.
He usually does not wake up easily even if his eyes are open, despite other people’s efforts to wake him up. If this is finally successful, the child appears confused, disoriented for a few minutes and with a sense of dread. The next day they do not remember the dream or what happened, unlike nightmares, in which they do remember the episode.
In somnambulism the essential characteristic is the existence of episodes in which the child gets up abruptly from bed and may even get up and start walking. The eyes may be open and the gaze fixed. The child may pronounce one or a few words normally without coherence. The child may also perform more complex behaviors. All this happens with total indifference to his environment.
Bruxism is the unconscious habit of grinding the teeth at night or during the day. It is usually a consequence of situations that require great concentration or a lot of emotional tension, reacting unconsciously by clenching the teeth, usually at night during sleep. Among the symptoms observed is hearing noises with the opening and closing of the mouth, the child may also have pain in the jaw and the teeth may present dental wear. Apart from this, this alteration can also be a consequence of intestinal parasitosis by pinworms, and not by the state of anguish and emotional tension discussed above, in the latter case children can also laugh in their sleep without apparent cause.
Somniloquy, ofensa capitis and narcolepsy
Somniloquy is the presence of speech episodes during sleep. It is usually the emission of unintelligible words or a group of them forming short sentences. They may be accompanied by laughter, screaming or crying. They do not usually awaken the child, but are often disturbing to those around the child. It can express an emotional problem or stress, although it can also be a completely normal symptom and without any clinical significance.
The nocturnal offense capitis, consists of making rhythmic blows of the head against the pillow or the wall when trying to fall asleep. Guttural sounds may also appear. It usually appears at the time of falling asleep. It usually begins at 9 months of age and normally does not persist beyond 4 years of age. Another equivalent sleep disturbance is the presence of repetitive and involuntary behaviors, such as rocking various parts of the body to fall asleep.
A sleep disorder, although very rare in infancy, is narcolepsy, in which the child has irresistible restful sleep attacks that appear daily for at least 3 months. This disorder is dangerous because of its consequences, as it can lead, for example, to serious falls.