Sleep is one of the most natural and essential bodily functions. But, as any parent will tell you, it’s not always smooth sailing. Children go from babies not sleeping enough to teenagers sleeping way too much and in between it’s a never-ending stream of drinks of water, monsters under the bed, accidents, nightmares and more. While those struggles are all common and perfectly normal, there are some sleep disturbances that can be a bit more alarming for parents.
Sleepwalking
Believe it or not, sleepwalking is actually very common, especially in pre-school to school-aged children. As many as 30% of kids will sleepwalk at some point in their childhood. Sleepwalking can occur as often as every night and up to several times per night, though it usually occurs during the first part of the night.
Even though the child’s eyes may be open, they are asleep. They may seem confused and talk nonsense or appear agitated and scream during the episodes (sleep terrors). Sometimes they may do strange things such as urinate in random places or get dressed to go to school. In the morning, the children do not remember anything about the event. Children often outgrow sleepwalking by the time they are teenagers.
Sleepwalking runs in families — a child whose parent or sibling sleepwalks is more likely to sleepwalk. Additional causes include:
- Lack of sleep
- Fever or illness
- Having a full bladder during sleep — this disturbs sleep and can result in nighttime wandering to empty the bladder
- Sleeping in a different environment
- Stress
When a sleepwalking episode occurs, try not to wake the child. Rather, gently redirect them back to bed. If your child is experiencing sleepwalking, it’s important to make sure they’re safe. There should be no harmful objects, such as firearms or knives, that are easily accessible. And make sure the floor of their room is free of obstacles to reduce the risk of them tripping and falling. Also make sure all doors and windows are locked so your child is unable leave the house during an episode.
To help prevent sleepwalking, it’s important to keep a consistent sleep schedule for your child and make sure they get enough sleep.
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Headbanging
Head banging can be alarming to witness, but rest assured it’s perfectly normal. Head banging is a type of rhythmic movement that healthy infants and children often use to fall asleep. Kids tend to do this at the beginning of the night and when they wake up in the middle of the night.
In addition to head banging, babies can use other similar rhythmic behaviors to help them fall asleep, such as:
- Being on their hands and knees and hitting their head repeatedly on the pillow
- Hitting the back of their head against the wall, crib or headboard
- Rolling from side to side
- Humming or moaning with these movements
Many children find these repetitive movements soothing and only engage in these behaviors at night. Parents often fear their child will hurt their heads with the banging, but they won’t. But it is important to set up a few safety precautions.
It is important to make sure they won’t fall out of bed. This can be done by installing siderails on the bed. To decrease the amount of noise these movements may cause, you can move the bed or crib away from the wall or tighten screws on the bed frame. This will help prevent the rest of the household from waking up in the middle of the night. It is also essential to not draw attention to the head banging — if your child is otherwise healthy and normal, it is best to ignore the nighttime behavior.
Most children outgrow the head banging and body rocking by age 5. However, these rhythmic movements have been seen in adolescents and adults as well. And children with developmental disorders such as autism may also have these rhythmic, repetitive movements during the day in addition to the nighttime. Again, that’s rarely a cause for any concern.
Sleep Apnea
Obstructive sleep apnea (OSA) is a condition in which a child stops breathing while sleeping. This is usually caused by a blockage in the airway. As the body tries to breathe air into the lungs, the child often wakes up gasping for air. This can occur multiple times throughout the night, resulting in a lack of good, quality sleep.
The most common cause of OSA is enlarged adenoids and tonsils, the two glands on both sides of the back of the throat. When a person is asleep, their muscles relax, which along with the large tonsils/adenoids, results in blockage of the upper airway.
OSA is also more common in kids with Down syndrome — affecting 50-75%. There are several reasons for this:
- Large tongue relative to size of mouth
- Low muscle tone
- Higher risk for obesity
Every child may experience OSA differently, but the most common symptoms are:
- Loud snoring or noisy breathing during sleep
- Gasping noises at night
- Periods of not breathing
- Mouth breathing
- Restlessness during sleep
- Excessive daytime sleepiness or irritability
- Hyperactivity during the day
- Bedwetting
If you suspect your child may be experiencing OSA or if you have any other concerns about their sleep, you should start by talking with your child’s doctor. They can refer your child to an ear, nose and throat specialists for further evaluation. They may also recommend a sleep study — an overnight exam where your child is observed and monitored while sleeping.
Treatment for OSA depends on the cause. If your child has enlarged tonsils and adenoids, then removing those (tonsillectomy and/or adenoidectomy) would be the recommended course of treatment. If your child is overweight, we’d recommend weight loss as well as wearing a special continuous positive airway pressure (CPAP) mask while sleeping to keep the airway open.
Sleep can be tricky, but we’re here to help. If you ever have any concerns about your child’s health and well-being, please don’t hesitate to reach out to their pediatrician.
