One night, Angela Lim, 35, roused to the sounds of someone trying to open her front door. Fearing a burglar, she cautiously went to the living room with her husband to investigate. To her relief — and horror — her 4-year-old son Joshua was trying to open the locked door. He had been sleepwalking.
Says Lim, a fitness instructor, “It was the first time Joshua walked out of his room in his sleep. Previously, he would talk or shout in his sleep, and sometimes, he would sit up or climb off his bed to lie on the floor. It is very worrying. With the constant talking and moving around at night, I’m worried about his safety and that he is not getting enough quality sleep.”
The number of young children with sleep problems is climbing. Dr Mahesh Babu Ramamurthy, head & senior consultant, Division of Paediatric Pulmonary and Sleep, National University Hospital, notes that in Singapore, almost 44 per cent of parents of children under age 3 reported that their kids have sleep problems.
Here are sleep issues that your child may face.
Children who are afraid of the dark, of being alone or have a vivid imagination (monsters!) will have trouble falling asleep.
Snoring — noisy breathing during sleep — occurs when the flow of air through the mouth and nose is obstructed.
A combination of factors can cause the obstruction — obstructed nasal airways, poor muscle tone in the throat and tongue, bulky throat tissue, large tonsils and adenoids or a long soft palate and/or uvula. Snoring may be harmless but it may also result in poor quality sleep.
Snoring may be harmless but it may also result in poor quality sleep.
3. Obstructive Sleep Apnoea (OSA)
This happens when the tongue, tonsils, or other tissues in the back of the throat block the airway. When a child tries to breathe in, the air cannot flow through.
Children with OSA snore so loud, they can be heard in the neighbouring room. They may even stop breathing — briefly — while they sleep, and gasp before breathing resumes.
Such children face two problems — inadequate sleep from disrupted sleep patterns and possible blood pressure and heart problems in the long-term because their oxygen concentrations may drop during sleep. This could stunt their growth, while their memory and learning behaviour may be affected.
4. Sleeptalking and Sleepwalking
Fairly common, children usually outgrow these two disorders by adolescence. When a child walks in his sleep, he might fall off the bed, trip on any loose wires, pull down something unstable for support or even walk out of the house.
The grinding of teeth or the clenching of jaws during sleep. Although quite common among children, most outgrow it. Bruxism often happens during the deep sleep phase or when there’s stress.
These kids may grind because the top and bottom teeth are misaligned or in response to pain, such as from an earache or teething. Bruxism has no ill effects in most cases.
Studies have shown that sleep disorders like sleepwalking may run in the family. Insomnia and nightmares are more likely in generally anxious children, who may also have separation anxiety.
Dr Mahesh notes that parents should bring their children to see a paediatrician first if they have such sleep issues. He adds, however, that sleepwalking and sleeptalking are transient, as the child will grow out of it without needing therapy, but advises that children who snore loudly see a doctor.
If necessary, the GP might write a referral to paediatrician who specialises in respiratory medicine.
Insomnia and nightmares are more likely in generally anxious children, who may also have separation anxiety.
Children with mild sleep issues may be prescribed nasal sprays, while those with moderate to severe problems will sometimes require a simple surgical procedure (adeno tonsillectomy).
Occasionally, a child might require support in the form of Continuous Positive Airway Pressure (CPAP), where a machine will deliver air under pressure to the nose/mouth.
Dr Mahesh explains, “This pressure keeps the breathing pipes open and helps children with snoring.”
Talk to your paediatrician if your child displays the following signs of a sleep problem:
• Loud snoring.
• His breathing pauses or he chokes in his sleep.
• Difficulty falling asleep.
• Difficulty sleeping through the night.
• Difficulty staying awake during the day.
• Unexplained decrease in daytime performance.
• Unusual events during sleep such as sleepwalking or he has nightmares.
A child who sleeps through the night at a regular time and wakes up in the morning feeling refreshed is unlikely to have any major sleep problems.
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