Toddler health

Sleep busters

A parent's glossary

By Andrea Neblett
Sleep busters

Bedwetting, also known as nocturnal enuresis, is normal during potty training — many kids’ bladders are overactive with small capacities. But if your child does it more than twice a month past age six, that could indicate a problem — especially if the bedwetting recurs after six or more dry months (known as secondary enuresis). Causes can include stress or a medical reason such as a urinary tract infection. Enuresis runs in families and affects boys more than girls. Don’t blame or punish your child. Instead, try to be patient and supportive. Let your child wear disposable pull-on pants and avoid fluids within two hours of bedtime. Also cut out caffeinated, carbonated and citrus drinks, which can irritate the bladder. About 10 percent of kids stop bedwetting with each year of age.

Bruxism refers to grinding or clenching of the teeth, usually during sleep. It can start around age five or six, and most children outgrow it by 10. Some causes include having a bite that’s out of alignment, stress, tension or allergies. In most cases, the grinding doesn’t cause serious complications, but it can lead to tooth or jaw damage, facial pain, tension headaches and joint disorders. If you suspect stress is making your child grind her teeth, a first step is to figure out what’s bothering her and help her find ways to cope. A one-hour wind-down routine starting with a bath, followed by reading or a quiet hobby (no TV, computer or video games) may help. A light, healthy carbohydrate snack also results in serotonin and melatonin production — good for restful sleep. Also, a dentist can create a mouthguard to prevent further damage to teeth.

Nightmares are vivid, frightening dreams that occur during rapid eye movement (REM) sleep, the most active stage of the sleep cycle. Your child will wake up afraid and anxious and remember exactly what happened. Boys are more likely to get them than girls, starting as early as 18 months. Scary dreams are a normal part of child development and generally don’t require treatment — just lots of hugs and reassurance from you. Nightmares tend to diminish during adolescence. However, in some cases, persistent and frequent nightmares have been linked to sexual abuse or other traumatic experiences, or to nocturnal seizures (epileptic attacks that occur during sleep).

Night terrors occur when a child suddenly sits up during sleep with eyes open or closed and starts to kick, thrash or yell incoherently. He’ll appear afraid, his heart will race and he’ll sweat and breathe heavily. The episodes, also called sleep terrors or confusional arousals, may last just a few minutes, or up to 40, and generally occur from ages one to eight. Boys and girls are equally affected. Your child won’t respond to you, and will appear confused or disoriented once awake, unable to remember what happened, in contrast to nightmares. Night terrors run in families and are linked to fatigue, stress, sleepwalking and obstructive sleep apnea. Children often have them within the first few hours of sleep. Try waking your child about 30 minutes before they typically begin, talk to him for about five minutes, then let him fall asleep again. During a terror episode, while it may be difficult, try not to wake your child — it may add to his distress. Instead, talk to him calmly to intrude into the dream, keep the lights off and wait it out. To reduce future bouts, make sure your child doesn’t become overtired, keep regular bedtimes and try relaxation techniques.

Nocturnal leg cramps are sudden, sharp cramps in the leg (usually the calf) and feet. They can last for a few seconds or several minutes. Most children and teens experience them infrequently. The exact cause is unknown, but possible culprits include flat feet, dehydration, vigorous exercise, low blood calcium or magnesium levels, and diabetes. During a cramp, try massaging your child’s muscle, applying heat or moving the foot. Although there’s debate over prevention, methods include boosting calcium levels and fluids, increasing potassium levels (eating bananas, for instance), taking a hot shower or doing light stretching before bed. Sometimes medications such as asthma prescriptions may be partly to blame, so contact your doctor — ditto if your child’s condition is chronic.

Restless legs syndrome refers to a tingling, creeping sensation in the legs that happens mostly at night. Some people describe it as “bugs crawling in the muscles.” Your child will feel an uncontrollable urge to move her legs to relieve the sensations. About 50 percent of people with RLS have it in their family. The cause isn’t clear, although brain iron deficiency likely plays a role. It’s also worsened by antipsychotic, cold and allergy medications. RLS can cut into your child’s sleep and leave her moody, lethargic and unable to concentrate during the day. It’s also linked to ADHD — one study found that 44 percent of participants with ADHD had RLS or its symptoms. Unfortunately, RLS is typically a lifelong condition. Help your child cope through over-the-counter pain relievers, relaxation exercises such as yoga, hot baths and massaging her legs. Also, have her serum ferritin checked by a doctor to determine her iron levels.

Sleep apnea is the temporary interruption of breathing during sleep. Your child may snore loudly, gasp for breath and stop breathing several times an hour. During the most common type, obstructive sleep apnea, the tongue or other soft tissue blocks the airway. In children, it may be related to allergies, asthma or obesity, but the most common physical cause is enlarged tonsils and adenoids. Apnea can make your child drowsy during the day, irritable, hyperactive and prone to headaches. It’s recently been linked to ADHD. Treatments include breathing devices to keep the airway open during sleep; surgery may be recommended to remove tonsils and adenoids.

Sleepwalking is walking or doing other actions while asleep, typically with eyes open in a glazed stare. It often occurs early in the morning. In children, the cause is unknown, but may be related to fatigue and genetics. Sleepwalking, or somnambulism, occurs equally in boys and girls, peaking around age 11 or 12. Children who sleepwalk may have been more restless sleepers around age four or five, or experienced more frequent awakenings during the first year of life. A common misconception is that you shouldn’t awaken a sleepwalker. To reduce the frequency of sleepwalking episodes, try guiding your child through a pre-bedtime relaxation routine. Also, to keep him from getting hurt, try to keep toys, furniture and electrical cords out of the way. Sleepwalking in children isn’t usually serious and they often outgrow it.

Snoring happens when tissues in the throat collapse during sleep and airflow is blocked, resulting in noisy vibrations. Outside of sniffle-induced stuffiness, snoring is unusual in healthy children. In babies, it may be caused by a rare condition in which cartilage in the trachea fails to develop properly and may require surgery. In older kids and adults, the culprits can be seasonal allergies, a cold or sinus infection, a deviated septum, swollen tonsils, adenoids or obesity. Chronic snoring in children may be a sign of another problem such as sleep apnea. Some remedies include sleeping with head slightly raised, lying on the side or front. Also, keeping allergic triggers like stuffed animals out of the bedroom may help.

This article was originally published on Jan 11, 2006

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