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Common sleep disorders in children include narcolepsy, sleep disordered breathing, circadian rhythm disorders, parasomnias, restless leg syndrome, periodic limb movements in sleep, and periodic limb movement disorder.
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These disorders can have a wide range of effects in children, including severe daytime sleepiness, abnormal behaviors, hyperactivity, lack of concentration, and difficulties in school.
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Ongoing research is helping to clarify the pathophysiology and clinical features of these
Review of Narcolepsy and Other Common Sleep Disorders in Children
Section snippets
Key points
Narcolepsy
Narcolepsy is a complex sleep disorder that can manifest in childhood or adolescence. It is the most common cause of excessive daytime sleepiness and can occur in isolation or in combination with other symptoms such as cataplexy, hypnogogic/hypnopompic hallucinations, disturbed nocturnal sleep, and sleep paralysis [3], [4]. Cataplexy distinguishes type 1 (narcolepsy with cataplexy) from type 2 narcolepsy (narcolepsy without cataplexy) [4]. Cataplexy is reported by 60% to 75% of patients with
Sleep disordered breathing in children
Sleep disordered breathing (SDB) refers to several different disorders that affect the quality of oxygenation and ventilation during sleep. About 1% to 5% of children have SDB, and some may have more than 1 disorder simultaneously [1], [21]. SDB prevalence is much higher in children with certain risk factors, especially those with underlying genetic syndromes (eg, Down syndrome), craniofacial abnormalities, and neuromuscular disease.
Circadian rhythm disorders
Circadian rhythm, a biological process that has an endogenous and entrainable oscillation of about 24 hours, is controlled by the suprachiasmatic nucleus located in the anterior hypothalamus. Circadian rhythm disorders (CRSDs) occur when there is a desynchrony between the biological and environmental clocks and can occur when the person’s natural circadian timing differs from the sleep–wake times required by work or school [4], [30]. Zeitgebers, German for “time givers,” are cues or entraining
Parasomnias in children
Parasomnias are classified by the International Classification of Sleep Disorders as non-REM (NREM) sleep arousal disorders and REM sleep behavior disorders. Parasomnias occur in 10% to 28% of children and differ in pathophysiology and management from sleep–wake disorders in adults. The NREM parasomnias are most common in children and adolescents but may persist into adulthood [36] (Table 1).
NREM-related parasomnias can be triggered by significant sleep deprivation, OSA, fever, psychological
Restless legs syndrome, periodic limb movements in sleep, and periodic limb movement disorder
Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a common neurologic sensorimotor disorder that manifests as an irresistible urge to move the body to relieve the uncomfortable sensations. These sensations always occur during resting, sitting or sleeping. Pediatric RLS, which occurs in about 2% of children [41], commonly worsens at night, causing difficulties with initiating sleep [42]. In adults, it is more prevalent in females, but there is no gender difference in pediatric
Summary
In recent years, an increased understanding and awareness of sleep disorders in children have been achieved. Further understanding and research into the pathophysiology, epidemiology, clinical evaluation methods, sequelae, and supportive treatment options for children with sleep disorders are needed to effectively manage them in the clinical settings. Clarification of the important role that sleep disturbances play in children with medical, developmental, and mental health disorders is a goal
Acknowledgments
I would like to acknowledge Elizabeth Kociolek, MS, BA for her administrative support in composing this manuscript.
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Cited by (4)
Sleep and Epilepsy, Clinical Spectrum and Updated Review
2021, Sleep Medicine ClinicsCitation Excerpt :Fig. 17 highlights a conceptualized flowchart in the approach to the differential diagnosis of sleep-related movement disorders. Cataplexy refers to an abrupt but brief (<2 minutes) loss or decrease of voluntary skeletal muscle tone with retained consciousness precipitated by strong emotions, such as anger, laughter, joy, elation, or surprise65–67 (Figs. 17–19). It is estimated to be present in 65% to 75% of patients with narcolepsy68,69 and is the most specific symptom of narcolepsy type I.
Typical case of narcolepsy in paediatrics
2021, BMJ Case ReportsSleep disorders in children and adolescents
2020, Chronic Disease and Disability: The Pediatric Heart, Second EditionComorbidity of Narcolepsy and Psychotic Disorders: A Nationwide Population-Based Study in Taiwan
2020, Frontiers in Psychiatry
Disclosure: The authors have no conflict of interests or relevant disclosures to declare.