Sleep Disorders In Children, The Causes And How To Treat This Disorders.

 

Sleep disorders in children: causes and how to treat these disorders.

DISTÚRBIOS DO SONO EM CRIANÇAS

SLEEP DISORDERS IN CHILDREN

Children's sleep is a crucial part of their healthy development, but it can be affected by a number of factors, whether temporary or permanent, as well as acquired or chronic conditions.

FATORES DE INFLUÊNCIA

Several normal physiological manifestations are related to the maturation process of the body and brain pathways.

 It is essential to differentiate these normal conditions from pathologies or abnormalities that can affect this age group, as, if left untreated, they can harm your child's adequate development.

PRINCIPAIS CAUSAS

The causes of sleep disorders in children are varied and complex. 

Although it is not possible to identify a single cause, three factors have stood out, worrying both parents and experts around the world. Are they:

Physical and mental health problems

Rotina irregular :   Lack of a consistent bedtime routine can throw off a child's biological clock, making it difficult to adopt healthy sleep habits.

 Inappropriate environment : A noisy or poorly lit sleep environment can interrupt the rest needed for restorative sleep.

 Developmental disorders

Attention Deficit Hyperactivity Disorder (ADHD). Children with ADHD often have difficulty falling asleep and staying asleep due to hyperactivity and restlessness.

 Autism : Children on the autism spectrum may have irregular sleeping patterns and difficulty establishing a sleep routine.

Physical and mental health problems

                                          Physical and mental health problems

Respiratory disorders:

 Conditions such as obstructive sleep apnea can repeatedly interrupt sleep throughout the night, leading to a persistent feeling of tiredness. 

ANSIEDADE E ESTRESSE

Emotional factors can significantly interfere with children's sleep, causing insomnia or frequent awakenings.

 IDENTIFICAÇÃO E TRATAMENTO

Identifying the exact cause of sleep disorders in children requires careful assessment and often a multifaceted approach. 

 Healthcare professionals may recommend a combination of interventions, such as adjustments to sleep hygiene, behavioral therapies, and, in some cases, specific medical treatments..

 SÍNDROME DA APNEIA OBSTRUTIVA DO SONO (SAOS)

Obstructive Sleep Apnea Syndrome (OSAS) is a breathing disorder that can affect children differently compared to adults. 

 In children, this disorder is most common between 3 and 6 years of age and is generally related to an increase in adenoid tissue and tonsils, a condition known as adenotonsillar hypertrophy.

CAUSAS E SINTOMAS

Adenotonsillar hypertrophy leads to obstruction of the upper airways, causing snoring, a noise produced by the passage of air through the narrowed airways,

 And sleep apnea, which is the interruption of air passage through the airways.

 This condition can result in: Loud snoring: usually the first sign noticed by parents

Interrupted Breathing During Sleep: Can lead to frequent awakenings.Daytime Sleepiness: Due to poor sleep quality, the child may experience tiredness and irritability during the day.

Behavioral and Learning Problems: 

The lack of restorative sleep can affect school performance and social interactions.

 DIAGNOSIS AND TREATMENT

The diagnosis of OSAS in children generally involves a detailed medical evaluation and, in some cases, a sleep study (polysomnography). 

Treatment may include:

Surgery: Removal of the adenoids and tonsils (adenotonsillectomy) is often recommended to relieve airway obstruction.

ALTERNATIVE THERAPIES:

 In less severe cases, changes in sleeping posture or orthodontic treatments may be suggested.

PARASOMNIAS

Parasomnias are sleep disorders characterized by abnormal behaviors during sleep. 

Although they generally do not cause lasting harm, they can be disturbing for both the child and the parents. Parasomnias are associated with growth and tend to disappear over time.

COMMON TYPES OF PARASOMNIAS
Somniloquy

Description: This is the act of talking while sleeping. Unlike dreams, which occur during the REM phase of sleep, somniloquy happens in other phases of sleep.

Impact: Generally harmless, but it can be an indication of fragmented sleep.

SLEEPWALKING

-Description: Characterized by episodes where the child gets up and walks around while apparently still asleep. This disorder occurs during the NREM phase of sleep.

Impact: Can be dangerous due to the risk of falls or injuries.

Rem Sleep Behavior Disorder

REM SLEEP BEHAVIOR DISORDER

Description: Rare in children but more common in adults. 

It is characterized by rapid and vigorous movements during REM sleep, aligned with the dreams the person is having.

Impact: Can be disturbing and lead to injuries if not managed properly.

EPILEPSY

Although epilepsy is not directly related to sleep, it is important to consider this disorder when evaluating sleep problems in children. 

Between 20% to 40% of children who suffer from epileptic seizures experience them during sleep.

 ROLANDIC EPILEPSY

Description: A common type of epilepsy in school-aged children is Rolandic epilepsy. 

This is a benign form of epilepsy that occurs during sleep and can cause temporary paralysis of the face and upper limbs. 

Although it is considered benign and often disappears over time, it is essential for parents and caregivers to be vigilant for signs and seek medical advice if the seizures are frequent.

 IMPORTANCE OF MEDICAL EVALUATION

Despite many sleep disorders in children being benign and self-limiting, the frequency and intensity of occurrences should be closely monitored. 

If the disorders become persistent or significantly impact the child's quality of life, consulting a healthcare professional is essential for accurate diagnosis and appropriate treatment.

 WHAT ARE SLEEP DISORDERS?

For some people, sleep can be a relief, while for others, it can be a nightmare. 

Experts state that sleep changes throughout life. The older a person gets, the earlier they tire and the earlier they wake up. It is precisei at this stage of life that sleep disorders are most common.

CHANGES IN SLEEP THROUGHOUT LIFE

Babies: Can sleep up to 16 hours a day, with several periods of sleep throughout the day and night.

Adults: Typically need 7 to 8 hours of sleep per night, but the quality and quantity of sleep can vary.

Elderly: Tend to sleep less, with lighter sleep and more frequent awakenings during the night.

Daytime Sleepiness: Feeling tired and sleepy during the day due to an unsatisfactory night's sleep.

WHEN TO SEEK MEDICAL HELP?

Millions of people suffer from sleep-related problems. The question is knowing when it is isolated cases and when it is necessary to seek medical help. 

Indicators that it is time to seek professional advice include:

Insomnia: Difficulty falling asleep or staying asleep during the night.

Nighttime Awakenings: Waking up in the middle of the night and having trouble going back to sleep.

Daytime Sleepiness: Feeling tired and sleepy during the day due to an unsatisfactory night's sleep.

Frequency and Persistence: If sleep difficulties occur several times a week and last more than three months.

Impact on Quality of Life: If poor sleep negatively affects health, mood, work or school performance, and personal relationships.

Accompanying Symptoms: Presence of other symptoms, such as loud snoring, pauses in breathing, abnormal movements during sleep, or a feeling of choking.

SLEEP AND ITS PHASES

Sleep is divided into four phases, each responsible for different essential activities for health and well-being. Complications in any of these phases can cause short-term and long-term health damage.

Phase 1: Beginning of Sleep: The first phase of sleep starts when the person feels the first signs of sleepiness. 

During this phase, the person is easily awakened.

Phase 2: Light Sleep: In phase two, body temperature, breathing, and heart rate decrease. This phase is known as light sleep.

Phase 3: Deep Sleep: Phase three is similar to the second, but the sleep is deeper and more difficult to interrupt.

Phase 4: REM Sleep: The fourth phase is known as deep sleep or REM (Rapid Eye Movement) sleep. 

It is during this phase that dreams occur. During REM sleep, the eyes move rapidly, and brain activity is similar to when we are awake.

A good night's sleep is essential to ensure readiness for work, study, and leisure. More than that, it is fundamental to maintaining health.

SYMPTOMS OF SLEEP DISORDERS

The first signs of sleep disorders can include mood changes and mental capacity issues, such as memory and reasoning problems. Other common symptoms include:

Restless Legs, Sleepwalking, Insomnia, Excessive Sleepiness

SLEEP APNEA

Sleeping well is crucial for health. Good sleep quality is as important as diet and exercise. 

People who sleep too little or too much may be at risk of developing diseases such as hypertension and diabetes.

NOCTURNAL ENURESIS

Nocturnal enuresis, commonly known as "bedwetting," is the involuntary act of urinating during sleep. 

For girls over 5 years old and boys over 6 years old, it is considered abnormal if it occurs more than twice a month. 

While it mainly affects children and adolescents, it can persist in some young people, affecting 2% to 3% of this population.

CAUSES

Nocturnal enuresis has biological causes, with genetics playing a significant role. If one parent had enuresis in childhood, the child's risk is 40%, increasing to 80% if both parents had it. Other causes may include urinary tract infections or congenital malformations.

TYPES OF ENURESIS

1. Primary Nocturnal Enuresis: When the child has never had a prolonged period of urinary control. This is the most common form, affecting 15% of children over five years old.

2. Secondary Nocturnal Enuresis: When the child had a period of control (about six months) and suddenly starts wetting the bed again. It is usually associated with emotional factors.

IMPACT ON QUALITY OF LIFE

Untreated primary nocturnal enuresis can significantly impact a child's quality of life, resulting in low self-esteem, anxiety, and poor school performance. 

Children may isolate themselves, avoid sleeping outside the home, and decline friends' invitations.

TREATMENT

Effective treatments for nocturnal enuresis include habit changes, behavioral therapies, and medications. Treatment options vary according to each patient's needs. 

Some parents prefer to wait for the child to acquire control spontaneously, but treatment can accelerate the healing process and help preserve the child's self-esteem.

TIPS FOR PARENTS

Encourage Water Intake During the Day: This helps the brain recognize the sensation of a full bladder. However, limit liquid intake at night.

Create a Bathroom Routine: Ensure that urinating is the last thing the child does before bed and the first upon waking.

Be Patient: Approach enuresis with understanding. Various factors, including psychological ones, can contribute to the problem.

Seek Medical Help: If a child over seven still wets the bed at night, it is important to seek medical assistance.

 SNORING: CAUSES AND CONSEQUENCES

Snoring is considered a common sleep disorder, affecting up to 30% of the world's population. 

Although seen as a normal phenomenon, it can become a serious problem when its impact goes beyond the bedroom, disturbing even neighbors.

WHAT IS SNORING?

Snoring results from a partial obstruction of the airways during sleep. This can occur for several reasons:

Contact of the Pharynx Walls: During sleep, the pharynx walls can come into contact due to muscle relaxation and loss of elasticity, especially with aging.

Nasal Obstruction: Increased secretions and mucus production can cause nasal obstruction, contributing to snoring.

CONTRIBUTING FACTORS

1. Age and Elasticity: With aging, tissue elasticity decreases, increasing the likelihood of snoring.

2. Muscle Relaxation: Sleep causes muscle relaxation in the chest and throat, which can lead to involuntary mouth opening and altered coordination between diaphragm and throat muscle contractions.

 RELATION TO SLEEP APNEA

Intense snoring is often an initial sign of a more serious problem, sleep apnea. 

This condition is characterized by repeated periods of total airway obstruction, resulting in breathing pauses during sleep. 

These pauses can lead to multiple nighttime awakenings, fragmenting sleep and reducing quality of life.

IMPACT OF OBESITY

Obesity is a significant factor in snoring, especially in men, where weight gain is more common in the neck, chest, and abdomen. 

Accumulated fat in these areas can interfere with diaphragm contractions and push the diaphragm up, obstructing breathing. 

Abdominal fat hinders circulation, overloading the cardiovascular and pulmonary systems.

NEUROMUSCULAR DEFICIENCY DISEASE

In special cases, snoring can indicate a neuromuscular deficiency disease known as Floppy Throat. 

This condition results in decreased muscle tone in the pharynx, causing its walls to contact and vibrate during air passage, characterizing snoring.

CONSEQUENCES OF SNORING

While snoring affects those around the snorer, the most concerning consequences occur for the snorer. 

Airway obstruction can evolve into sleep apnea, where there is total obstruction of the respiratory flow. 

This prevents air from reaching the lungs, reducing blood oxygen levels, which can cause:

Heart Diseases: Reduced oxygen flow can increase the risk of hypertension, heart failure, and other cardiovascular problems.

Brain Complications: Lack of oxygen in the blood can lead to cognitive issues, including memory problems, concentration difficulties, and increased risk of stroke.

RECOMMENDATIONS TO REDUCE SNORING

To minimize the effects of snoring and prevent sleep apnea, consider the following recommendations:

1. Maintain a Healthy Weight: Losing weight can significantly reduce snoring.

2. Sleep on Your Side: Sleeping on your back can worsen snoring; try sleeping on your side.

3. Avoid Alcohol and Sedatives: These substances relax throat muscles, increasing the likelihood of snoring.

4. Treat Nasal Congestion: Keep airways clear through treatments for allergies or colds.

5. Elevate Your Head: Using pillows to elevate your head can help keep airways open.

6. Exercise: Strengthening throat muscles through specific exercises can reduce snoring.

WHEN TO SEEK MEDICAL HELP

If snoring is intense and frequent, or if there are signs of sleep apnea, it is important to seek medical help. 

A specialist can conduct exams and recommend appropriate treatments, which may include the use of Continuous Positive Airway Pressure (CPAP) devices, surgeries, or other interventions.

CONCLUSION

It is crucial for parents and caregivers to be aware of their children's sleep patterns and seek professional guidance when necessary. 

Quality sleep is essential for healthy physical, emotional, and cognitive development in children, and proactively addressing any sleep problems can make a significant difference in their overall well-being.

Understanding and identifying sleep disorders in children is essential to ensure their healthy development. 

Obstructive Sleep Apnea Syndrome and parasomnias, though distinct, require attention from parents and guidance from health professionals for proper diagnosis and treatment. 

With proper management, it is possible to improve children's sleep quality and, consequently, their general well-being.

Quality sleep is fundamental for health and well-being throughout life. 

Understanding sleep disorders and their causes can help identify when it is necessary to seek professional help. 

For children, in particular, monitoring and managing sleep disorders can prevent developmental problems and ensure healthy and happy growth.