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Signs and Symptoms That Your Child Isn’t Sleeping Well

When children have health or behavioral issues, parents look for answers. But here’s one possibility that parents sometimes overlook: sleep problems.

Up to 50% of children will have some type of sleep issue, which can cause or exacerbate a surprisingly wide range of health and behavioral issues. Sleep problems can trigger bedwetting, long after a child has been potty trained. A child may begin struggling in school due to sleep problems. Poor sleep can even cause repeated bouts of strep throat or ear infections.

Unfortunately, diagnosing sleep problems in children is challenging. Children aren’t always aware they’re not sleeping well. Instead of fatigue or drowsiness, a sleep-deprived child may exhibit hyperactivity or other behavioral issues.

Sometimes, parents discover sleep problems by accident. While on vacation, family members sleep together in a hotel room. Often, that’s the first time that parents notice that their child snores or sleeps restlessly. Pediatric sleep clinics tend to see an uptick in new patients after spring break or summer vacation.

If you are concerned your child may have a sleep related conditions, look out for the signs below.

Disrupted Sleep

Some sleep problems in children are obvious. The child can’t go to sleep in the evening, wakes often during the night, has trouble waking in the morning or can’t stay awake during the day. But many problems aren’t so clearly linked to sleep. Here are some signs to keep an eye on:

Restless sleeping. Babies or children who move around often at night—five times or more per hour—could have disordered sleep.

Restless legs. Legs that that twitch or jerk during the night could be signs of restless legs syndrome (RLS) or periodic limb movement disorder (PLMD).

Abrupt arousals or pauses in breathing. If you notice your child stops breathing for periods of time while asleep, or jerks awake frequently during the night, that’s a symptom that could signal disordered sleep breathing.

Snoring. Snoring is not normal for a child. Snorting, rasping or gasping sounds should be investigated.

Parasomnias. Another big concern for many parents are “parasomnias”—nightmares, night terrors, sleep eating or sleep walking. Depending on how often they occur, they could be a sign of a sleep related disorder.

New onset bedwetting. Lack of sleep prevents the release of hormones, causing the body to produce more urine. As a result, the child wets the bed. If your child has been potty-trained and stayed dry at night for a long period of time—then starts wetting the bed again—that could signal a sleep problem.

Multiple nighttime bathroom breaks. A child getting up frequently at night to use the bathroom may have sleep problems or even diabetes.

Frequent infections. Children with disordered sleep breathing may snore or sleep with their heads tilted back, an unconscious attempt to open up the airway. That prevents mucus from draining normally, leading to frequent ear infections or instances of strep throat.

Behavioral issues may arise from sleep problems. These can include irritability, learning difficulties, even poor academic performance. Many times, behavioral problems in children caused by lack of good quality sleep can mirror those of attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD).

Many pediatricians and other practitioners may not explore the possibility of sleep problems. It’s not uncommon for a child to be diagnosed with ADD or ADHD for problems that stem from poor sleep. Always investigate the possibility of sleep problems when a child or teen begins exhibiting new behavioral issues that weren’t previously occurring.

The Next Step

The American Academy of Pediatrics recommends a sleep evaluation for children who exhibit one or more of these symptoms. In a sleep evaluation, you’ll meet with a board-certified sleep specialist to discuss your concerns about your child’s sleep. The specialist may recommend a polysomnography, or sleep study, a comprehensive test for diagnosing sleep disorders. Based on the results of the sleep evaluation, a sleep medicine physician will make a diagnosis and identify the best treatment plan for your child’s condition.

Finally, remember that not all sleep issues are caused by medical conditions. With babies and toddlers, parents often establish habits that unknowingly encourage the baby to awake in the middle of the night for feeding or even socializing. A sleep specialist can advise parents on the best way to adjust night-time and sleep habits for improved sleep. Many issues can be prevented or addressed by making sure your child is practicing good “sleep hygiene.”

The bottom line

If you recognize any of these symptoms or suspect your child may have a sleep disorder, talk with your pediatrician. Ask if a sleep evaluation is needed.

With the right diagnosis and treatment plan, you may be pleasantly surprised by how much happier and healthier your child becomes with the benefit of a good night’s sleep.

Promoted content provided by Pediatric Sleep Institute at Texas Health Center for Diagnostics and Surgery.