Both children and adults need a sufficient amount of high-quality sleep to maintain good overall mental and physical well-being. Health Canada recommends 9 to 11 hours of sleep every night for children aged 5 to 13 years old, and 8 to 10 hours of sleep per night for those aged 14 to 17 years.
However, sleeping problems are common among children and a variety of sleep disorders can occur during infancy, early childhood, and adolescence. Some sleep disorders in children are associated with specific behaviours, whereas others can arise as a result of certain medical conditions.
How do I know if my child has a sleep disorder?
Symptoms of sleep disorders in children can include:
- Difficulty falling asleep or waking up in the morning
- Problems with sleep throughout the night
- Recurring episodes of sleepwalking or intense nightmares
- Snoring or breathing interruptions
- Decreased daytime performance or trouble staying awake during the day
- Teeth grinding (also known as bruxism)
It’s normal for children to experience occasional episodes of short-term insomnia, but persistent issues before and during bedtime can be an indicator of a sleep disorder and should be addressed by a doctor.
Types of sleep disorders in children
Movement disorders — like restless legs syndrome (RLS) — are nervous system conditions that lead to increased, decreased, or slower movements (which can be voluntary or involuntary). Symptoms of these conditions are often worse at night, and this can result in sleep disturbances.
Parasomnias involve abnormal movements, talk, and actions that happen while a person is sleeping (although they may appear to be awake). Childhood parasomnias like sleepwalking, sleep talking, and sleep terrors are common, but studies suggest that many children don’t experience these episodes as frequently after they enter adolescence.
Hypersomnia is characterized by excessive daytime sleepiness. Conditions that disrupt sleep can cause hypersomnia, but it can also be a sign of other medical problems such as concussion or epilepsy. Children who have migraines may be more susceptible to hypersomnia, with a 2013 study finding that they reported more daytime sleepiness than children in the control group.
Delayed sleep phase syndrome
Adolescents are most likely to have delayed sleep phase syndrome, which presents as difficulty falling asleep and waking at “normal” times. Children with this condition typically cannot fall or stay asleep until two or more hours past their usual bedtime, making it harder for them to wake up in the morning when it’s time to go to school or partake in other activities. Delayed sleep phase syndrome can also cause children to sleep much later than normal on weekends.
Behavioural insomnia refers to a learned inability to fall or stay asleep. It is most often seen in children aged 0 to 5 years, but the condition can persist into later childhood and adolescence if left unaddressed. A common example of behavioural insomnia is when a child refuses to go to bed or has trouble drifting off without the aid of a caregiver or object, such as their favourite stuffed toy.
Causes of insomnia in children
Childhood insomnia is a result of both intrinsic factors (conditions or traits that inherently predispose a child to sleep disorders) and extrinsic factors (stimuli in the child’s environment or their caregivers' response to sleeping problems, for example).
Certain medical conditions are associated with childhood insomnia, as well as a child’s circadian preferences (whether they are an “early bird” or a “night owl”). A child’s temperament is another intrinsic factor that can make them more or less likely to have a sleep disorder, and studies have suggested that genetics may also play a role in the development of insomnia in children.
A parent or caregiver can become an extrinsic factor in childhood insomnia if they are unable to set limits or boundaries with their child, as they may inadvertently perpetuate the sleeping problem by encouraging or allowing behaviours associated with poor sleep hygiene. In some cases, parental expectations for how long a child should stay in bed exceed what is normal for their development trajectory. Having a child stay in bed for longer than they need to may lead to oversleeping in the morning, which can make it more difficult for them to drift off at night. Other extrinsic factors in childhood insomnia include unrestful sleeping environments and exposure to stress-inducing adverse experiences early in life.
Which sleep disorder is commonly seen in children?
According to the Canadian Sleep Society, the most prevalent childhood sleep disorder in Canada is behavioural insomnia. Up to 25% of children in Canada have difficulty falling or staying asleep, and this figure rises to over 50% in children with physical and mental health problems.
A child may be more prone to insomnia if they have other mental or physical health conditions. Conditions that cause pain or discomfort during the night (such as gastrointestinal reflux disorder, or GERD), can prevent children from falling asleep or awaken them throughout the night. Mental health disorders that are associated with insomnia include anxiety, depression, and attention-deficit hyperactivity disorder (ADHD).
Identifying concerns around sleep early can help reduce the risk of negative consequences, such as behavioural issues, daytime sleepiness, irritability, and poor academic performance. If your child is experiencing symptoms related to sleeping problems, consult with your doctor for guidance and treatment.