Growing recognition over the past two decades that primary sleep disorders
may harm children's neurocognitive, behavioral, and affective development has
fostered the emergence of pediatric sleep medicine as a distinct clinical
specialty, Anna Ivanenko, M.D., Ph.D., told Psychiatric News.
About one-quarter of parents of 4- to 12-year-olds report that their
children have clinically significant difficulty sleeping, said Ivanenko, who
directs the pediatric sleep program at Central DuPage Hospital in Chicago. She
is an assistant professor of clinical psychiatry and behavioral sciences at
Northwestern University School of Medicine (see Questionnaire Helps Identify
Children's Sleep Disorders).
Parents describe problems such as bedtime resistance, bedtime anxiety,
delayed sleep onset, nighttime awakenings, nightmares, night terrors,
sleepwalking, snoring, enuresis, early morning awakenings, and excessive
Sleep disorders may mimic or worsen psychiatric disorders, Ivanenko noted.
Irritability, apathy, and other symptoms suggesting a mood disorder in an
adolescent, for example, may reflect chronic sleep deprivation associated with
early school start times. What appears to be attention deficit/hyperactivity
disorder or learning difficulty in an elementary school child may result from
a sleep-related breathing disorder. Successful treatment of the sleep disorder
may ease or end psychiatric symptoms.
Ivanenko is the editor of the new book Sleep and Psychiatric Disorders
in Children and Adolescents (Informa Healthcare), which explores such
issues in depth. Topics covered in the book's 28 chapters by 57 contributors
include current pharmacological and nonpharmacological treatment for sleep
disorders in children, assessment of sleep problems in schools or private
practice, sleep problems in children with mood and anxiety disorders, and
sleep and substance abuse in adolescents.
"It is important for child psychiatrists to assess sleep in every
child," she said, "and to watch for possible adverse effects of
psychiatric medications on sleep and daytime alertness."