Why is sleep disturbed in children? The child does not sleep well - how to overcome insomnia? Sleep disturbance in a 2-year-old child Komarovsky.
Carolina Tedke, University medical college South Carolina, Charleston, South Carolina
Sleep disorders are common in children. A distinction must be made between cases where polysomnography detects abnormalities (eg, parasomnias, apnea, and narcolepsy) and cases where the problems are behavioral in origin and polysomnography is normal. Parasomnias (night terrors, somnambulism, and enuresis) are caused by the immaturity of the central nervous system and often resolve with age. obstructive syndrome sleep apnea(OSAS) in children is often not diagnosed in time, although it can be successfully treated surgically. Behavioral sleep disorders can be cured with proper parental instruction. Physicians can be of great help to such families by recommending effective methods parents. ( American Journal of Family Medicine, 2001;63:277-84 )
Sleep problems in children are often a concern for parents. A child who goes to bed reluctantly or wakes up frequently during the night often causes very big problems in family. Sleep disorders in children, confirmed by sleep laboratory data, are in principle similar to disorders in adults. However, problems that are defined as sleep patterns that are unsatisfactory for the parent, child, or doctor are more common in children. Determining a sleep behavior disorder is quite difficult due to significant differences in sleep patterns at different ages. So, for example, it is not abnormal if a two-month-old baby often wakes up at night, but this will also be a pathology for a two-year-old child. To understand the complexity of the problem, one can also take into account the large difference in tolerance for sleep problems, which varies significantly between families.
Normal sleep in children.
Sleep in very young children is significantly different from sleep in adults. Infants under 6 months of age spend 50% of their sleep in inactive REM sleep compared to 20% in adults. Sleep in babies begins through the initial active REM stage, while in adults the first REM phase appears no earlier than 90 minutes after falling asleep. The active REM phase often recurs in infants, resulting in shortened sleep cycles. Before 6 months, restful REM (also defined as restful or indeterminate sleep) cannot be subdivided into EEG stages known as mature sleep patterns. After 6 months, the infant's sleep architecture begins to resemble that of adults. After an initial "setting" period, which usually lasts 10 to 20 minutes, there is a transition from NREM stage 1 to stage 3 or 4. The child may return to stage 1 and repeat the cycle. After one or two cycles of NREM sleep, REM sleep occurs 60-90 minutes later. The first third of the night is represented mainly by deep sleep (NREM Stages 3 and 4). Stage 2 NREM and REM sleep predominate in the second half of the night. In newborns, total sleep time is evenly distributed between the daytime and nighttime periods of the day. Nocturnal sleep gradually consolidates into one continuous episode by the first year of life. The amount of daytime sleep gradually decreases during the first three years of life. By the age of four, most children no longer need naps. The need for nighttime sleep is also reduced, so that in adolescence it is comparable to the need in adults.
The scope of the task.
Parents of young children are eager to learn more about what they can expect from their child's nighttime sleep. The conducted studies gave different results, since they were carried out on different populations, used different terminology and data processing methods. Typically, the frequency of nocturnal awakenings was estimated at 100% in newborns and dropped to 20-30% in six-month-olds. After a continuous night sleep, some children may begin to wake up again at night - this is more often the result of social factors, rather than problems with maturation. Nocturnal awakenings are more typical for early childhood. Studies have shown that approximately one in three children under the age of 4 continue to wake up during the night, requiring parental intervention to get them back to sleep.
parasomnia
Parasomnias are sleep disorders characterized by an abnormal polysomnogram. They are episodic in nature and reflect the immaturity of the central nervous system (CNS). Therefore, parasomnias are more common in children than in adults and usually resolve with age. Parasomnias tend to run in families. These disorders are paroxysmal, predictable by occurrence in a particular sleep cycle, unreactive to external influences, and are characterized by retrograde amnesia. The diagnosis is often made solely on the basis of a thorough history. Additional diagnostic studies are rarely required.
Pavor nocturnes or night terrors
Pavor nocturnus or night terrors occur about 90 minutes after falling asleep, in stage 3 or 4 NREM sleep. The child suddenly sits up and starts screaming uncontrollably. It may take up to 30 minutes for him to calm down and fall asleep again. This is accompanied by tachycardia, rapid breathing, and other signs of autonomic activation. Night terrors usually occur in children between the ages of 3 and 8. They must be distinguished from nightmares (Table 1). Night terrors are more likely to occur during periods of stress or overwork. Despite their intimidating nature, parents need to make sure they are self-sustaining. One should try to find out if there is any stressful situation in the child's life and make sure that the child has opportunities for rest and recovery. Diazepam (Valium) can be given to children in whom night terrors do not stop on their own and these episodes are extremely destructive.
Table 1. Comparison of night terrors and nightmares
Sleepwalking and sleepwalking
In sleepwalking (somnambulism) and sleep-talking (somniloquy), the child sits up in bed with his eyes open, but with the so-called "unseeing gaze." Activity can range from aimless restlessness in bed to actually walking around the house. Speech is slurred and rarely intelligible. These disorders occur in children school age, more in boys than girls, and often accompanied by enuresis. Children with sleepwalking can be injured and parents should take steps to avoid dangerous situations such as falling off balconies or stairs. Bedrooms for such children should be located on the first floor, windows and doors are securely closed. During the sleepwalking episode, the parents should interfere minimally and refrain from shaking him, yelling at him. This type of sleep behavior usually resolves with age and usually does not require special intervention other than the precautions noted above. Another way is the so-called "scheduled wake-ups". Parents keep a diary, write down the time of sleepwalking for several nights, and then start waking the child 15 minutes before the expected time. In this case, it is necessary to make sure that the child is in a state of full wakefulness for at least 5 minutes. Using this method eliminates sleepwalking in 80% of children.
Nocturnal enuresis
Nocturnal enuresis or bedwetting is one of the most prevalent and persistent problems in children. Enuresis is classified as primary if the child has never been "dry" in bed before and secondary if it occurs after the child has been able to stop urination for at least a year. Primary enuresis is much more common and is unlikely to be the result of pathology.
The etiology of primary enuresis is most likely multifactorial. Often primary enuresis is associated with a family history. The ability to control urination is closely related to the maturity of the nervous system and a child who is retarded at the age of 1-3 years is much more likely to be an enuretic at six years of age. Enuretic children have been found to have lower functional capacity Bladder(volume of urine that the bladder can hold) than in children without enuresis, although true capacity did not differ. Finally, enuresis is classified by most researchers as a parasomnia, as it is observed only in the stages of NREM sleep. Nevertheless, despite the subjective opinion of parents, enuretic children are no more difficult to wake up than others.
In most cases, if there are no symptoms of other disorders on a thorough history, general and neurological examination, no additional tests are required. diagnostic studies including urinalysis. As a rule, even before the first visit to the doctor, parents are already taking some measures, in particular, limiting evening fluid intake, waking up the child to go to the toilet before the parents themselves go to bed. Although doctors sometimes resort to drug treatment such as the administration of imipramine (Tofranil) and as the next step of desmopressin (DDAVP), numerous studies have shown the superiority of wetness signals in terms of effectiveness, lack of side effects and a rare recurrence rate of episodes. These devices are available through pharmacies or can be ordered online. There is also "containment training" (bladder), which involves a number of methods, which is, however, beyond the scope of this article (see Sheldon).
Obstructive sleep apnea syndrome
It is believed that obstructive sleep apnea syndrome (OSAS) occurs in 1-3% of children. Symptoms include snoring, difficulty breathing or mouth breathing during sleep. Parents of infants with severe OSA may report difficulty feeding their child. OSAS in children is often caused by adenotonsillar hypertrophy. Other causes include craniofacial pathology, obesity, and neuromuscular disease. reported about high percentage allergic diseases in children with snoring and OSAS.
In adults, airway obstruction is transient and often severe. In children, if the cause is adenotonsillar hypertrophy, the obstruction is permanent but less severe. Children are less likely to experience hypersomnolence (daytime sleepiness) than adults, but they often also have enuresis, excessive sweating, and developmental delay. SOAS. There is clear evidence of OSA in a certain percentage of children who experience learning difficulties, behavioral problems, including hyperactivity disorder and attention deficit disorder. Diagnosis of OSA is made in the pediatric sleep laboratory using nocturnal oximetry and polysomnography. Most of these children show significant improvement after tonsillectomy. The latter is not indicated if the cause of OSAS in a child is another pathology (craniofacial anomaly, neuromuscular disease, obesity). In these cases, and also if tonsillectomy surgery has not brought a satisfactory result, treatment with CPAP, a device that creates positive air pressure in the upper respiratory tract. This technique is usually used in adults, but has proven to be effective and safe in children as well.
Narcolepsy
Narcolepsy is uncommon in childhood, although it can occur in adolescents. The main symptom, as in adults, is increased daytime sleepiness. Obviously, this can create difficulties in the learning process. In children, cataplexy or hypnagogic hallucinations are much less common than in adults. At first, the child begins to have difficulty waking up in the morning. After awakening, some confusion may be noted, the child may even be aggressive in words and deeds. Diagnosis can be quite difficult, and initial polysomnography may be normal. If the diagnosis remains in doubt, repeated polysomnography is indicated. Such children can be helped by regular short daytime sleep. Sometimes medication may be required. Because it is a lifelong disease with increased mortality, children with narcolepsy should be monitored by a sleep specialist.
Secondary sleep disorders
Secondary disorders are much more common than primary ones and are characterized by normal indicators polysomnography data. The sleep pattern disorder is often transient, but can cause serious family problems if it continues for a long time. The most common secondary sleep disorder is nocturnal awakenings and reluctance to fall asleep at the appointed time, which is most often observed in only toddlers and in general in the preschool period. Although 95% of newborns cry after waking at night and require parental attention to fall asleep again, by the age of one year, 60 to 70% of children can, in principle, fall asleep again on their own. Important is the concept of sleep associations. A child who goes to bed awake and learns to fall asleep using comfortable measures is usually able to calm himself if he suddenly wakes up in the middle of the night. Conversely, a child who falls asleep with the help of a parent, such as rocking or simply by physical presence, may have difficulty falling asleep on their own after a nighttime awakening. In such cases, parents can be advised to change behavior, stop rocking the baby, etc., wait longer than usual when the baby cries upon waking until the baby gradually learns to calm down and fall asleep on its own.
Colic and nocturnal awakenings.
Colic in children is often a real scourge for new parents. While colic is not a sleep disorder problem in and of itself, babies with colic have shortened total sleep duration. Sleep problems can sometimes continue after colic has passed with age - because the measures that parents used to stop crying attacks (sickness in the arms, in a stroller) can interfere with the assimilation of a normal sleep pattern. An infant older than 4 months who continues to wake up at night is considered a "trained night mourner". These babies calm down quickly after being picked up. One way is to recommend that parents gradually increase the time intervals of "ignoring", another way to stop the crying of the child is "cold turkey." Either method leads to difficulties for several nights, but ultimately helps in "training" the child to fall asleep on his own (Ferber). Another method that is also effective and more readily accepted by some parents is "scheduled wake-ups." Parents at the same time wake the child at a certain time, shortly before the expected independent awakening of the child. As the frequency of spontaneous awakenings decreases, the duration of the interval between "scheduled awakenings" may increase, up to the termination of spontaneous awakenings.
Sleep initiation and maintenance disorders
Disorders of initiating and maintaining sleep (DIMS) are most common in children preschool age due to the peculiarities of psychological development and the difficulties inherent in this age. Sometimes parents have difficulty in setting firm limits or agreeing to the child's demands - "one more glass", "one more story". Parents in such cases are advised to take such attempts to delay going to bed calmly but firmly, ignoring the protests of the child. To avoid further confrontation, tell the child that the door to his room will be open while he is in bed, but will be locked (not padlocked) if he tries to get out of it. One recommended technique is called a "bed pass" - a card with the child's name written on it, which can be exchanged without penalty for one short exit from the bedroom per evening and then returned to the parent for the rest of the evening. For children who have difficulty falling asleep, it may be helpful to develop a predictable routine - 3 or 4 components, lasting from 20 to 30 minutes, for example, a fairy tale, a song, a drink, a back massage; continuous use of such a procedure is very effective. The procedure can be shifted in time earlier, until the desired time.
Sleep problems in older children.
In adolescence or a little earlier, sleep problems again become more relevant. As parental control wanes and educational and social demands rise, sleep may begin to become more and more erratic. Sometimes there is a delay in the onset of falling asleep, a decrease in sleep time and increased daytime sleepiness. In some cases, these children may develop delayed phase sleep syndrome. This means that they cannot sleep at night and cannot stay awake during the day. This condition may represent a form of school avoidance. Treatment consists in strict control of the time of falling asleep, which gradually shifts towards evening. Total sleep problems and proposed measures are presented in Table 2.
Table 2. Sleep disorders at different ages.
| Age | Sleep disturbance | Recommendations |
|---|---|---|
| 0 – 4 months | Night awakenings and meals are age appropriate | |
| 4 – 12 months | Night awakenings, night food demands | Systematic ignoring, "scheduled awakenings." Increase the interval of feeding, decrease the amount of food, the duration of feeding |
| 24 years | DIMS | Predictable procedure and conditions for falling asleep, reward system, setting limits |
| 36 years | Night terrors | "Scheduled wake up", sometimes medication |
| 6 – 12 years old | Nocturnal enuresis | "Moisture signals", training, drug treatment |
| 8 – 12 years old | Somnambulism | Precautions, "scheduled wake-up" |
| Teenagers | Retarded sleep phase syndrome. Narcolepsy |
Setting limits, gradually shifting falling asleep to an early time. Contacting a somnologist |
| Any | SOAS | Appeal to a somnologist, possible surgical treatment |
Co-sleeping
Co-sleeping is a term that refers to parents and children who sleep in the same bed. Many experts frown upon such practices due to concerns about possible sexual harassment or a violation of personal independence. However, statistical studies do not reliably confirm these concerns. Co-sleeping is especially developed in a number of cultures and is believed to promote a sense of security and love in a child. Regardless of the above, it can be argued that the frequency of co-sleeping is much higher, since parents may simply not talk about it or even hide it for fear that the doctor will disapprove of it. According to various sources, 33-55% of preschoolers and 10-23% of schoolchildren sleep in the same bed with one of their parents. It is impossible not to take into account the likelihood of dramatic consequences that are not actually related to sleep disorders. Recently, a special commission in the United States published a report that described 515 deaths of children in the same bed with adults over 8 years. Approximately every fourth death was caused by mechanical compression of the child by an adult. Three-quarters of the cases were caused by mechanical disturbances in the bed or mattress, which led to strangulation and suffocation of the child.
How to improve and normalize your sleep pattern.
Due to the prevalence of sleep disorders in children, pediatrician or family doctor at each of his visits or examinations, he should pay attention to this aspect by asking his parents (Table 3). The doctor should tell parents about the importance healthy sleep in a child, no less important than normal nutrition or the growth of teeth. If there are any problems with sleep, it is necessary to take a thorough history, pay attention to the presence of other medical problems, like that chronic diseases, respiratory problems, seizures, recurring ear infections, medications. It is very effective for parents to keep a diary of their child's sleep throughout the week. Parents need to be taught how to develop bedtime rituals and how to behave at night with a particular problem.
Table 3. Questions for parents to assess their child's sleep
Each visit should include questions about:
If, in response to a question, the parent points to problems
What time do you put your baby to bed?
What usually happens in your house before dinner and going to bed?
What do you usually do 60 and 30 minutes before falling asleep?
What happens when the lights turn off?
When a baby cries, how do you respond? How fast?
Does the child receive a bottle or is he fiddled with when falling asleep in the evening?
Does the baby get a bottle or is he handled when he wakes up at night?
How many times does the child wake up at night?
How do you or the other parent react?
How quickly does the child fall asleep again?
What time does the child wake up in the morning?
Does the child play quietly by himself before falling asleep or wait for someone to come to him?
Does the baby sleep in a cradle or in a bed?
Are the conditions of the children's room conducive to falling asleep?
Does the child ever sleep with you in bed?
Does the child sleep with a toy, soft toy, or favorite blanket?
Does your child fall asleep during the day? How often? How long?
3 18 156 0
In 97% of cases, women are faced with when the child does not sleep well, often wakes up at night and cries.
Such a condition can not only negatively affect the well-being, but also the development of the child himself. What reasons bad sleep in a child under 1 year old and what needs to be done in order to cope with the problem, we will find out in this article.
Long daytime sleep
Babies are not born with a specific daily routine. It is determined by the parents. Often a child's day is divided into two categories: wakefulness and sleep. A child under 1 year of age has 3 to 5 daily naps. Moreover, their duration varies depending on age. For example, a baby under 3 months old should sleep at least 2-2.5 hours each time. With age, this time does not particularly decrease, but the amount of daytime sleep is significantly reduced.
The development of the child and his mental state depend on daytime sleep.
According to research, children who have not been accustomed to a sleep-wake regimen are more restless and grow poorly.
This is an overabundance of rest. It often happens that parents create such conditions for the child when he sleeps too much. This can cause problems sleeping at night.
During the night's rest, growth hormones are released, biologically active substances, which help to calm the nervous system and rest all body systems. Therefore, the child must definitely sleep at night.
In order to ensure a normal sleep of the child - create the correct sleep-wake regime.
0-6 weeks |
|
3 months |
|
4 months |
|
6 months |
|
9 months |
|
Features of the temperament of the baby
The duration of sleep may depend on the individual characteristics of the child. A "difficult" child generally sleeps less, tosses and turns frequently, and wakes up.
But do not rush to attribute temperament as the cause of insomnia. There may be other causes, such as erupted teeth, excessive sleep, or colic.
Bad atmosphere at home
If there is discord in the family and frequent quarrels, this affects not only adults, but also children.
Try to walk more often in the fresh air and limit conflicts at home. Perhaps the quarrels are due to overwork.
Practice babysitting. Then you can rest together. It is advisable to get out somewhere, and not spend time in familiar surroundings.
Age features
Poor sleep in a child may be associated with age characteristics. In babies under 1 year old, sleep is mostly superficial, they often wake up and fall asleep on their own.
Be careful with co-sleeping so as not to accidentally hit the child. Use lots of cushions for conditional fencing.
Wrong daily routine
Among the common mistakes parents make in caring for a child is the lack of a regimen in the first year of life. This can lead to numerous problems. One of the most common is overwork, which leads to sleep disorders and health problems.
Don't let your baby stay awake for too long. You may not notice the signs of overwork, but it is there. Talk to your doctor about the optimal time to be awake.
Children under 6 months of age should not be awake for more than 2 hours in a row.
You can not skip daytime sleep and greatly increase the time between feedings.
Colic in the stomach
Because of this, he often shudders, tosses and turns and cries. Colic in children under 1 year old mainly appears due to the accumulation of gases in the intestines through dysbacteriosis and disorders of the enzymatic system.
In case of colic, do not self-medicate, so immediately consult a doctor. If the problem is identified immediately, treatment is quick and effective.
Teething
This causes great pain to the baby and naturally affects the quality of sleep.
Signs of teething:
- Often cries, chews or bites;
- Rash on chin;
- Liquid stool;
- Increased secretion of saliva;
- Waking up frequently;
- Restlessness of the baby;
- Frequent scratching of cheeks and ears.
Try to stick to a well-organized daily routine. Keep in mind that the baby will need additional feeding, as teething stimulates motor skills and the desire to eat. Ask your pediatrician about special products designed to soothe the gums and local anesthesia.
The presence of diseases
Respiratory infections that cause nasal congestion. This interferes with restful sleep.
Frequent drowsiness is a symptom of the disease. Elevated temperature the baby is unacceptable, since the natural mechanisms of heat transfer have not yet been formulated. If there are signs of illness, check the temperature by placing your palm on your forehead.
If you suspect a disease, do not self-medicate and consult a doctor.
Vitamin D deficiency
An excess or lack of vitamins can affect not only a child’s sleep, but also general state. Lack of vitamin D is the cause of poor sleep.
To determine the presence of a problem, you need to pass a urine test according to Sulkovich. Normally, children are given 1-2 drops of vitamin D.
Improper nutrition
Proper development depends on nutrition digestive system absorption of nutrients.
- In the first and second months of life, the baby should eat exclusively breast milk. Water, tea or other products are prohibited.
- Complementary foods are introduced from the fourth month (a few drops of juice a day will be useful), but breast milk remains in the diet.
The need of the child's body for sleep is greater than for food. Good dream indicates the health of the child.
These or other violations of night rest are present in 15% of children. Consider why some children have sleep problems. When should I see a doctor because of a child's poor sleep? Let's listen to the advice of neurologists and nutritionists of baby food.
Many children experience sleep disturbances to varying degrees.
Why do children need to sleep?
Sleep is a physiological state in which regenerative processes occur in the body. At night, children produce growth hormone. No wonder they say that children grow in their sleep. Recovers during sleep the immune system by producing immunoglobulins and activating protective T-lymphocyte cells. While children sleep, the short-term information accumulated by them during the day passes into long-term memory. In other words, at night there is a consolidation of knowledge gained during the day.
The duration of sleep in babies at 2–3 years old is 12 hours, of which 1.5–3 hours falls on daytime rest. As they grow older, daytime rest decreases and by the age of 4 years, the need for it in many children disappears.
Types of sleep disturbances and awakenings at night
Difficulty falling asleep or frequently waking up at night is considered a violation. There are more than 100 types of sleep disorders, which fit into 3 main types:
- Insomnia - difficulty falling asleep and nocturnal awakenings.
- Parasomnias - sleepwalking, night terrors, enuresis, sleep-talking, bruxism, startling.
- Sleep apnea is short-term pauses in breathing.
Parasomnias are caused by the immaturity of the nervous system and progress to adolescence. Long-term sleep disturbance for more than 3 months requires observation by neurologists. With a protracted problem, somnologists conduct a study using the polysomnography method.
Individual characteristics of children
Every child is different, so they may need less sleep than other children their age.
As children get older, they need less time to sleep at night and more time to stay awake. Features of the physiology of children from 2 years old are that their sleep and wakefulness regimen is already well-established, and babies can sleep all night. By virtue of individual features some children sleep less than their peers, but still feel fine. Such features of children are not associated with any diseases. The fact that, in your opinion, the child does not sleep enough for his age is a problem, it can be a reason to visit a doctor.
Reasons for falling asleep or waking up at night
Sleep disturbance in children 2 years of age is often associated with improper diet and nutrition, or caused by diseases.
The most common causes:
- neurological causes;
- emotional overload during the day and at bedtime;
- malnutrition;
- physiological features;
- somatic diseases.
In children 2 years of age, the most common cause poor sleep or interruption of a night's rest is an emotional overload, which can manifest itself in the form of night terrors.
What to do with disturbed sleep?
Most often, the cause of night fears is emotional overload before bedtime and the wrong mode. Sometimes the cause of fear is fear. Emotional overload can be caused by the late return of the father, who, before going to bed, makes a noisy emotional communication with a child. Excited children have difficulty falling asleep, often wake up and call their mother. These conditions happen several times a week. Night terrors go away by adolescence.
Noisy games in the evening should be canceled
If the baby woke up at night from his own cry, take the baby in your arms, calm him down in a quiet voice and ask all the household members who came running to the cry to leave the children's room. With frequently recurring nighttime fears in a baby, you need to consult a neurologist. Prolonged night terrors may be of epileptic origin.
In the treatment of disturbed sleep in children 2 years old, it is very important to adhere to the following measures:
- observe the daily routine;
- do not allow games on a computer or phone before a night's rest;
- it is recommended to put the baby to bed at 2 years old at 21 o'clock at the same time;
- provide daytime sleep 1.5–2 hours;
- avoid watching TV before going to bed;
- an hour before falling asleep, do not allow noisy active games;
- it is useful to take a walk with the baby before bedtime or dinner;
- ventilate the room well before going to bed;
- the baby should not be too hot or cold during the night's rest.
Daytime rest is important for children 2 years old. A baby who does not sleep during the day will not sleep well at night. It is useful to perform the ritual of preparing for falling asleep - to collect toys, read a fairy tale. AT younger age in violation of falling asleep or waking up at night, you can give soothing herbal infusions of valerian, lemon balm. It is useful before going to bed to conduct a course of treatment with warm baths with an infusion of herbs, consisting of equal parts of thyme, valerian, motherwort, lemon balm. For infusion, brew 2 tbsp. l. dry mixture with 1 glass of water and leave for a quarter of an hour in a water bath. The water temperature must not exceed 37.0 °C.
Improper nutrition
The nutrition of the child should be balanced and fortified
Sleep problems in healthy children can occur with improper nutrition. Daily diet should be high in calories. The food eaten at dinner should be enough so that the baby does not wake up at night from hunger. A large dinner before bedtime will cause colic in the stomach. Chips and fast food can very well cause children to vomit at any time of the day. The nutrition of children 2 years old should be balanced.
In the diet of children from 1 to 3 years old, the following foods should be present daily:
- Animal protein is a building material necessary for growth and providing blood with iron. With a lack of meat dishes from beef, children develop Iron-deficiency anemia weakens the immune system. Due to the lack of protein, babies lag behind in development, their memory deteriorates.
- Fish is a source of vitamin D, without which a growing body develops a lack of calcium, phosphorus and magnesium. The imbalance of these minerals negatively affects the growth of bones and teeth of a growing organism. With a lack of minerals, children do not sleep well, sweat in their sleep, they develop dental caries. Deficiency of minerals and vitamins affects the intellectual development of children.
- Dairy products are a source of calcium and protein, which are needed for the formation of bones and teeth of a growing organism.
- Fruits and vegetables provide the body with vitamins and minerals.
Children from 1 to 3 years of age need food after cooking. Vegetarianism for children from 1 to 3 years is unacceptable. Keeping fast, medical point vision, is interpreted as an inhumane attitude towards children. The raw food method is also unacceptable for feeding children. Children as young as 2 cannot digest that much raw food. Gastrointestinal tract children from 1 to 3 years of age are unable to provide enzymes for the digestion of crude fiber. The result of a raw food diet will be gastritis and colitis. Eating problems impair falling asleep and cause you to wake up at night.
Snoring in children
The cause of frequent awakenings may be snoring, which occurs in some children after 1 year with enlarged adenoids and tonsils. With a strong increase in the tonsils, the flow of air to the lungs is limited. The child wakes up oxygen deficiency. In severe cases, the adenoids can be so enlarged that they completely block the air flow during sleep and cause a short-term cessation of breathing - apnea. At the same time, children often wake up, and feel sleepy during the day. With such a serious sleep disorder, children need to be examined by ENT specialists and somnologists who study sleep using the polysomnography method. In case of enlarged adenoids and tonsils, the operation eliminates snoring and restores nighttime rest.
As a result, we emphasize that the main problems of sleep are emotional overload and violation of the regime. Improper or insufficient nutrition also contributes to sleep disturbance in children from 1 to 3 years of age. To get rid of the problems of a night's rest, you first need to establish the right regimen and adjust a balanced diet.
It is believed that babies always sleep soundly and sweetly. In fact, sleep disorders in children are quite common: parents of about 20% of children complain that their children wake up crying at night or cannot fall asleep on time in the evening. A restless baby can seriously affect the health and performance of all family members. There are also more unpleasant pathologies that indicate the presence of certain problems in the child himself.
Types and symptoms of sleep disorders in children
Causes of sleep disorders in children are associated with diseases internal organs or directly disruptions in the ratio of sleep and wakefulness. Experts call the last violation an incorrectly formed sleep pattern. The fact is that the ability to fall asleep at a certain time of the day and rest continuously throughout the night is not innate. During the period of intrauterine development, the baby simply does not need it. Infants of the first year of life sleep 16-17 hours a day, distributing this time equally between night and day. It is natural for these babies to wake up frequently to eat. Gradually, the intervals between night feedings increase, and by the age of six months, the child can sleep peacefully from evening to morning.
Often, after the formation of the correct sleep pattern, the following deviations appear:
- Night fears. Occur in children from 3 to 6 years; boys are affected more often than girls. The child suddenly sits up in bed, begins to cry and scream. It takes about half an hour to calm him down. Full awakening does not occur, the baby is in a state of half sleep. In the morning he cannot remember either the fact of his anxiety or the content of the dream;
- Nightmares. It can affect children of any age, but adolescents are more commonly affected. The child awakens fully and remembers well the dream that frightened him;
- Bruxism. The baby in a dream clenches his jaw tightly and grinds his teeth. In this case, the cause of sleep disturbance in children is not exactly known, but, contrary to popular belief, it has nothing to do with helminthic invasions. This disorder most often manifests itself in teenagers 12-13 years old;
- Startles. If a baby under the age of one year often shudders in a dream, parents should be wary. This phenomenon can be a symptom of such a serious illness as epilepsy. At risk are children born with hypoxia or with malformations of intrauterine development;
- Sleepwalking (somnambulism, sleepwalking). The child is active during night sleep. Sometimes it's just anxiety, but in some cases, the baby gets out of bed and walks around the house. There is no awakening. The child's eyes are open, the movements are a little clumsy, but he does not stumble or bump into furniture. The disorder is more often observed in children of school age (mainly in boys);
- Sleep talk. In some cases, it manifests itself in combination with sleepwalking. The child, without waking up, pronounces individual words or whole phrases. Speech is slurred and slurred. Just as in somnambulism, by morning there are no memories left;
- Bedwetting (enuresis). Sometimes the cause of this disorder is purely urological problems, but more often this sleep disorder in children is caused by the immaturity of the nervous system. Often, enuresis affects children 6-12 years old with a delay mental development. A large role in the occurrence of the disease has a hereditary factor;
- Obstructive sleep apnea syndrome (OSAS). This disorder occurs in 3% of children and can present at any age. Symptoms of the disease are pronounced: the child in a dream breathes through his mouth, snores. Infants have difficulty eating, and older children have learning problems associated with daytime sleepiness. The cause of the disease is often an increase in the adenoids and tonsils (adenotonsillar hypertrophy). Sometimes OSAS is provoked by neuromuscular diseases, obesity, or congenital pathologies;
- Sleep initiation disorders. The child cannot calm down for a long time in the evening, tries to delay the moment of falling asleep, protests, asks for “one more fairy tale”, etc. The disorder is usually observed in preschoolers. The reason is the excessive excitability of the baby, problems with adaptation in the children's team, psychological discomfort;
- Night awakenings. Usually children aged 4-12 months are prone to them. Experts believe that in these cases, the development of the disorder is provoked by the wrong behavior of the parents, who react too nervously to nighttime anxiety and immediately rush to “comfort” the baby. For children over 4 months old, who constantly wake up at night, demanding attention and food, there is even a special definition - a trained night mourner;
- Retarded sleep phase syndrome. More commonly seen in teenagers. The disorder is connected both with the psychological problems of growing up and with the increased workload at school. The disorder is expressed in the transfer of active wakefulness to night hours, drowsiness and lethargy during the day.
Treatment of sleep disorders in children
If a child suffers from a sleep disorder, parents are required to urgently contact a pediatrician who will prescribe a consultation with a specialist (neurologist, somnologist, otolaryngologist) and determine the tactics of treatment. Before visiting a doctor, you must:
- Start keeping a sleep diary. During the week, you should record the time the baby falls asleep and wakes up, the duration of periods of nighttime wakefulness, behavioral patterns, etc .;
- Optimize your daily routine. It is necessary to organize walks in the fresh air (at least two hours a day), eat meals at the same time;
- Create comfortable conditions in the child's bedroom. It is necessary to regularly ventilate the room, maintain correct temperature and humidity;
- Check your baby's bedding and nightwear. They should be clean, comfortable and made from hypoallergenic materials;
- Reduce the activity of the child in the evening, limit TV viewing and computer games;
- Make sure that the atmosphere in the family is calm, friendly and comfortable. Talk to your child and find out if he has problems communicating with peers, teachers, etc.
Treatment of sleep disorders in children in most cases without medication. Sometimes the disorder goes away as the baby grows up. With night fears, awakenings, sleepwalking and sleepwalking, a simple technique helps well - waking up on a schedule. Its essence is that the child is awakened 10-15 minutes before the expected time of onset of the symptom. In the treatment of enuresis positive results gives the use of so-called humidity signals. Children suffering from sleep initiation disorders are helped by organizing a predictable routine called a sleep ritual. Retarded sleep phase syndrome can be corrected by gradually shifting the start time of a night's rest.
A restless baby affects the performance of all family members. At night, the body is restored, and problems with sleep negatively affect the immune system.
If sleep disturbance in children occurs repeatedly, this indicates a pathology. You need to see a doctor. It is important to determine whether a sleep disorder is a whim or a disease.
Falling asleep at night and uninterrupted sleep are not genetically determined, but laid down during life: there is no change of day and night in the womb.
Therefore, babies of the 1st year of life always wake up at night and sleep during the day.
The causes of sleep disorders are varied:
- diseases of internal organs;
- hereditary predisposition;
- emotional stress, stress (going to Kindergarten, mom's going to work);
- incorrect pattern of behavior in relation to sleep and wakefulness;
- physical discomfort (teeth cutting, colic, wet bed, crumbs on the sheet, unsuitable room temperature);
- hunger;
- late dinner, weaning.
Sleep disorders in children under one year old can be caused by rickets, inguinal and umbilical hernia, diseases of the spine, stomach and intestines, rheumatism.
20% of babies do not fall asleep well in the evening, wake up and cry at night.
Different types of disorders have different manifestations.
About treatment and prevention measures nervous tick see adults.
The main manifestations of sleep disorders in children
The wrong pattern of sleep and wakefulness is expressed in the fact that the baby repeatedly falls asleep during the day and wakes up at night.
In addition, the following deviations are common:
fears. Sleep disturbance in a child of this nature usually occurs at the age of 2-6 years, more often in whining boys. The half-asleep child sits up, screams and cries in bed; comforted by the efforts of the parents.
During an attack, the child cannot be awakened; by morning, he cannot remember his behavior and retell dreams.
These are manifestations of a strong excitation of the nervous system. By the age of 10-12, the disorder disappears.
Waking up in the middle of the night. They are found in babies from 4 months to a year. There is nothing serious here and the reason lies in the wrong behavior of parents who rush to lull their child. The baby develops conditioned reflex in which the attention of parents acts as a reinforcement. The body is "set" to wake up to receive food and parental care.
The cause can also be diseases of the heart, blood vessels, respiratory organs.
Sleepwalking. While sleeping, the child (usually a boy of 5-10 years old) behaves actively, walks and performs purposeful actions. His eyes are open, his movements clumsy, but he doesn't stumble or bump into furniture; remembers nothing in the morning.
The disorder may occur in connection with epilepsy, enuresis, diseases of the central nervous system and the genitourinary system.
Sleep talking. Children, while in a state of sleep, pronounce words or sentences, though indistinct; remember nothing after waking up.
nightmares are characteristic of any age, but more often such a sleep disturbance can be seen in a child of 3-7 years old, as well as 10-12 years old. Man wakes up in the middle of the night and remembers the dream - this is the difference from fears. If scary dreams last more than once a week, it's time to see a doctor.
Bruxism. A child (usually 12-13 years old) grits his teeth, his breathing and heartbeat change. The reason for this behavior is not clear, but the worms have nothing to do with it.
This may speak of malocclusion. Due to the erasure of the enamel, the child needs to be shown to the orthodontist. Bruxism is a consequence of a violation of the activity of the nerves, when the tension of the facial muscles does not go away even at night. This requires the help of a neurologist.
shudders manifest in babies up to a year old, born with hypoxia or malformations, and adolescents. Trembling is indicative of epilepsy ill health of the nervous system and mental sphere.
Urinary incontinence (enuresis) children 6-12 years old, with mental retardation or genetically predisposed are susceptible.
The reason is the immaturity of the nervous system (awakening reflexes are not developed), as well as urological diseases, stress.
In this case, a neurologist will help.
Respiratory arrest found in everyone. The person breathes through the mouth, snores, his breathing is intermittent; sleep disturbance in infants can be expressed in the difficulty of eating, older children are poorly trained due to daytime sleepiness. The disease is associated with an increase in adenoids and tonsils, sometimes with diseases of the nerves and muscles, congenital pathologies, and overweight.
This is where a lore consultation is needed.
Sleep initiation disorder. Difficulty falling asleep in the evening among preschoolers is common with difficulties in adapting to a team, increased excitability of the nervous system, and psychological discomfort.
delayed phase sleep syndrome. Teenagers lead active life at night, and in the morning it is difficult for them to wake up, they are lethargic all day. The problem has psychological roots associated with the entry into adulthood, and with increased school workloads.
Respiratory arrest affects 3% of children, bruxism - 20%.
Sleep disorders in children treatment
You should go to the pediatrician if the sleep disorder:
- accompanied by a serious change in mood;
- combined with enuresis and interruptions in breathing;
- lasts more than 3 weeks;
- occurs in children under 1 year of age.
Correction of fears, nocturnal awakenings, walking and talking in a dream is that the child should be awakened 10-15 minutes before the onset of the symptom (terrible dreams are seen 1-2 hours after falling asleep).
Then the awakened baby will fall asleep again and will no longer disturb the parents at the “urgent time”.
With bruxism, mouth guards are worn to protect the jaw; if its cause is neurological, sedatives are taken. Enuresis uses "humidity signals" - alarms that go off as soon as the baby urinates. It is important to wake up the child so that he does not do this unconsciously, and always go to the toilet before going to bed.
Those suffering from sleep initiation disorder will benefit from falling asleep at a specific time. The baby will intuitively begin to prepare for bed in advance. Retarded sleep phase syndrome is corrected by shifting nighttime rest to an earlier time.
Pediatricians often prescribe "Bayu-bay" drops for mobile, excitable babies from 5 years old, "Citral" bromine mixture, as well as "Notta", "Domirkind" preparations, and Epam drops are prescribed for depressed adolescents.
You can not drink drugs longer than the doctor prescribed, otherwise apathy will occur.
Prevention
Before going to the doctor you need:- Keep a sleep diary. During the week, write down the time the child wakes up, the duration of anxiety, the time to fall asleep again, etc.
- Go to bed and wake up, eat at the same time. At least 2 hours a day to walk in the air, in the morning to do exercises and wet wipes.
- Limit emotional stress (even pleasant ones). View a large number cartoon overloads nervous system. Watch TV 2 hours before bedtime. You can’t play outdoor games with the child in the evening, persuade him to eat something through force. It is better to load the child physically in the 1st half of the day, and read a fairy tale at night. Do not give sweets before bed.
- Regularly ventilate the baby's room, monitor the physical parameters. Optimum temperature 22°C, humidity 70%. This can be achieved by placing a damp cloth on the battery.
- follow bed linen. It should be clean, made of natural fabrics, semi-hard mattress.
- Provide a comfortable psychological climate. There must be a trusting relationship between family members. Parents need to find out whether their child feels comfortable at school, whether he has a relationship with teachers.
To correct sleep, it may be necessary to keep the child from sleeping during the day. A soft toy - a symbol of protection - will provide a calm falling asleep.
When a child who falls asleep only in his arms wakes up in bed, he is naughty. You can stop this with the following method. Mom sits by the bed and goes about her business. The child in a rage scatters all the toys, moves the pillow. Mom comes over, puts everything back in place, then leaves.
In no case should a child be denied sleep when he asks, under the pretext of being busy with various things.
It is impossible not to react to the crying of a child: in adulthood, this will develop into a neurosis, complexes.
Sleep is favored by twilight, reading at night, planning for tomorrow, monotonous noise washing machine, TV from next room.
Children's sleep is the key to a child's health and a fulfilling married life. In sleep disorders, the actions of parents who do not limit irritating factors are to blame. In the absence of visible causes of disorders, you need to go to the doctor.
Related video