Sleep reciuiremeiits ‘Ihcsc gradually lessen throughout childhood until about the time of puberty, when the need for sleep might actually increase somewhat. This, combined with a physiological delay in the sleep phase at puberty (opposite to the sleep phase advance in the elderly), as well as

late-night social activities, sets the scene for potentially severe sleep deprivation and excessive daytime sleepiness (the delayed sleep phase syndrome, or DSPS) which readily leads to educational and social difficulties in adolescence. Pattern of occurrence of sleep behaviors and disorders ‘Ihis differs between children and adults. Some sleep disorders Inhibitors,research,lifescience,medical occur much more Inhibitors,research,lifescience,medical commonly in children and adolescents, notably bedtime settling and troublesome nightwaking in

young children (the result of not acquiring good sleep habits and ovcrdepcndence on parental attention). Adolescent DSPS has just been mentioned. Other examples include rhythmic movement disorders (such as head-banging), nocturnal enuresis, and arousal disorders seen mainly in prepubertal children. Interestingly, some sleep disorders previously thought to occur mainly or exclusively in adults are now recognized in children, eg., obstructive sleep apnea, restless legs syndrome,9 periodic limb movements in sleep,10 and even REM sleep behavior disorder Inhibitors,research,lifescience,medical (RED).11 Etiological factors In explaining the cause of sleep problems at any age, both physical and psychological possibilities (perhaps in combination) have to be considered. In children, as in adults, neurological, respiratory, metabolic, endocrine, genetic, medication, or other physical factors may have an influence. That said, parenting practices play a major part Inhibitors,research,lifescience,medical in many children’s sleep problems. Parental knowledge, attitudes,

and emotional state often determine selleck kinase inhibitor whether a child’s sleep pattern is a problem or not. Some parents construe normal behavior as a problem; others do not seek help when they should, perhaps because they mistakenly think there is no treatment available. Clinical manifestations Inhibitors,research,lifescience,medical and associations Whereas obesity is a common feature of obstructive sleep apnea (OSA) in adults, enlarged tonsils and adenoids are usually responsible in children. first Although obesity is increasingly an important factor at all ages, only a minority of children with OSA are overweight and, indeed, ver}’ early onset may cause low body weight from failure to thrive. Adult OSA generally causes sleepiness and reduced activity. In contrast (as in other causes of excessive sleepiness such as narcolepsy), some sleepy children are abnormally active. This can lead to a diagnosis of attention-deficit hyperactivity disorder (ADHD) and inappropriate treatment with stimulant drugs. Misdiagnosis ‘Ihcrc is a risk that certain sleep disorders will be misdiagnosed at any age.