Identification of sleep problems is important because a growing body of evidence suggests a link between sleep disorders and physical, cognitive, emotional, and social development. In addition, children with neurodevelopmental problems, learning differences, or behavior problems may be at increased risk for sleep problems compared with the general pediatric population.
The insomnia category includes conditions that are characterized by difficulty initiating or maintaining sleep, or by poor quality sleep.
Sleep Related Breathing Disorders
Sleep related breathing disorders are characterized by abnormal breathing or repeated episodes of cessation of breathing during sleep. They occur in both adults and children. The most common is obstructive sleep apnea syndrome. Lung disorders (eg, chronic obstructive pulmonary disease, asthma) are not considered sleep related breathing disorders themselves; however, they can cause or exacerbate abnormal breathing during sleep.
Central Disorders of Hypersomnolence
They include those disorders in which the primary complaint is daytime sleepiness that is not due to disturbed sleep or misaligned circadian rhythms. The major diagnoses within this category are narcolepsy, idiopathic hypersomnia, and Kleine-Levin syndrome. Insufficient sleep syndrome (ie, voluntary sleep deprivation) and hypersomnia due to medical or psychiatric disorders, a medication, or a substance are also included in this category.
Circadian Rhythm Sleep-Wake Disorders
Circadian rhythm disorders are characterized by chronic or recurrent sleep disturbance due to misalignment between the environment and an individual’s sleep-wake cycle. Shift work sleep disorder and jet lag syndrome are the 2 most common disorders in this category usually presenting in patients with excessive sleepiness and/or fatigue.
Parasomnias are undesirable physical events (movements, behaviors) or experiences (emotions, perceptions, dreams) that occur during entry into sleep, within sleep, or during arousals from sleep. The behaviors can be complex and appear purposeful; however, the patient has no conscious awareness of the behavior.
Sleep Related Movement Disorders
Sleep related movement disorders are characterized by simple, repetitive movements that disturb sleep. Patients may or may not be aware of the movements. Symptoms of sleep disturbance (eg, daytime sleepiness, fatigue) are required to diagnose a sleep related movement disorder. Movements that occur during sleep but do not adversely affect sleep or daytime function are not considered a sleep related movement disorder. Classic sleep related movement disorders include restless legs syndrome, periodic limb movement disorder, sleep related leg cramps, sleep related bruxism (teeth grinding), and sleep related rhythmic movement disorder.