Sleep Disorders in Children

Kids sleep a lot. And that’s normal. It’s important for their growing bodies — and developing brains. But did you know up to 30% of kids have sleep problems at some point? Often, these disruptions are temporary. But sometimes, they become ongoing (chronic). Especially if they’re linked to other health conditions.

Sleep disorders in children can do more than make them feel overly sleepy during the day. These disorders can cause behavior changes, moodiness, anxiety, depression and challenges in school and with friends. In older kids, it can lead to chronic absenteeism and even substance use. And some sleep disorders can even affect physical health — causing problems with their  heart and lungs.

There are more than 80 different types of sleep disorders. Common ones in children are:

• Bedtime struggles.
• Bedwetting.
• Circadian (biological sleep clock) rhythm sleep disorders.
• Head banging.
• Hypersomnia (problems staying awake).
• Insomnia (problems falling or staying asleep).
• Mouth breathing in sleep.
• Narcolepsy.
• Night awakenings.
• Nightmares.
• Nighttime seizures.
• Restless legs syndrome.
• Sleep apnea.
• Sleepwalking.
• Snoring.
• Too little (insufficient) sleep.

Diagnosing Sleep Disorders in Children

We do several things when we’re diagnosing sleep disorders in children. Your child will first have an evaluation with our sleep team. And then we’ll do testing if necessary. We want to be sure we correctly diagnose your child’s sleep disorder. This lets us build a highly personalized treatment plan.

What to expect at your first visit

When you and your child come to their first appointment, their provider will spend time talking with you about their sleep habits. They’ll want to know things like:

• What time does your child usually go to bed?
• How long does it take your child to fall asleep?
• How long does your child sleep at night?
• Does your child wake up at night? If so, how many times?
• Is your child restless while sleeping?
• Does your child snore at night?
• Does your child wake up choking or gasping for air?
• Does your child have pauses in breathing while asleep?
• How does your child behave when they have disrupted sleep?
• Is your child unusually sleepy during the day?

The provider will also do a physical exam to check your child’s overall health. They’ll look at their ears, nose and throat for signs of breathing problems. We may also do a neurological exam. The provider may order sleep disorder tests to help confirm a diagnosis.

Sleep diaries and actigraphy

Your child’s provider may ask you (or your child, depending on their age) to keep a sleep diary for a week or two. You’ll log things like your child’s bedtime, how long they slept, if they woke up during the night and more.

Our team may also have your child wear a smartwatch-like device called an actigraphy. This tool records your child’s activity when they’re asleep and awake for at least a few days — or even a few weeks. Actigraphy can help determine what times they fell asleep and woke up.

Sleep studies at Cleveland Clinic Children’s

An overnight sleep study (polysomnogram) is one of the best ways to diagnose sleep disorders in children. Why? Because we keep a close eye on them while they sleep.

You may wonder if our team will come to your house overnight or where this will happen. We typically have your child sleep in special hotel rooms or in one of our sleep labs all night. We have beds and cribs, so we can test kids of all ages. You’ll be with your child for the entire sleep study. You’ll share a room, but not a bed. Be sure to bring their favorite bedtime items like snacks, toys, a blanket or a pillow.

We start the test by attaching painless sensors on their head with washable glue. These sensors track brain activity during sleep and when they wake up at night. We electronically track your child’s sleep behavior until about 5 a.m. or 6 a.m. We use the information from the study to help us find out if they have a sleep disorder.

Other tests

We may want to see if anything in their brain affects how they sleep. Our team may order a test called an electroencephalogram (EEG). This lets us look for unusual brain activity that can trigger sleep problems. Your child could have imaging tests like a CT scan or brain MRI. All these tests let us take a closer look at their brain.

If your child snores, pauses breathing while asleep or breathes out of their mouth, we may test for obstructive sleep apnea. They may be referred to an ear, nose and throat specialist (otolaryngologist) for a more thorough exam of their nose and sinuses.

Meet Our Sleep Disorders in Children Team

Sleep (or lack of it) can affect a lot of different things in your child’s body. That’s why we use a team-based approach to diagnose sleep disorders in children. Your child may see sleep specialists like:

• Pediatricians.
• Pediatric neurologists (brain specialists).
• Pediatric cardiologists (heart specialists).
• Pediatric pulmonologists (lung specialists).
• Pediatric otolaryngologists (ear, nose and throat specialists).
• Child psychologists.
• Child life specialists.

This team works together to coordinate testing, confirm a diagnosis and plan your child’s care.

Treatment plans for sleep disorders in children depend on the diagnosis. We may recommend:

Improving sleep habits

For most sleep disorders, a consistent sleep schedule is a must. This means going to bed and waking up at the same time every day — even on weekends and vacations. We may recommend your child give up things with caffeine in them (including soda and chocolate). It’s also important to avoid stimulating activities like video games, TV and smartphone use before bed. A cool, dark bedroom can also be helpful.

Medications

Some sleep disorders in children respond to medications. Others don’t. Your child’s care team will go over what options they think could help treat the sleep disorder. Or, if your child has a health condition that’s causing issues with their sleep, medications like antidepressants, allergy medications and more might be options.

Counseling

Our team of child psychologists is here to help your child have better sleep. Cognitive behavioral therapy (CBT) can treat root causes like anxiety, depression and more.

Breathing treatments

If obstructive sleep apnea contributes to your child’s sleep problems, we may have them use a special device at night. It works by delivering continuous positive airway pressure (CPAP). Your child will wear a small mask over their nose while they sleep. It’s attached to a portable breathing machine that blows air through their nasal passages and airway. This keeps the airways open so your child can breathe better during sleep.

Some children may need surgery to treat severe sleep apnea. Our ear, nose and throat specialists can remove enlarged tonsils or adenoids that block airways. Or they may repair other problems that cause blocked airways during the night.

Taking the Next Step

When your child doesn’t sleep well, chances are you don’t, either. This can take a toll on your physical and mental health. You may experience daytime sleepiness, mood swings and problems with attention. Suddenly, you realize that sleep is essential. You may feel relieved to know that most sleep disorders in children are treatable. And the team at Cleveland Clinic Children’s is here to help your child (and your family) start resting easy at night.