Your child’s sleep issues: Real or imagined?

Do your children really have as much trouble sleeping as you think they do? A recent study suggests that how well a parent sleeps may affect how well he or she thinks their children sleep. The study, published in the April 2016 issue of Pediatrics, ultimately found that parents who have trouble sleeping tend to overestimate their children’s sleep problems.

We asked Brent Haberman, MD, a Le Bonheur pediatric pulmonologist and sleep medicine specialist, to weigh on this finding.

What are your thoughts on this study? Are parents’ sleep patterns or habits something you consider when treating a child?

This is an interesting study and one of the firsts to link parental sleep habits to over-reporting of their children's sleep symptoms.  Several earlier studies have shown that parental report of sleep time and sleep symptoms can often be inaccurate and over- or under-reported. 

Sleep questionnaires are often good predictors of sleep apnea or restless leg syndrome in adults, but similar questionnaires are not nearly as accurate in children.  This makes sense if you think about parents closely observing their toddler’s sleep and thinking that normal sleep behaviors like pauses after deep breaths or arousals are abnormal.  In contrast, one can also think about a teenager who has his parents convinced that he is asleep, when he is actually quietly playing video games or texting in his bedroom. 

In our clinic, when there is significant concern of a patient's sleep pattern, or if the parents don't feel like they know what the pattern is exactly, then we use a technique like they used in this study -- using a wrist- or ankle-worn device that detects movement to tell when the child may be asleep. We look at this pattern over several weeks.

When should you consult a doctor about your child’s sleep disturbances?

The most common reasons for referral to our sleep clinic are:

• concern for sleep apnea (continuous and/or loud snoring for more than three nights per week for most of the night)
• daytime sleepiness despite adequate sleep times
• difficulty initiating or maintaining sleep despite improving sleep hygiene (no TV before bed, no co-sleeping, etc.). 

Sleep behaviors such as sleep talking, sleep walking and night terrors are normal variants and usually just need simple counseling.

What are some causes of sleep issues in kids?

The main sleep issue in children is the same in adults—insufficient sleep.  There are many reasons for this.   Electronic media used close to bedtime is a powerful stimulant telling the brain to stay awake.  This can often mask when a person is actually sleepy.  Co-sleeping is also a common sleep disruptor.  Children need a quiet, dark and cool environment for sleep.  Early wake times for school and late parental work schedules are also common reasons for sleep deprivation in children. 

One easy way to detect sleep deprivation is if your child falls asleep on short car rides or when not stimulated.  Most children who get the recommended amount of sleep will not fall asleep in these situations. 

How important is sleep for children? What other issues can be caused by poor sleep?

Sleep is incredibly important in children.  We already know that sleep influences the way our brains learn and react, and this is no different in children.  Sleep deprivation can also lead to inattention, emotional irritability and hyperactivity in younger children (toddler-school aged) and learning issues or drowsiness in older children (late grade school-high school).  The important thing to know is that your toddler will not appear sleepy in the same way an adult appears sleepy.  They may be aggressive or hyperactive in contrast.

What else do we need to know?

Many sleep concerns such as insomnia in children are treated with behavioral therapies, which have been shown to be more effective and longer lasting than treatment with medications.  These therapies work best when implemented by a sleep specialist who has been trained to treat these issues.