Sleep Disorders in Children

Non–REM (NREM) parasomnias are common in children and occur during deep sleep. During an episode, a child may be very hard to wake and appear confused or disoriented. NREM parasomnias include:

• Sleepwalking: A child partially wakes from deep sleep and walks around; if awakened, they are confused.
• Night terrors: A child suddenly screams or appears terrified after arousing from deep sleep; they may not recognize parents and are confused if awakened.
• Confusional arousals: A child wakes up seeming confused and not fully alert.

Most children outgrow sleepwalking and night terrors, but episodes can be frightening and sometimes dangerous if a child is at risk of injury. If your child’s parasomnias are frequent, disturbing, or raise safety concerns, we can evaluate for seizures and other underlying causes, confirm NREM parasomnias, and recommend appropriate treatment.

request an appointment with our experienced clinical team at Sleep & Attention Disorders Institute in Sterling Heights, Michigan, for a comprehensive parasomnia evaluation and personalized treatment plan.

Excessive daytime sleepiness (hypersomnia) is common in children who are not getting enough restful sleep at night. Sleepy children may doze off in class, struggle to stay awake, have mood changes, and, in teens who drive, face a higher risk of car accidents. Common causes of hypersomnia include:

• Sleep apnea: Children snore and stop breathing in sleep, leaving them unrefreshed.
• Sleep deprivation: Teenagers typically need 8–10 hours in bed, and younger children need even more; regularly getting less can cause sleepiness and attention problems.
• Narcolepsy: A brain disorder in which a low level of the chemical orexin leads to excessive sleepiness and a tendency to enter REM (dream) sleep quickly; it often begins in childhood or adolescence and may include sleep paralysis, vivid hallucinations at sleep onset or awakening, and cataplexy (sudden loss of muscle tone with emotions).
• Idiopathic hypersomnia: Excessive daytime sleepiness without the REM pattern seen in narcolepsy; it often starts in the teen years.
• Depression, psychiatric medications, drugs, and alcohol: These can all contribute to daytime sleepiness.

Treatment options may include:

• Tonsillectomy or CPAP therapy for sleep apnea
• Ensuring adequate time in bed for sleep-deprived children and teens
• Stimulant medications and medications that reduce REM sleep for narcolepsy, to help control sleep paralysis and cataplexy
• Stimulant medications for idiopathic hypersomnia

If your child is excessively sleepy during the day, we can determine the cause and create a treatment plan to help control sleepiness and improve school performance, mood, and safety. Call 586-254-0707 or complete our online contact form to schedule an evaluation.

Children with insomnia have ongoing difficulty falling asleep, staying asleep, or getting restful sleep, despite enough time in bed. Like adults, children with insomnia can feel tired all day, perform poorly in school and activities, and experience moodiness, irritability, and strained relationships. Common symptoms include:

• Trouble falling asleep at bedtime
• Waking up often during the night
• Waking too early and unable to fall back asleep
• Sleep that does not feel refreshing

If your child’s sleep problem lasts more than a month, a professional evaluation is recommended. The Sleep & Attention Disorders Institute in Sterling Heights treats children ages one and up and is the oldest accredited sleep center in Macomb and Oakland counties. Causes of insomnia in children include:

• Sleep apnea: Repeated choking or gasping at night that prevents deep, restorative sleep
• Brain chemical imbalances: Changes in serotonin, norepinephrine, histamine, dopamine, orexin, and other chemicals that help regulate wakefulness
• Poor sleep habits: Spending too much time in bed, irregular bedtimes, noisy or bright bedrooms, using computers, phones, or TVs in bed, or frequent daytime naps
• Depression and anxiety: Mental health conditions and many medications can interfere with sleep; sleeping pills and alcohol can worsen insomnia in children

Effective, child-safe treatments may involve:

• Treating sleep apnea with tonsillectomy or CPAP, when appropriate
• Medicines that reduce overactive wake-promoting chemicals in the brain (not addictive sedative sleeping pills)
• Cognitive behavioral therapy for insomnia (CBT-I) to improve sleep habits, including:
  • Shorter time in bed and no naps
  • Getting out of bed if unable to sleep
  • Avoiding TV, reading, and electronics in bed
  • Keeping a regular sleep schedule
  • Relaxing before bedtime
  • Making the bedroom quiet and dark

Sedative sleeping pills are usually not effective or appropriate for children and can be addictive, so they should not be routinely prescribed. We focus on safe, evidence-based treatments tailored to your child. To find the best treatment for your child’s insomnia or other sleep disorder, call 586-254-0707.

Circadian rhythm sleep disorders (CRSDs) are problems with the body’s internal 24-hour clock that keeps sleep and wake times aligned with the sun’s cycle. The most common type in children and especially teenagers is Delayed Sleep Phase Disorder.

Children and teens with delayed sleep phase disorder naturally fall asleep much later and wake up much later than desired, often complaining of insomnia at bedtime and experiencing daytime sleepiness. Although challenging, this condition is treatable.

If your child struggles to fall asleep and wake up on time for school or activities, we can look for underlying causes, confirm a circadian rhythm disorder, and recommend strategies and treatments to adjust their sleep schedule. Call 586-254-0707 or complete our secure online form to request an appointment.

Sleep-related movement disorders involve unusual or repetitive movements at rest, at bedtime, or during sleep. Some of these conditions are more common in children and can be distressing for families. Examples include:

• Restless Legs Syndrome (RLS): Uncomfortable leg sensations and an urge to move the legs, usually at rest or near bedtime, temporarily relieved by movement; in children, RLS is sometimes mistakenly called “growing pains.”
• Periodic Limb Movement Disorder (PLMD): Repeated leg jerks during sleep, often identified on a sleep study.
• Sleep-related leg cramps: Sudden, painful leg cramps during sleep, less common in children.
• Sleep-related bruxism: Teeth grinding during sleep; dentists can provide devices to protect the teeth and keep upper and lower teeth separated.
• Sleep-related rhythmic movement disorder: Repetitive rocking or head-banging while falling asleep or during brief awakenings, often more common in young children and usually improves with age.

These conditions can be frightening or disruptive, and seizures can sometimes look similar. If mild, rhythmic movements may not need treatment; when symptoms are more severe, medications may be considered, though they do not always work reliably. If your child has unusual movements in sleep, we can help determine whether a movement disorder, seizure, or another condition is present and advise you on the safest next steps.