Sleep disorders

Summaries

Objective: The aim of this article is to update the topic of sleep disorders in childhood. Data sources: normal aspects of sleep ontogenesis and the management of the most prevalent sleep disorders in childhood were reviewed. The text was based on classic articles and books in the literature and on Medline research (publications from the years 2000 and 2001), using the terms sleep disorders and childhood. Data synthesis: the article was structured in topics, presented in a descriptive way, containing the definition of the sleep disorder, age at risk, clinical characteristics and therapeutic management. Conclusions: sleep disturbances are quite frequent complaints in the pediatric office, and its accurate diagnosis is essential for the establishment of adequate therapy. In most cases,

sleep disorders; childhood; sudden infant death syndrome; apneas

Objective: the aim of this article is to review and update the knowledge about sleep disorders in childhood. Sources: normal sleep ontogenesis and therapeutics for the most prevalent sleep disorders were reviewed. The text was based on traditional articles and books and on Medline (publications from 2000 and 2001) using the key words sleep disorders and childhood. the article was structured on descriptive themes containing definition of the sleep disorder, age, clinical presentation and therapeutics. Swift of the findings: sleep disorders are frequent concerns referred to in pediatrics outpatient clinics, and a correct diagnosis is the main goal to establish therapeutic procedures. Conclusions:

sleep disorders; childhood; sudden newborn death syndrome; apnea

Sleep disorders

Magda Lahorgue Nunes 1

ABSTRACT

Objective: The aim of this article is to update the topic of sleep disorders in childhood.

Data sources: normal aspects of sleep ontogenesis and the management of the most prevalent sleep disorders in childhood were reviewed. The text was based on classic articles and books in the literature and on Medline research (publications from the years 2000 and 2001), using the terms sleep disorders and childhood.

Data synthesis: the article was structured in topics, presented in a descriptive way, containing the definition of the sleep disorder, age at risk, clinical characteristics and therapeutic management.

Conclusions: sleep disturbances are quite frequent complaints in the pediatric office, and its accurate diagnosis is essential for the establishment of adequate therapy. In most cases, a good history is sufficient for the diagnosis and to assure the parents that the problem is benign and that the best treatment is provided.

sleep disorders, childhood, sudden infant death syndrome, apneas.

Objective: the aim of this article is to review and update the knowledge about sleep disorders in childhood.

Sources: normal sleep ontogenesis and therapeutics for the most prevalent sleep disorders were reviewed. The text was based on classical apprenticeships and books and on Medline (publications from 2000 and 2001) using the key words sleep disorders and childhood. the article was structured on descriptive topics containing definition of the sleep disorder, age, clinical presentation and therapeutics.

Summary of the findings: sleep disorders are frequent concerns referred to pediatrics outpatient clinics, and a correct diagnosis is the main goal to establish therapeutic procedures.

Conclusions: In the majority of cases clinical history is sufficient to establish diagnosis and assuring parents of the benign evolution of the symptoms of the better treatment.

sleep disorders, childhood, sudden infant death syndrome, apnea.

Introduction

Normal sleep pattern from the neonatal period to adolescence

Sleep disturbances are quite frequent complaints in the pediatric office. However, in most cases, a good anamnesis is sufficient for the diagnosis and to assure the parents that the problem is benign and that the best treatment is provided (1-3). Most sleep disorders can occur in both adults and children, what differs is their presentation. Possibly, only colic and sudden infant death syndrome (SIDS) are sleep disorders unique to childhood (2), the others can occur at any age, although some predominate in childhood. The objectives of this article are to illustrate normal aspects of sleep ontogenesis, since, in some cases, knowledge of normal sleep patterns guide the treatment of sleep disorders,

Normal sleep pattern from the neonatal period to adolescence

Circadian rhythms are already established from the perinatal period. The newborn (NB) has its sleep pattern within an ultradian rhythm (< 24 hours), and, only after the neonatal period, sleep starts to present a circadian rhythm (equivalent to 24 hours).

At birth, the NB has periods of 3-4 hours of continuous sleep, interspersed with about an hour of awakening. This rhythm occurs continuously throughout the day and night. In the neonatal period, the alternation of sleep stages lasts 50-60 minutes, the cycle starts in REM sleep and, the more premature the NB, the longer the duration of time in REM sleep. During the first month of life, the sleep-wake cycle begins to adapt to the night-day cycle. At the end of the first month of life, the periods of night sleep become longer.

Important structural changes in sleep architecture start during the third month of life, sleep starts in the NREM phase, and by the sixth month of life, 90% of infants should have already made this change. At this age, the longest period of uninterrupted sleep usually does not exceed 200 minutes.

At six months, the longest period of uninterrupted sleep does not exceed six hours. The night is divided into two continuous periods of sleep, interspersed with an awakening. During the day, wake consolidation begins to occur, but it is still interrupted by periods of daytime sleep.

Between 9-10 months, the infant sleeps an average of 9-10 hours a night, and 2-3 hours a day, divided into two naps.

At 12 months, nocturnal sleep consolidation should occur, with 1-2 daytime naps remaining.

Between 2-3 years, there are long periods of nocturnal sleep (± 10 hours), and one or two daytime naps (mid-morning and early afternoon), which do not exceed a total of two hours. By age three, only an afternoon nap is usually required.