Sleep & Insomnia in Children

Sleep is a normally recurring state characterized by lessened consciousness, awareness of the surroundings and movement.  In humans, the main sleep episode usually occurs as one consolidated period of approximately 8 hours every night, and accounts for about one third of human life. 

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Why is sleep important?

Sleep is essential at all stages of life. In childhood, where neuronal development occurs, adequate sleep, both in terms of quantity and quality, are particularly essential. 

The optimal amount of sleep one should have each night varies between individuals. Babies need as much as 19 hours every day. By the time children begin school, they need 10-12 hours per night.   However, research shows teenagers tend to sleep less as they go to bed later, which result in an increased level of sleepiness and inattention during the day. 

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Sleep has also been linked to the correct functioning of various vital organs and metabolic processes such as:

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• Regulation of fat in the liver that can lead to severe issues like diabetesand obesity

• Reduced risk  of cardiovascular disease

• Vital brain functions such as cognitive functioning, learning, memory, decision making and behavior

• Hormone secretion

• Immune system function

 

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What is the mechanism behind sleep?

Our sleeping patterns are governed by the circadian rhythm, the cyclical changes in the body over a 24-hour period. In humans these rhythms are set to overlap the day-night period by the brain’s ‘clock’, a region known as the suprachiasmatic nucleus (SCN). The circadian clock regulates when we sleep and when we are awake. 

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The brains’ clock is very sensitive to the hormone melatonin, the signal of darkness. It is produced in the pineal gland and is released into the brain and blood. Melatonin production is diminished by bright light exposure and is raised to high levels as night falls and in accordance with circadian clock. Melatonin continues to deliver the darkness signal to the body throughout the night period to ensure proper control of homeostatic systems such as sleep and blood pressure rhythms. 

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What is insomnia?

Insomnia disorder is defined as having a sleep difficulty occurring at least 3 nights per week and being present for at least 3 months. These difficulties may include one or more of the following symptoms: 

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• Delayed Sleep Onset

• Maintained Sleep

• Early morning awakening. 

 

According to DSM-5, people who suffer from insomnia are affected also the next day: they feel tired, unrefreshed and often will find it difficult to function during the day causing distress and impairment in social, occupational, educational, behavioral and other important areas of daytime functioning. 

 

The prevalence of insomnia in children that goes beyond bedtime refusal and night awakenings ranges from 1-6% in the pediatric general population and is as high as 50-80% in children with neurodevelopmental or psychiatric comorbidities including ASD. 

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New studies demonstrate the negative consequences of sleeplessness in children and adolescents, including hyperactivity, irritability, restlessness, poor concentration, impulsiveness, suicide risk, and poor memory. Families of children with sleep disturbances also suffer from sleep deprivation, exhibiting negative effects on daytime function and well-being, as well as elevated levels of family stress, mood swings, relationship instability and others. Furthermore, chronic sleep disturbance in ASD children is a frequent cause of families placing their children into care.