Sleep Physiology and Sleep Disorders in Childhood

Sleep is important and critical to each person from babies to old-aged people. It helps in improving, developing and maintaining ones health generally including both mental and physical. When one is in the state of sleepiness, they are in consciousness whereby the bodys metabolisms are carried out normally but at a decreased pace. When one goes to sleep, they do not directly move into the deepest phase of sleep, but they have to transit through a number of stages. Whereby; one transits from light sleep to the deepest of all sleep. Rapid eye movement (REM) and Non-rapid eye movement (NREM) are the two phases of sleep. Dreaming mainly occurs in the rapid-eye movement phase.

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The amount of hours one sleeps at night varies depending on the age group in which one is. This hugely relies on the development stage at which one is and the temperament. Adults require a maximum of 8 hours of sleep whereas children tend to take the most hours of sleep approximately 16-18 hours at most in a day.

Childhood age ranges from the infancy stage to toddlerhood to preschool to school age. During this time, as much as a child requires most sleeping hours, these hours vary from one stage to the other. A newborn infant tends to sleep the most. They sleep during the day and night too. This totals to approximately 16-18 hours in a day. A toddler may require up to 14 hours of sleep in a day. Toddlers are physically active as compared to infants. Children in the preschool age group tend to be more troubled with nightmares and night terrors than younger children. Most of these children in the preschool age group do not want to go to bed because of having the assumption and fear that a monster might be lurking under their beds. As children grow up and start going to school, they become busier and are faced with many sources of stress. Therefore, children who have started attending school require from 8 to 10 hours of sleep.

Sleep disorder tends to affect 15-30 % of the young children under the age of 10 years and may occur quite a number of times in a week or a month. These disorders occur as a result of a symptom of the central nervous system development as well as external stressors in the outside or even the home environment. Sleep disorders as a result of increased stressors mainly occur to children in the school-age age group. A few numbers of times, some of these orders are as a result of physical and mentally associated problems which in most cases occur in children who are either hyperactive or attention-deficient. In other cases, these children might have been subjected to physical and sexual abuse.

The sleeping disorders are mainly categorized into Dyssomnias and Parasomnias, which include; excess daytime sleepiness, difficulties with sleeping (Dysomnias), or undesirable experiences when ones asleep (Parasomnias). Dysomnias disorders cause too little sleep which may be caused by either excessive sleepiness during daytime, or difficulty initiating and maintaining sleep. They may include primary insomnia, primary hypersomnia, narcolepsy, breathing-related disorders and circadian rhythm disorders. Dysomnias disorders can be intrinsic, extrinsic or circadian rhythm. Parasomnias disorders are undesirable phenomena that mainly occur when one is asleep. This may be as a result of inappropriately timed activation of physiological systems. Parasomnias cases may include; sleep terrors and nightmares and sleep walking.

(Montgomery and Dunne, 2006) Sleep problems tend to be greater in prevalence and severity among children with physical and learning disabilities. For example, pain is related to sleep disturbance, and attention paid to helping the child sleep better is likely to improve recovery. Visually impaired children are most affected by circadian rhythm problems: they have a poor light perception and their primary cue for sleep onset is lost. Disabilities such as Smith Maenis, Prader-Willi, and Williams syndrome have cardinal features whereas Downs syndrome and mucopolysaccharidoses are associated with sleep-related breathing problems.

Sleep Apnea is one of the sleep-related breathing problems whereby breathing is disrupted during sleep. Usually, the breathing process is restarted by the brain but associated with a physical toll. The central and obstructive sleep apneas are the two types of sleep apnea. The former being less common; happens when there is a failure in the sending of appropriate indicators to the inhalation muscles by the mind to start breathing. Obstructive sleep apnea happens to be the most common one which is caused by the blockage of air such that it cannot stream in or out of ones nose despite efforts of breathing continuing. Quantifying the risk of sleep apnea occurring usually depends on ones weight, race and upper and lower respiratory problems.

Autism is a mental health condition which is as a result of abnormal brain development resulting in difficulty in communicating both verbally and non-verbally as well as relating to people. Most children who suffer from autism tend to have sleeping disorders. Colic, the child being the first born and difficult temperaments (e.g. a decreased adaptability); are factors that are associated with a sleep disorder. Evidence of the etiology of sleep disorders in children is generally limited; however the proportion of rapid eye movement (REM-active sleep) is greater in infants. REM is frequently associated with awakenings, and infants who suffer from sleeping disorders often need assistance to resume sleep after such arousals (Montgomery and Dunne, 2006).

Sleep plays a huge role when it comes to learning, memory, and other neurobehavioral functions. It can influence learning and memory function and intensified learning and training can influence sleep or have correlates in brain functioning during sleep (Maquet, 2001; Pilcher and Huffcutt, 1996). In a study conducted (Sadeh, Gruber & Raviv, 2002), a significant relationship between sleep fragmentation and neurobehavioral functioning (NBF) was identified in school-age children. It was found that an increased number of nights waking and lower sleep efficiency were associated with compromised NBF. Many studies demonstrated that sleep problems and sleep fragmentations were associated with learning difficulties or compromised NBF.

Children who sleep excessively during the day or night walks are more prone to impaired daytime functioning if not treated. Furthermore, children with Parasomnias are more likely to serious accidental injuries (Montgomery and Dunne, 2006). Sleep is necessary for the well-being of anyone therefore with Dyssomnias and Parasomnias being the major causes in children, if nothing is done about it, childrens behaviors are affected as well as it results to increments in stress levels of parents. Children react differently to sleep disorders as compared to adults who become sleepy during the day. Children, on the other hand, become hyperactive, always on the go thus becoming difficult to handle and keep up with. It may also affect their school performance, and learning becomes impeded.

These sleeping disorders can be treated but have to be tailored as to their particular problems. Eliminating elements that may distract a child from sleeping in the bedroom can be very helpful. The sleeping environments are very crucial when it comes to sleep. They may slow down or fasten the transition to sleep. Establishing a consistent bedtime routine is important in helping the child overcome sleeping disorders. Some of the things or activities that disrupt children from sleep should be eliminated from the bedroom environs. If a child tends to have frightening dreams, it is advisable for the parents to assign a psychologist to him or her. These nightmares can be, as a result, of a circumstance or a life problem whereby both the parents and the psychologist are to help the child overcome. Most of these disorders end as time passes of course, with treatment and help from parents and physicians.

The current literature, which is typically built on adult studies, proposes that sleep breakup, characterized by numerous and/prolonged night-waking, devises adverse effects on daylight alertness as well as cognitive performance (Sadeh, Gruber & Raviv, 2003). This means that there is less literature provided on the study of sleep disorders on children. Studies should be conducted mainly basing on children. These studies should focus on understanding the neurobehavioral functioning of the children and how it is related to the sleep patterns. Links between arousal levels and the time of the day should be established and the role of the time of the day should be assessed. Afterward, the public should be educated about the importance of sleep as well as the effects of sleep disorder. This will help in reducing the rates of sleep disorders in the country.

References

Gruber, R., Raviv, A. & Sadeh, A. (2003). The Effects of Sleep Restriction and Extension on School-Age Children: What a Difference an Hour Makes. Child Development, 47, 444-455. Retrieved from http://scholar.google.com/scholar?q=sleep+psychology+in+childhood&hl=en&as_sdt=0&as_vis=1&oi=scholar&sa=Xved=0ahUKEwjOqaCZhtTLAhVHuhQKHSeuC-cQgQMIGTAAMaquet, P. (2001). The Role of Sleep in Learning and Memory. Science, 294(5544), 1048-1052

Montgomery, P. & Dunne, D. (2006). Clinical evidence: Sleep disorders in children. Retrieved from http://scholar.google.com/scholar?q=sleep+disorder+on+children&hl=en&as_sdt=0&as_vis=1&oi=scholart&sa=X&ved=0ahUKEwjsuJqjhtTLAhUGuRQKHdj0DjEQgQMIHDAAPilcher, J. & Huffcut, A. (1996). Effects of sleep deprivation on performance: A meta-analysis. Sleep, 19, 318-326.