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  • Sleep disorders in children and adolescents†

  • Gregory Stores
  • Journal:
    BJPsych Advances / Volume 21 / Issue 2 / March 2015
    Published online by Cambridge University Press:
    02 January 2018, pp. 124-131
    Print publication:
    March 2015
    • Article
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  • Disordered sleep has long been recognised as both a consequence of psychiatric illness and a contributory factor to its development. Significant sleep disturbance occurs in about 25% of children and adolescents and 80% or more of children in high-risk groups; it often continues into adulthood. All psychiatrists should therefore be familiar with the principles of sleep medicine and the impact of sleep and its disorders. In this article, the relationship between sleep disorders and the breadth of child and adolescent psychiatry in particular is explored. The classification, aetiology and implications of sleep disorders are discussed, as well as the practicalities of screening, diagnosis and management, with a view to informing readers how accurate diagnosis, prevention and successful treatment of sleep disorders can benefit patients and their families.

Sleep and its Disorders in Children and Adolescents with a Neurodevelopmental Disorder
  • A Review and Clinical Guide
  • Gregory Stores
  • Published online:
    05 November 2014
    Print publication:
    27 October 2014
  • Sleep disorders are common in children and adolescents with neurodevelopmental disorders, exacerbating behavioural problems and hindering overall care. Based on a review of published evidence and a wealth of clinical experience, this book provides paediatricians, paediatric neurologists, specialists in intellectual disability, psychiatrists, psychologists, and primary care staff with practical guidance for the investigation and management of these disorders. The book outlines sleep and its disorders in children and adolescents, before discussing special considerations in children with a neurodevelopmental disorder. The next section reviews comorbid conditions that contribute to sleep disturbances, including intellectual disability, epilepsy, sleep-related breathing disorders, sensory deficits, psychiatric disorders, and parenting difficulties. The remainder of the book gives accounts of the sleep disturbance aspects of various neurodevelopmental disorders. Each disorder is considered separately, focussing on the need for a comprehensive, co-ordinated multidisciplinary approach to assessment and treatment. Emphasis throughout is placed on aspects of practical clinical importance.

  • 18 - Sleep disorders

    • By Gregory Stores, Emeritus Professor of Developmental Neuropsychiatry, Department of Psychiatry, University of Oxford, UK
  • Edited by Sarah Huline-Dickens
  • Book:
    Clinical Topics in Child and Adolescent Psychiatry
    Published online:
    02 January 2018
    Print publication:
    01 March 2014, pp 287-300

  • Summary

    Much knowledge about sleep and its disorders has accumulated in recent times, but awareness of these advances among both the general public and professionals remains inadequate. This is especially so regarding sleep disorders in children and adolescents, despite the publication of valuable sources of information relevant to clinical practice such as that by Mindell & Owens (2010).

    Before the scientific study of sleep began, important observations were made by some writers. For example, Charles Dickens provided some of the best descriptions of a wide variety of sleep disorders (presumably based on his observations of real people), including some in children and adolescents (Cosnett, 1992). The most notable of these is Joe the Fat Boy in The Pickwick Papers, who might well have suffered from obstructive sleep apnoea. Dickens's accounts of this and other sleep disorders preceded those of clinicians many years later.

    Although sleep medicine is now a specialty in its own right, all clinicians would benefit from having at least a working knowledge of the field. Many patients seen in both primary and secondary care are likely to have sleep problems, and these can often be treated without recourse to the special sleep centres that are now available for complicated cases. This chapter reviews main aspects of sleep and its disorders, with special emphasis on clinical practice in child and adolescent psychiatry. More detailed accounts are provided elsewhere, both in terms of children's sleep disorders in general (Stores, 2006a) and also sleep disturbance in children and adolescents who have disorders of development (Stores & Wiggs, 2001).

    Only selected references to the literature are provided. In places, ‘child’ or ‘children’ can be taken to include adolescents.

    Links between disturbed sleep and child and adolescent psychiatry

    Sleep medicine is a multidisciplinary specialty based on approaches and information from general medicine and paediatrics, adult and child psychiatry, neuropsychiatry, psychology (including developmental aspects) and several other disciplines. Increasingly, advances are being made concerning the neurobiology of sleep, aspects of which are reflected in disorders of sleep and wakefulness (Schwartz & Roth, 2008). Mahowald and colleagues (2011) refer to wakefulness, rapid eye movement (REM) sleep and non-rapid eye movement (NREM) sleep as the ‘primary states of being’. These are not necessarily mutually exclusive states and they can occur in various combinations to produce intriguing and surprising clinical consequences in various sleep disorders.

  • Chapter 23 - Sleep in developmental disorders

  • from Section VI - Sleep Disturbance in Psychiatric Illness
  • Edited by John W. Winkelman, David T. Plante, University of Wisconsin, Madison
  • Book:
    Foundations of Psychiatric Sleep Medicine
    Published online:
    01 June 2011
    Print publication:
    23 December 2010, pp 371-386

  • Summary

    Sleep problems are all too common in children in general but their occurrence is increased in certain high risk subgroups, notably children with a neuro-developmental or psychiatric disorder and those with other chronic pediatric conditions. Recent years have seen increasing interest in sleep disturbance in children with autism spectrum disorders (ASD), the number of whom is now considered much greater than once supposed. An important distinction throughout the range of learning disabilities is that between sleep problems of behavioral origin and those attributable to physical or medical aspects that are part of or associated with the basic condition. The sleep-related breathing disorder usually takes the form of some degree of obstructive sleep apnea (OSA), but central apnea is also described in the skeletal disorders and the Arnold-Chiari malformation. Neurofibromatosis, an autosomal dominant disorder resulting in tumor growth in neural crest cells, may also be associated with sleep disturbance.

  • Chapter 11 - Confusional arousals

  • from Section 2 - Disorders of arousal
  • Edited by Michael J. Thorpy, Giuseppe Plazzi, Università di Bologna
  • Book:
    The Parasomnias and Other Sleep-Related Movement Disorders
    Published online:
    10 November 2010
    Print publication:
    10 June 2010, pp 99-108

  • Summary

    This chapter briefly reviews the use of structural and functional neuroimaging in the assessment and management of parasomnias. The majority of the work in the area of neuroimaging and parasomnias and sleep-related movement disorders has been in the area of RLS and PLMD. The scope of the work performed to date has been driven by, and constrained by, clinical manifestations of the disorder and by the measurements currently available by using neuroimaging tools. The most extensive work has been performed in the area of central dopaminergic dysfunction in these disorders. Neuroimaging methods allow determination of brain volumetric changes in patient samples to see if structural cerebral abnormalities may play a role in the disorder. Low-dose opioid treatment has been used in the management of some RLS patients, and nuclear medicine study reveals regional brain function associated with sleepwalking.

A Clinical Guide to Sleep Disorders in Children and Adolescents
  • Gregory Stores
  • Published online:
    13 August 2009
    Print publication:
    07 June 2001
  • Sleep disturbance is commonplace and causes much personal distress to sufferers and their families. It is implicated in a variety of problems, from poor educational performance or disturbed behaviour to accidents or physical dysfunction. Traditionally, research into sleep disorders has generally been undertaken within separate, unconnected medical disciplines and has mainly involved adults. As sleep disturbance is closely associated with serious problems, identifying and treating sleep disorders early is essential for good long-term health and well-being. Yet there is no up-to-date, comprehensive, one-stop source of information for clinicians concerning sleep disorders in young people. Gregory Stores addresses this need with a cross-disciplinary account of available clinical information and treatments, illustrated by actual cases of sleep problems in the young. This book will be essential reading for all professionals involved in child healthcare from infancy to adolescence, and will also be invaluable to general readers looking for up-to-the-minute information and references.

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