Last update:

   08-Jul-2004
 

Arch Hellen Med, 19(6), November-December 2002, 633-644

REVIEW

Τhe developmental approach to sleep disorders

H. LAZARATOU,1 D. DIKEOS2
1Community Mental Health Centre, Child Psychiatry Service,
Department of Psychiatry, University of Athens, Medical School
2Sleep Research Unit, Department of Psychiatry,
University of Athens, Medical School, Athens, Greece

Sleep disorders of childhood are quite common, but they have been studied to a lesser extent than those of adulthood. This review, which concerns only the primary sleep disorders and not sleep disorders related to other mental disorders or medical conditions, is based on a developmental approach. Primary sleep disorders of childhood vary in regard to the age of onset and presentation depending on the developmental stage. Sleep during infancy is depend on temperamental factors and on the establishment of a healthy interaction between mother and infant. The most important sleep disorder at this age is insomnia, which is the commonest psychosomatic disorder of early childhood. During the pre-school age insomnia is related mainly to separation anxiety. At this age parasomnias, such as night terrors, nightmares and sleep-walking, can also appear. Difficulty in settling to sleep is the most common sleep problem of school age. Two intrinsic dyssomnias, sleep apnea syndrome and narcolepsy, as well as parasomnias such as enuresis and bruxism may also be first manifested at this age. During adolescence, disorders related to the circadian rhythm are the most prominent sleep result from problems; these dyssomnias restinction of sleep in favour of educational, recreational, social and other activities, leading to interruption of the normal sleep-wake pattern and to marked reduction of the total sleep time. The treatment of sleep disorders of childhood consists of parental counseling, in order to ameliorate sleep hygiene, behavioral modification of sleep habits, psychotherapy and, only rarely and if strongly indicated, drug administration.

Key words: Adolescence, Children, Development, Sleep, Sleep disorders.


© Archives of Hellenic Medicine