Insomnia and other sleep disorders, such as sleepwalking, nightmares, night terrors, obstructive sleep apnea, narcolepsy and even wetting the bed, affect children as well as adults. When kids have sleep disturbances, the daytime effects are numerous and include drowsiness, disciplinary problems, irritability, depression, hyperactivity, difficulty concentrating and aggression. Because kids may be unable to articulate to their parents that they are having difficulty sleeping or may not even realize it in the first place, it is often not evident when a child has a sleep disorder. Given the comprehensive nature of these manifestations, the availability of effective remedies is crucial.
Establishing a Routine
Fixed bedtimes are a well-established means of ameliorating or eliminating a number of sleep disorders in children. Toddlers--who frequently have problems with disorders of initiating and maintaining sleep, or DIMS, and need more sleep than anyone--often ask for another drink of water or another story. When they do, bedtime should be postponed via quiet but firm refusals to accede. Ultimately children internalize the idea that bedtime is bedtime and separation anxiety wanes. At the other end of the childhood spectrum, adolescents, who often encounter delayed sleep syndrome as parental control over their behavior dwindles, should be encouraged to adhere to strict and consistent bedtimes.
Active Parental Involvement
Nonpunitive parental support can make a tremendous difference in helping kids overcome sleep difficulties. Once children approach and reach school age, nightmares and night terrors become more common. Kids between the ages of 3 and 8, who are frequent sufferers of night terrors, can be awakened at scheduled intervals and given reassurance that dreams are only dreams, that they will happen from time to time and that their parent or parents will always be there. Preadolescents, on the other hand, are frequent sleepwalkers. The danger of falls and similar mishaps is significant, and their environments should be made especially safe, for example, by blocking access to lower floors via staircases.
Medications
Most professionals feel that medications should be used to treat sleep disorders in children only when nonpharmacological methods have proven ineffective. Medications used to induce sleep in adults, such as Ambien, Lunesta, Rozerem and others, are not approved by the FDA for use in children. As a last resort, over-the-counter drugs such as Benadryl may be used, as may benzodiazepines, the class of drugs to which Valium and Klonipin belong. Benzodiazepines have a high addiction potential. One exception to the drugs-as-last-result standard is enuresis, the clinical term for bed-wetting, as this condition often responds very favorably to pharmacological intervention. Melatonin, a nutritional supplement rather than a drug per se, has been put to use on occasion.
