Sleep disturbances in children
Sleeping

Sleep disturbances in children

Some practical and expert advice on what to do if your child is experiencing sleep disturbances.

For any parent to witness their child experiencing sleep disturbances such as sleep walking, nightmares and night terrors can be a very startling experience. However, it is not a representation of a psychological or emotional disorder. It is a representation of a maturing neurological system.

According to mum of four Lucy Wolfe, a paediatric sleep consultant; “Any of these presentations can be very unnerving for the observing parents, but typically the child is completely unaffected. Children with abnormal sleeping schedules may be more vulnerable to these sleep disturbances. Beyond the age of two, as many as 70 per cent of children will experience a sleep disturbance at some time.”

Types of sleep disturbances in children

1. Sleep walking

Sleepwalking can occur up to 12 times per year in around five per cent of children between the ages of six to 16 years old. An additional five to 10 per cent of children may sleep walk one to two times per year. It has been suggested that there is genetic factor also, and boys are more likely to experience this sleep concern.

Typically, sleep walking, a partial arousal parasomnia disorder, will occur within the first one to three hours of going to sleep when the brain is entering a slow wave type sleep. Despite the fact that your child appears to be awake, this is often not the case. “Each episode may last for up to 20 minutes and mostly parents will be ineffective here until the situation has passed. It is unlikely that your child will remember the next day,” explains Lucy.

A large concern with a sleep walker is safety, so it is a good idea to be prepared if your child has demonstrated a vulnerability to this disorder. Although your first instinct might be to wake your child up, you should not disturb them, Lucy explains. “Parents should be encouraged not to intervene, as waking your child may potentially upset your child unnecessarily. Gently guide your child back to bed and remain with them until they have settled back to sleep.”

Lucy’s top 5 tips on sleep walking:

1. Keep the floor clear of toys or large furniture that your child could stumble over.

2. Ensure that windows and doors are locked and secure.

3. Use a stair gate at the top of the landing.

4. Don’t allow your child to sleep in the top bunk.

5. Use an alert system like a bell hanging over their door to signal to you that your child is on the move

2. Sleep talking

A less worrying, yet a very common sleep disturbance, is sleep talking which is just as common in adults as it is in children. Where children are concerned, they more likely to talk in their sleep because the linguistic centres of the brain are highly stimulated, particularly in the preschool years.

“From three to ten years old almost 50 per cent of children will chat in their sleep at least once a year,” says Lucy. “Once again, boys may be more inclined to experience this sleep disturbance. It is not unusual for children to shout out simple phrases such as ‘I don’t want to’, or ‘go away’. There is no need to worry, it is a normal presentation.”

3. Nightmares

Nightmares are also a normal part of development and happen during the second part of the night during Rapid Eye Movement, better known as REM or ‘dreaming sleep’.

It is a very common complaint especially between the ages of three to six years, with studies suggesting that 25 per cent of children have at least one nightmare per week.

According to Lucy, ”A nightmare can be very alarming for a young child and the fear is very real: normally represented by being chased or stuck somewhere. Your child will typically call for you or come into your bedroom looking for reassurance and comfort that you should provide.”

It can be useful to avoid allowing your child to be exposed to scary or frightening images, programs or audio. Lucy suggests: “Carefully pick the type of books that are read at bedtime and be mindful of anything that may cause fear and anxiety. Talk to your child about what disturbs them, ideally during the day and consider a coping mechanism for scary thoughts like a monster spray, a magic wand or shield or a special stuffed toy to keep him or her safe.”

Lucy’s top 5 tips for dealing with nightmares:  

1. If you are open to it, have the family pet share the room with your child.

2. Have siblings share, as long as they behave!

3. Don’t let them play with iPads or watch TV before bed.

4. Ensure that your child is relaxed ahead of bedtime, avoiding stimulating activity, televisions and computer games, for example.

5. Be mindful of what your child is seeing and hearing to avoid anxiety.

4. Night Terrors

Often parents would mistake night terrors as being a nightmare. However, the difference between the two can be easily identified; typically night terrors can happen within the first few hours of sleep, during deep ‘non-REM’ sleep.

Lucy explains, “During an episode, the child jolts awake from a deep sleep, wide eyes, frightened, screaming/shouting and possibly sweating with a racing heart. As this is a partial arousal disorder, your child is not awake, will not recognise you or realise you are there; he/she may push you away while at the same time call for you.

Unfortunately, this can last for up to 15 minutes and then end. Your child usually won’t even remember having the night terror. It can be very upsetting for us parents to witness our children so distressed; thankfully, they are not a representative of a psychological disorder.”

She continues, “Commonly, night terrors will happen within two hours of the onset of sleep, but I have experience in my practice of them happening throughout the night and/or the early part of the morning, but this is extreme and commonly a child who is not efficient at sleeping independently.”

So what is the single biggest cause of night terrors? “It is being over-tired. You need to ensure that your child gets enough sleep and this can in some instances diminish significantly and in others completely eliminate the phenomenon.” Even something as simple as sending your child to bed a half an hour earlier can hep. As Lucy suggests “As little as an extra 30 minutes of sleep at the start of the night can make all the difference.”

Lucy’s top 5 tips for dealing with sleep terrors:

1. Don’t try to wake your child, there is no benefit for them to be roused and they may be more upset on wake up, as they are not officially awake during the night terror.

2. Avoid touching or picking up your child as this can sometimes prolong the terror.

3. Ensure that your child is safe and cannot come to harm during his/ her thrashing about.

4. After the episode, guide your child back to bed.

5. Stay with your child and reassure them afterwards until they are calm and have gone back to sleep.

Lucy recommends that if there is regularity to the night terrors, by keeping a sleep diary you may be able to see a pattern. “If they are happening two to three times a week at the same time, you can try to pre-empt the partial awaking of your child 15 minutes before the episode typically happens; for example to help them roll over and stay with them until they go back to sleep. When this is implemented for up to ten nights, it may help to break the cycle.”

If you are in any doubt about your child’s sleep disturbances, it is advisable to seek medical advice.

About Lucy: Lucy Wolfe, CGSC, MAPSC, is a paediatric sleep consultant and mum of four young children. She runs a private sleep consulting practice where she provides knowledge, expertise and valuable support to families across the country. Visit: www.sleepmatters.ie

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Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.

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Q. I’m would like to start an exercise programme that will benefit my emotional health as much as my physical health, but I don’t know which type of class would be best. Should I consider choosing from yoga, pilates, tai chi, or could you recommend a class, please?

A It’s great that you have decided to get into exercise. The benefits to you are going to be great. You’ll sleep better, have more energy, better skin, reduced stressed, not to mention all the amazing physical benefits of your clothes fitting better, and looking healthy, trim and toned! My advice to you would be to try them all. Even if some don’t offer pay-as-you-go sessions, if you get in touch directly with the instructor, they will almost always let you try it out first to see if it’s for you. All of the above things that you mentioned are great for mental health, so it really will be a personal preference as to which you go for. On top of the classes you mention, all forms of exercise will give you great mental rewards so consider the not so obvious interval training sessions, bootcamp, and circuits too, as you will also feel on top of the world after a class like that.