Sleep disturbances part 2: sleep-onset disorders
These disorders are different from the arousal disorders in that they are almost always limited to the manner in which a child falls asleep.
They can happen when little ones experience a lot of difficulty in getting off to sleep in the first place. Although many sleep-onset disorders are harmless, they can be quite disturbing for parents. However, for some reason it is one of the only ways some children can fall asleep.
These disorders can include, for example, energetic rocking on all fours in order to fall asleep, banging their heads on cot railings, chanting quite loudly and making all sorts of noises. Sometimes, this becomes a child’s normal pattern, rather than being a difficulty for the little one. As long as children are safe, I would tend not to be too concerned about these as children tend to grow out of them. They are usually trying to process the events of the day. As children get older, and if the disorder seems to become a bigger problem, some behavioural therapies to help them with their coping skills can be really effective.
Sleep apnoea is often thought of by parents simply as “repeated waking” and, therefore, wrongly treated with sleep-training techniques.
However, true sleep apnoea needs to be diagnosed by a GP or paediatrician. It is more often found in adults who are overweight, but can happen with young children too.
An apnoea occurs where the brain forgets to tell the body to breathe for a short period. Then, the child will start breathing again with quite a startle. Sleep apnoea is caused by breathing difficulties due to a possible obstruction. Children with these difficulties may snore quite loudly, or may breathe with their mouths open whilst they sleep. They may also be extremely tired during the day, because they are often jolted out of their sleep at night; they don’t really experience good-quality rest, resulting in their feeling exhausted during the day. So, even though they may not be bothering parents at night, they are not having good restful sleep.
Sleep apnoea can often be eased by having your tonsils out or adenoids removed. In worst-case scenarios, there is a breathing machine called a CPAP, which involves wearing a breathing mask at night in order to keep breathing patterns more regular.
I know that this all sounds very dangerous, but it really should be something parents are aware of. People’s lives are not at immediate risk directly from having a sleep apnoea, but the knock-on effect of stopping breathing regularly during the night can seriously impact health. That is why, if you suspect your child may have this problem, you should go to see your GP or paediatrician.
Narcolepsy is a very rare condition in which people have an uncontrollable urge to sleep. It is potentially very dangerous, as they can fall asleep at any time and place. Narcolepsy requires medical intervention. I am including it here simply as part of general information on the topic of sleep disorders. Should I come across it in my practice, I would always recommend a consultation with a paediatrician or medical specialist.
So, whilst the above sleep disorders are relatively uncommon, they are really worth being aware of. Like I have said, they are all manageable and/or treatable, either through medical intervention or in the case of last months’ piece, some simple adjustments to sleep habits.
Niamh O’Reilly is a sleep coach. She's also a baby and childcare guru, a 'parent nanny' and the answer to many a weary parent's woes. A regular in the Irish media, Niamh's book, No Fuss Baby & Toddler Sleep, is now available to buy from all good book stores or online from Amazon.com.