Sleep problems are often still a problem for toddlers and kindergarten children. But when do we speak of a sleep disorder?
Many children have problems with sleeping from time to time
Almost a quarter of all infants have problems sleeping through the night – or more precisely, falling back to sleep. Some children even show severe sleep disorders.
Even at the age of three or four, many children still find it difficult to sleep. However, problems with going to bed and falling asleep come to the fore at this age. In preschool and school age, children’s sleep can still be frequently disturbed by night terrors (Pavor nocturnus), nocturnal sleep drunkenness, sleepwalking and talking in their sleep or by nightmares. Some disabilities may also be associated with problems falling asleep and/or sleeping through the night. However, not every sleep problem is also a disorder.
In the first twelve months of life, there is generally no talk of sleep disorders. The baby has yet to develop its sleep-wake rhythm, and nighttime awakenings correspond to the frequent feeding and growth that is still necessary at this age. Even in the further course of development, children’s sleep continues to change. In certain age and developmental phases, problems can occur again and again, but they are usually of a temporary nature. Although they can sometimes disturb the child’s sleep and that of the entire family, they do not have to be a cause for concern.
It is different when sleep problems are persistent and affect a child’s health and development or become a heavy burden for the whole family.
When to talk about "sleep disorders
Problems with sleeping can reveal a lot about what is going on in a child’s life – what they have experienced during the day or what developmental steps they are currently taking. In some cases, sleep problems can also be an indication of illnesses.
The most common sleep disorders in childhood and adolescence can be assigned to three groups:
- Difficulty falling asleep and staying asleep (insomnia),
- Waking disorders (parasomnias, nocturnal awakenings associated with special phenomena),
- Sleepiness and daytime sleepiness (hypersomnia).
As a rule, however, we only speak of a sleep disorder when a certain problem appears regularly and frequently over a longer period of time and the child is older than twelve months:
Sleep disturbances occur when a child has problems sleeping after the end of the first year of life
- Regularly can only fall asleep with elaborate help from parents, for example, by carrying them around for a long time, and
- needs more than 30 minutes of sleep on more than five nights a week for more than one month.
Trouble sleeping through the night is when a child of this age regularly has
- Wakes up three or more times a night on more than five nights a week for more than a month,
- is awake for more than 30 minutes on average when they wake up at night, and
- needs the parents’ help to fall back asleep.
Whether medical treatment is necessary always depends on whether the problem is a burden on the child and parents and how much it affects everyday family life.
Once a sleep problem is known, it can often be solved with some patience and consistency. For example, a structured daily routine with fixed bedtimes, bedtime rituals and bedtime routines not only makes it easier for the child to "learn to sleep. Also with many sleep problems the solution of the problem usually already begins with such routines and structures.
Sleep-in and sleep-through problems are often found in the first two years of life
Most children develop a fairly stable rhythm between sleeping and waking during the first six months of life. With the help of the nightly bedtime ritual, they gradually find it easier to fall asleep on their own, and if they repeatedly wake up briefly at night – which is quite normal in infancy – they are usually soon able to fall asleep again without significant help from their parents.
However, some children also find it difficult. They may have a natural tendency to be restless, have difficulty regulating their behavior according to their age and stage of development, or have overall difficulty finding a rhythm.
Often, however, the cause of sleep problems with falling asleep and staying asleep lies in already ingrained habits. They have crept in – perhaps quite unnoticed – and make it difficult for the child to learn to fall asleep and stay asleep on their own. For example, once a child has become accustomed to being carried or driven around until it falls asleep, it usually needs the parents’ support when it wakes up at night. Often it demands then also as a toddler such complex sleep aids every evening still in.
Even if the sleeping times simply do not want to settle in after the first months of life, it is often the case that the child – for example, due to a lack of routines and structures in the daily routine – may find it difficult to find a stable rhythm overall. In most cases, regular mealtimes have not yet become established. If such an unstable rhythm becomes established, it may be that falling asleep is still difficult in infancy, the child still wakes up several times during the night and is noticeably tired during the day. Such rhythm-related sleep disorders can be very persistent and require consistent adherence to fixed bedtimes over a longer period of time, often under medical supervision.
In most cases, however, once established habits have been identified, they can be changed with a little patience and consistency. Here’s how you can help your child get to bed and fall asleep. Try to structure the daily routine with fixed mealtimes and bedtimes, introduce consistent bedtime routines and calm your child with an evening bedtime ritual in which he or she receives attention and care.
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