Sleep Problems in Children and Adolescents with Common Medical Conditions
Section snippets
Allergic Rhinitis
One of the most common medical problems in children is allergic rhinitis, a chronic inflammatory disease of the upper airway affecting 10% to 30% of the population, with the greatest frequency found in children and adolescents.20, 21 Chronic allergies are associated with sleep problems and a known risk factor for SDB including habitual snoring, obstructive sleep apnea, and adenoid hypertrophy due to the chronic effects of inflammation.22, 23 Atopic symptoms can also affect sleep in children,
Hospitalization and Treatment-Related Factors
The experience of being in hospital is associated with sleep disruptions for many children with medical conditions.31, 72, 73 For example, 25% of hospitalized children with cancer reported poor sleep involving, for example, sleep fragmentation and night wakings.72 Sleep disturbances may be due to disruptions in routine, fears and anxiety about separation from parents, loss of privacy, and frequent interruptions by medical staff. Children may also have to alter their sleeping position because of
Effects of medication on sleep
Both over-the-counter and prescription medications used to treat chronic medical conditions affect sleep. Therefore it is important for the clinician to understand the effects on sleep of commonly used medications including antihistamines, antidepressants, anticonvulsants, corticosteroids, opioids, and benzodiazepines.
Evaluation of sleep problems
The clinical evaluation of sleep and its related disorders in children with medical conditions is challenging. Some sleep disorders or disturbances have a gradual onset and remain undetected for an extended period of time, in part because of the absence of adequate sleep assessment. Parents, children, and adolescents may not be familiar with the signs and symptoms (ie, altered mood, daytime sleepiness, inattention, and hyperactivity) or may attribute sleep disruptions to their underlying
Treatment of sleep problems
The clinician’s approach to management of sleep problems in children with common medical conditions is challenging and complex. The goal of treatment involves promotion of healthy sleep habits, prevention strategies, and treatment of diagnosed sleep disorders. Similar to otherwise healthy children, treatment of SDB in children and adolescents with medical conditions includes tonsillectomy and adenoidectomy, pharmacological interventions, and the use of noninvasive ventilation devices (eg,
Summary and recommendations
Sleep is an important consideration in the management of common medical conditions in children and adolescents. Sleep loss carries specific health risks that may exacerbate a chronic condition and disease-related symptoms. Because of the adverse effects of inadequate sleep and untreated sleep disorders on health outcomes, routine screening for sleep disturbances and disorders as well as sleep assessments are needed to improve the clinical care of children and adolescents with medical
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Cited by (0)
This work was supported in part by Grants No. HD05343 and No. HD060068 from the National Institutes of Health (T.P.).
The authors have nothing to disclose.