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Apnea Hypopnea Syndrome
Sleep pathology in children

Definition

Childhood insomnia is a sleep disturbance that affects between 20%-30% of the child population up to preschool age (similar data in different studies even in different cultures), and is characterized by difficulty falling asleep autonomously. and/or frequent nocturnal awakenings during the night with inability to return to sleep without external help (Sleep Onset Association Disorder).

It also occurs in the form of the child’s resistance to going to bed at night at the stipulated time (Limit Setting Disorder) or a combination of both.

Symptoms

Symptoms of childhood insomnia may include difficulty falling asleep, frequent nighttime awakenings, early morning awakenings, resistance to going to bed, restless or restless sleep, unrefreshing sleep, excessive daytime sleepiness, irritability, changes in behavior. ment and mood, difficulties in school performance, problems with attention and concentration, and fatigue during the day.

It is important to note that these symptoms can vary from child to child and may have different underlying causes.

Causes

The cause of childhood insomnia can be multifactorial, and predisposing, precipitating and perpetuating factors must be analyzed through a functional analysis to reach an accurate diagnosis. It can have various causes, including emotional, environmental and medical factors, and may require a multidisciplinary approach for diagnosis and treatment.

Childhood insomnia can have a strong impact on the child, including daytime effects on mood, cognitive, behavioral and health, as well as family dysfunctions. It can also affect the quality of life and mood of parents.

The etiology of pediatric insomnia may respond to medical causes (food intolerances, gastroesophageal reflux, pain…), sleep disturbances (infantile RLS, apneas…) or psychological causes (anxiety disorders, fears…).

Diagnosis

The diagnosis of childhood insomnia requires a complete evaluation that includes a detailed review of the child’s medical and sleep history, as well as a psychological and behavioral evaluation.

It is important to analyze the factors that contribute to insomnia, including predisposing, precipitating and perpetuating factors, and perform a functional analysis of the situation to reach an accurate diagnosis.

Additionally, other medical and psychiatric conditions that may be affecting the child’s sleep should be ruled out. Diagnosis may require the participation of an interdisciplinary team that includes a pediatrician, a sleep specialist, a psychologist, and an occupational therapist.

Treatment

The treatment of childhood insomnia depends on its cause, and to address childhood insomnia due to incorrect habits, behavioral interventions based on the principles of behavioral psychology are used. Treatments may vary depending on the age of the children, but in general, behavioral guidelines are taught to parents to apply to younger children, while in older children, the child’s direct collaboration is required and positive reinforcement and distraction techniques.

It is essential to make an adequate diagnosis before starting any therapeutic strategy.