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Home » Sleep Disorders

Psychiatric Times. Vol. 23 No. 11
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Assessment and Management of Sleep Disorders in Children

By Anna Ivanenko, MD, PhD and Clifford Massie, PhD | October 1, 2006



Sponsored by CME LLC for 1.5 Category 1 credits.
Original release date 10/06. Approved for CME credit through September 2007.


Educational Objectives

After reading this article, you will be familiar with:

  • The phenomenology of sleep disorders in children and adolescents
  • Diagnostic studies in the evaluation of pediatric sleep disorders
  • Treatments for pediatric sleep disorders

Who will benefit from reading this article?

Psychiatrists, pediatricians, primary care physicians, neurologists, nurse practitioners, psychiatric nurses, and other mental health care professionals. Continuing medical education credit is available for most specialties. To determine whether this article meets the CE requirements for your specialty, please contact your state licensing board.

Dr Ivanenko is a board certified specialist in psychiatry, child and adolescent psychiatry, and sleep medicine. She is an assistant professor of psychiatry and behavioral neurosciences at the Loyola University Stritch School of Medicine in Maywood, Ill; in addition, she is director of pediatric sleep medicine of the Chicago Sleep Group at the Sleep Disorders Center at Alexian Brothers Medical Center in Elk Grove Village, Ill, and the Sleep Center at Central DuPage Hospital in Winfield, Ill.

Dr Massie is a licensed psychologist and is board certified in sleep medicine and behavioral sleep medicine. He is clinical director of the Chicago Sleep Group at the Sleep Disorders Center at Alexian Brothers Medical Center in Elk Grove Village, Ill, and the Sleep Center at Central DuPage Hospital in Winfield, Ill.

The authors report that they have no conflicts of interest regarding the subject matter of this article.

Sleep disorders are highly prevalent across the life spans of many persons. Epidemiologic studies comprising infants, children, and adolescents indicate a high rate of reported sleep problems. Most of these studies refer to problematic or disrupted sleep with frequent nocturnal awakenings, delayed sleep onset, and restless sleep; the studies also include behaviors associated with sleep, such as sleepwalking, sleeptalking, snoring, witnessed apneas with gasping for air, excessive daytime sleep, and daytime sleepiness. Many of the studies used parental reports or self-reports but some studies used more objective measurements, including actigraphy or polysomnography (PSG).1-3

About 25% of children experience some type of sleep-related problem during their development. A recent large study of children in a community sample found sleep problems in 20% of children aged 5 years and in 6% of those aged 11 years.1 Other studies of school-aged children showed the prevalence of sleep problems to be as high as 37% and 50%.2,3 The high rates of sleep complaints that have been reported by adolescents include problems with sleep initiation, maintenance, and excessive sleepiness due to chronic sleep loss. Recent survey data from a random sample of 1014 adolescents revealed a 10.7% lifetime prevalence of insomnia with a median age of onset at 11 years; 52.8% of those with insomnia also had another psychiatric disorder.4

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Drugs Mentioned in This Article
Clonazepam (Klonopin, Rivotril)
Dextroamphetamine (Dexedrine)
Diazepam (Valium)
Diphenhydramine HCI (Benadryl, others)
Gabapentin (Neurontin)
Lorazepam (Ativan)
Melatonin (Bevitamel)
Methylphenidate (Ritalin LA)
Modafinil (Provigil)
Montelukast (Singulair)
Pramipexole (Mirapex)
Ropinirole (Requip)
Trazodone (Desyrel)

Evidence-based Medicine:

  • Kuhn BR, Elliot AJ. Treatment efficacy in behavioral pediatric sleep medicine. J Psychosom Res. 2003;54:587-597.
  • Owens JA, Babcock D, Blumer J, et al. The use of pharmacoltherapy in the treatment of pediatric insomnia in primary care: rational approaches. A consensus meeting summary. J Clin Sleep Med. 2005;1:49-59.


 
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