Sleep & Insomnia in Children

Sleep is a normally recurring state characterized by lessened consciousness, awareness of the surroundings and movement.  In humans, the main sleep episode usually occurs as one consolidated period of approximately 8 hours every night, and accounts for about one third of human life.

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Why is sleep important?

Sleep is essential at all stages of life, particularly so during childhood where neuronal development occurs. Insufficient sleep in children affects cognitive performance and aggravates adaptive behavioral problems. Longer sleep duration at preschool age may be important for a child’s later behavior.

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The optimal amount of sleep one should have each night varies between individuals. The National Sleep Foundation (NSF) provides guidelines to determine how much sleep is needed per age group. Babies need as much as 19 hours every day, preschoolers between 10 and 13 hours, and school-aged children between 9 and 11 hours. For teenagers, 8 to 10 hours was considered appropriate. However, research shows teenagers tend to sleep less as they go to bed later, which result in an increased level of sleepiness and inattention during the day. 

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Sleep has also been linked to the correct functioning of various vital organs and metabolic processes such as:

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• Vital brain functions such as cognitive functioning, learning, memory, decision making and behavior

• Regulation of fat in the liver that can lead to severe issues like diabetes and obesity

• Reduced risk of cardiovascular disease

• Growth hormone secretion

• Immune system function
   

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What is the mechanism behind sleep?

Sleep is a biological necessity, the homeostatic urge to sleep increases with time following awakening. Our sleeping patterns have a circadian rhythm, undergoing cyclical changes over a 24-hour period. In humans these rhythms are set to overlap the day-night period by the brain’s ‘clock’, a region known as the suprachiasmatic nucleus (SCN). The circadian clock regulates when we sleep and when we are awake.

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The brains’ clock is very sensitive to the hormone melatonin, the signal of darkness. It is produced in the pineal gland and is released into the brain and blood. Melatonin production is raised to high levels as night falls and in accordance with circadian clock and is diminished by bright light exposure and. Melatonin continues to deliver the darkness signal to the body throughout the night period to ensure optimal adjustment of homeostatic systems such as sleep and blood pressure rhythms to the day-night schedule.

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What is insomnia?

Insomnia disorder is defined as a complaint on having a sleep difficulty occurring at least 3 nights per week and being present for at least 3 months. These difficulties may include one or more of the following symptoms:

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• Difficulty falling asleep

• Difficulty staying asleep

• Early morning awakening

 

According to DSM-5, people who suffer from insomnia have difficulties also the next day: they feel tired, unrefreshed and often will find it difficult to function during the day causing distress and impairment in social, occupational, educational, behavioral and other important areas of daytime functioning.

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New studies demonstrate the negative consequences of sleeplessness in children and adolescents, including hyperactivity, irritability, restlessness, poor concentration, impulsiveness, suicide risk, and poor memory. Families of children with sleep disturbances also suffer from sleep deprivation, exhibiting negative effects on daytime function and well-being, as well as elevated levels of family stress, mood swings, relationship instability and others.