Health news
Health news top Health news

   Login  |  Register    
Health News Make AMN Your Home PageDiscussion BoardsAdvanced Search ToolMedical RSS/XML News FeedHealth news
  You are here : Health.am > Health Centers > Healthy Sleep Health Center > Sleep Disorders > Childhood Sleep Disorders

Childhood Sleep Disorders

Thomas F. Anders, M.D.

In this section, I review some of the common sleep disorders of childhood and how they affect families. Developmental failures in achieving consolidated nighttime sleep and daytime wakefulness, in going to bed and falling asleep easily, in maintaining continuity of sleep, and in circadian regulation of sleep-wake cycles are significant risk factors for potential sleep disorders in infants, children, and adolescents. An understanding of childhood sleep disorders is facilitated by knowledge about the development of both sleep-state architecture and sleep-wake-state temporal organization. The maturation of sleep-wake states has been reviewed elsewhere (Anders and Eiben 1997; Coons and Guilleminault 1982), and only a summary is provided here.

Developmental Aspects of Sleep-Wake Organization
Newborns spend 50% of their sleep time in rapid eye movement (REM) sleep (also known as active sleep or dreaming sleep) and 50% of their sleep time in non-REM (NREM) sleep (also known as quiet sleep or slow-wave sleep). By adolescence, the relative proportion of REM sleep during sleep time has diminished to 20%, whereas NREM sleep has increased proportionally to 80% of sleep time. Four stages of NREM sleep (Stages 1-4) can begin to be differentiated from patterns on the electroencephalogram (EEG) by age 3-4 months. REM and NREM periods alternate with each other in 50- to 60-minute (i.e., ultradian) sleep cycles. A period of 30 minutes of REM sleep is followed by 30 minutes of NREM sleep in a sleep cycle, and three to four sleep cycles constitute a 4-hour episode of sleep for the newborn. At age 3 months, diurnal influences begin to affect sleep-cycle organization (Ferber 1999).

Early sleep cycles have 40-50 minutes of NREM sleep and 10-20 minutes of REM sleep; in sleep cycles later in the night, the reverse is true. Thus, NREM sleep, especially Stage 4 NREM sleep, shifts to the beginning of a sleep period, and REM sleep predominates later in the sleep period. As the continuous periods of sleep consolidate and lengthen, the number of REM-NREM sleep cycles increases.

However, the 50- to 60-minute sleep cycle itself does not lengthen until adolescence, when the 90-minute sleep cycle of mature adults is achieved. Another noteworthy developmental landmark occurs at sleep onset. When young infants make the transition from wakefulness to sleep at the beginning of their night, their initial sleep-onset state is typically REM sleep. By age 3 months, sleep-onset REM periods begin to be replaced by sleep-onset NREM periods. By the time the child is 1 year old, transitions from waking directly to REM sleep are rare.

Appreciating these maturational changes is useful for clinicians in differentiating many of the common sleep disorders that affect infants, children, and adolescents.

 

 

 

 

 

 

 

 

   [advanced search]   
Interactive Quiz:
1. The most common form of contraception used by couples in the United States is
Pills
Condom
Diaphragm
Intrauterine device (IUD)
Permanent sterilization



Health Centers

  Physiological Basis of
  Sleep and Wakefulness


  - NREM sleep

  - REM sleep

  Sleep Disorders

  - Dyssomnias

  - Parasomnias

  Childhood Sleep Disorders

  Sleep and Sleep Disorders

  Common Sleep Disorders

  Healthy Sleep

  Sleep and gender

  Sleep and obesity

  Classification of
  sleep disorders


  Timing of sleep

  Sleep hygiene

  Sleep and age

  Structure of sleep

  What Is Sleep?

  What Makes You Sleep?

  What Does Sleep
  Do for You?


  Types of Sleep

  How Much Sleep Is Enough?

  Top 10 Sleep Myths

  What Disrupts Sleep?

  Good Night's Sleep

  Is Snoring a Problem?

   Sleep Apnea

   Restless Legs Syndrome

   Narcolepsy

   Parasomnias

   Diagnose

   Common Signs

   Susceptible to sleep apnea

   Do You Have
  a Sleep Disorder?


» » »


Health Centers





Diabetes









Health news
  


Health Encyclopedia

Diseases & Conditions

Drugs & Medications

Health Tools

Health Tools



   Health newsletter

  





   Medical Links



   RSS/XML News Feed



   Feedback






Your Guide to Healthy Sleep
Add to My AOL

Add to Google Reader or Homepage