Sleep Disorders in Children and Adolescents
Sleep, which is one of the most basic needs of human beings, is very important in the development of attention and learning processes in the brain. It is a special form of mental activity. It is an active and neuronal process. There are special areas in the brain related to the initiation and maintenance of sleep. Although it is important in every period of life, it is gaining more importance especially in infancy and childhood, which is the fastest period of brain development and growth. It is difficult to describe a normal sleep. Because the sleep - wake cycle varies according to age, gender, light - dark state, exercise status, stress and diseases. Sleeping is a normal sleep that makes you feel physically and mentally ready when you start your day.
In the first years of life most of the day is spent asleep. Newborn babies sleep 14 to 16 hours per day on average. The concept of night sleep is not exactly available, as they sleep both day and night. The concept of night sleep starts to become clear around the age of 1. The need for daytime sleep decreases by around 3 years of age. Morning sleep does not continue after 1-2 years. As the age grows, the body's need for sleep decreases, and during adulthood, close to adult sleep hours (8 to 10 hours) are settled.
Sleep disorders can be caused by many different causes. These are the most common problems that arise from attitude and border problems of parents, who can easily recover when the help is sought. Many mental illnesses (depression, anxiety, attention deficit hyperactivity disorder, autism spectrum disorders, etc.) can be accompanied by sleep disorders. Although there is no mental illness, one of the most frequent reactions to stressful events is sleep disorders. Also, sleep disorders are seen due to medical diseases (gastroesophageal reflux, pain, allergy, asthma, etc.).
Sleep disorders can lead to learning, attention and memory problems, nervousness, daytime sleepiness and mental illnesses, especially in long-term sleep disorders. It is very important to solve these problems in childhood when the brain development is very fast.
Sleep disorders are seen in approximately 20-30% of children.
FREQUENTLY SLEEP DISORDERS
NIGHTMARE
The most common age group is 3 - 5 years. But it can happen in every period of life. It usually occurs late in the night because it is more frequent in the second half of sleep. It may be more frequent in periods of increased stress and anxiety. There is no specific treatment. It is important to investigate and treat the underlying causes. Children may increase after exposure to inappropriate horror cartoons or video games. It may also increase after periods of stress and anxiety.
NIGHT / SLEEP TERRORISM
It is common between 1,5 - 10 years. The incidence is 40% in preschool children. Since it's the first half of sleep, it's early in the night. The child sits in his bed 2 to 3 hours after sleeping, shouting or crying in fear. His eyes are open, but the gaze is blank and dull. The duration may vary from 30 seconds to 3 minutes. In the morning, the child does not remember or very little (if not awakened) because he is heavily in sleep. Daytime sleep may be recommended as it may increase during very tired times. Again, scheduled wake-up can sometimes work. Differential diagnosis is important when it starts in adolescence.
UYURGEZERKLİK
The incidence is 15% in children. It starts most often between 4 and 8 years of age and decreases towards puberty. The repeater is periods of waking up and crawling during sleep. The eyes are still open and motionless, the gaze dull. Again during the heavy sleep period is not remembered in the morning or little remembered. In addition to walking, actions such as walking out the door or urinating in the wrong place can be seen. It is very important to take home safety precautions. Although sleep hygiene and programmatic wake-up benefit, the problem needs to be resolved with professional help.
SLEEP MOVEMENT DISORDERS
Normally all our muscles are paralyzed except for the respiratory and eye muscles when we dream. These individuals do not develop this paralysis, which is normal during a dream. And one moves when he is dreaming. He can kick, hit someone near him, he can flutter. This can be confused with other sleep disorders or epilepsy. Benefit from treatment.
OBSTRUCTIVE SLEEP APNEA
A person's breathing during sleep is called apnea, and a partial discontinuation is called hypopnea. May be caused by brain or respiratory tract. In long-term apneas, oxygenation of the brain is impaired, which is a very serious condition. Generally, individuals with this disease complain of snoring during night sleep, waking tired during daytime and sleepiness.
NON-LEG LEG SYNDROME
Resting in the evening, legs appear in restlessness, desire to move, chills, tingling, burning, itching or pain manifests itself. In the light ones, this feeling of restlessness is eliminated by movement. There are also leg movements during sleep. Control of symptoms and treatment of underlying diseases are important.
narcolepsy
Children and adolescents usually present with excessive, uncontrollable daytime sleepiness. Patients suddenly fall asleep while talking or eating at unexpected times. The duration of these sleeps may take hours. The second symptom is the sudden loss of muscle strength when a strong emotion occurs (excitement, sadness, happiness) or during laughter. This condition called 'cataplexy' is seen in 50-70% of narcolepsy cases in children. Sleep paralysis and hallucinations during sleep may occur in some of the cases. It is caused by the lack of nerve cells that provide alertness in the brain. The diagnosis is clarified by special sleep tests and analysis of a specific substance produced by the sleep cells in the cerebrospinal fluid. Benefit from treatment.
SLEEP - AWARENESS DISORDERS RELATED TO SIRKADIAN RHYTHM (24 HOURS)
The 24-hour sleep-wake cycle is called “circadian rhythm.. It varies according to age, sex, light - dark state, exercise status, stress and diseases. It is a sleep disorder especially seen in adolescents. While the need for physiological sleep increases parallel to academic life in adolescents, there is a change in sleep time patterns due to increasing social activities. At the same time, the hormone melatonin released at the beginning of sleep begins to be released later. For all these reasons, phase delay occurs in the circadian rhythm of adolescents. This sleep disorder can also be seen on long journeys and shift workers.
bruxism
It is the state of grinding teeth during sleep. It can be seen at any age. It causes abrasion of the jaw joint and teeth. To prevent abrasion of the teeth, a personalized intraoral apparatus should be used. It can cause headaches due to pressure. It is recommended to investigate and eliminate the underlying causes (stress, etc.).
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