PEDIATRICS & TEENS
What makes pediatric sleep different than adult sleep?
Children are not “small adults” when it comes to sleep. Sleep architecture and processes vary between infants, school-aged children, and adolescents. Children’s sleep does not begin to resemble the stages, processes, or characteristics of adult sleep until their teen years.
The main differences between pediatrics and adults
The amount of sleep necessary to function is different.
While adults need about 7 to 9 hours of sleep per night, newborns require 18 hours daily; toddlers need up to 14 hours mostly at night (but with naps), and preteens, up to 11 hours at night.
The time of day when sleep occurs varies.
Infants sleep at all times of the day, but gradually develop circadian rhythms which match the rhythms of adults over the course of childhood. Daytime naps are generally a good practice for toddlers up to preschool age to ensure they get adequate sleep while transitioning to a mostly wakeful day and sleep-filled night.
The types of staging that make up sleep architecture are not the same, in the beginning.
Babies do not have regular sleep stages until around six months. They cycle through periods of “active” and “quiet” sleep. Active sleep might be compared to the adult REM cycle: the eyes make distinct movements while shut during this stage of sleep, and busy neurological processes take place at this time. Quiet sleep is the time when growth hormones are released to help with body development. Eventually, as their brains continue to develop, their brain waves take on new patterns that more closely resemble those in normal adult sleep; their breathing and other sleep-related processes also evolve over childhood as well.
>>>Note: It’s no longer safe to assume that behavioral problems during the day in school-aged children point to problems with attention deficit or hyperactivity. Many of the same daytime behavioral symptoms seen in kids with ADHD are also the same problems occurring in kids with untreated obstructive sleep apnea. Learn more here.
What makes adolescent sleep different than adult sleep?
Teenagers have sleep patterns that closely resemble adult sleep. However, they still experience a much larger quantity of deep sleep than adults do, which is due to the fact that the adolescent brain is undergoing some major developments at this time.
The other pattern that changes for teens, which is also related to these core changes in brain physiology, is their need to sleep (and rise) later. This is not a behavior caused by laziness, defiance, or bad attitude; the brain changes occurring at this time demand a shift in circadian rhythms to a later phase due to major fluctuations in hormones.
If you can’t rouse your teenager at 7am in the morning to go to school, it’s probably because their brain was running on full steam until about 2am and they aren’t ready to wake up yet. They still need 9 or more hours of sleep and will continue to need this until early adulthood. If they don’t get regular full nights of sleep, this deprivation will show up in both athletic and school performance as well as behavior problems.
Pediatric Sleep Disorders
The following are the most common sleep problems in children.
- Insomnia (all ages)
- Sleep Breathing Disorders
- Central Sleep Apnea (younger children, usually)
- Obstructive Sleep Apnea (OSA) (all ages)
- Sleep Related Hypoventilation/Hypoxemic Syndrome (younger children, usually)
- Snoring (all ages)
- Upper Airway Resistance Syndrome (UARS) (all ages)
- Klein-Levin Syndrome (adolescence)
- Narcolepsy with or without Cataplexy (adolescence)
- Circadian Rhythm Disorders
- Delayed Sleep Phase Disorder (adolescence)
- Confusional Arousals (all ages)
- Nightmare Disorder (all ages)
- REM Behavior Disorder (all ages)
- Sleep Enuresis (bedwetting) (younger children, usually)
- Sleep Paralysis (all ages)
- Sleep Terrors (younger children, usually)
- Sleepwalking (younger children, usually)
- Sleeptalking (all ages)
- Sudden Infant Death Syndrome (infants)*
- Movement Disorders
- Restless Leg Syndrome (all ages)
- Rhythmic Movement Disorder (younger children, usually)
- Periodic Leg Movement Disorder (all ages)
*Regarding Sudden Infant Death Syndrome (SIDS): There is no conclusive agreement as to the cause of SIDS, but current research is pointing to potential triggers in brain functions regulating respiration, the presence of sleep-induced cardiac arrhythmias and, possibly, Congenital Central Hypoventilation Syndrome. Learn more here.