Skip to main content

Advertisement

Log in

Clinical practice

Sleep problems during infancy

  • Review
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Sleep problems are very prevalent during infancy. The most common problems are those related to night wakings and sleep-disordered breathing (SDB). Most common night waking problems do not have identified physiologic etiology. Their causes appear to be behavioral or developmental by nature, and they usually respond well to behavioral interventions. SDB may result from a variety of anatomic and neurologic factors and is associated with a variety of medical and developmental disorders. Because of the high prevalence of sleep problems during infancy, their persistence, their potential adverse developmental effects, and the positive treatment outcomes, pediatricians should serve as the primary address for screening and referral to proper assessment and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Abbreviations

SDB:

Sleep-disordered breathing

PSG:

Polysomnography

GER:

Gastroesophageal reflux

OSA:

Obstructive sleep apnea

References

  1. Adair R, Bauchner H, Philipp B et al (1991) Night waking during infancy: role of parental presence at bedtime. Pediatrics 87:500–504

    PubMed  CAS  Google Scholar 

  2. American Academy of Sleep Medicine (2005) International classification of sleep disorders: diagnostic and coding manual, 2nd edn. American Academy of Sleep Medicine, Westchester, IL

    Google Scholar 

  3. Armstrong KL, Quinn RA, Dadds MR (1994) The sleep patterns of normal children. Med J Aust 161:202–206

    PubMed  CAS  Google Scholar 

  4. Chamlin SL, Mattson CL, Frieden IJ et al (2005) The price of pruritus: sleep disturbance and cosleeping in atopic dermatitis. Arch Pediatr Adolesc Med 159:745–750

    Article  PubMed  Google Scholar 

  5. Dauvilliers Y, Stal V, Abril B et al (2007) Chiari malformation and sleep related breathing disorders. J Neurol Neurosurg Psychiatry 78:1344–1348

    Article  PubMed  CAS  Google Scholar 

  6. Durand VM, Mindell JA (1999) Behavioral intervention for childhood sleep terrors. Behav Ther 30:705–715

    Article  Google Scholar 

  7. Gozal D (2008) Obstructive sleep apnea in children: implications for the developing central nervous system. Semin Pediatr Neurol 15:100–106

    Article  PubMed  Google Scholar 

  8. Greenfeld M, Tauman R, DeRowe A, Sivan Y (2003) Obstructive sleep apnea syndrome due to adenotonsillar hypertrophy in infants. Int J Pediatr Otorhinolaryngol 67:1055–1060

    Article  PubMed  Google Scholar 

  9. Greenfeld M, Tauman R, Sivan Y (2004) The yield of esophageal pH monitoring during polysomnography in infants with sleep-disordered breathing. Clin Pediatr (Phila) 43:653–658

    Article  Google Scholar 

  10. Hoeve LJ, Pijpers M, Joosten KF (2003) OSAS in craniofacial syndromes: an unsolved problem. Int J Pediatr Otorhinolaryngol 67(Suppl 1):S111–S113

    Article  PubMed  Google Scholar 

  11. Kahn A, Groswasser J, Franco P et al (2000) Breathing during sleep in infancy. In: Loughlin GM, Carrol JL, Marcus CL (eds) Sleep and breathing in children: a developmental approach. Marcel Dekker, New York, pp 402–422

    Google Scholar 

  12. Kirjavainen J, Kirjavainen T, Huhtala V et al (2001) Infants with colic have a normal sleep structure at 2 and 7 months of age. J Pediatr 138:218–223

    Article  PubMed  CAS  Google Scholar 

  13. Kirjavainen J, Lehtonen L, Kirjavainen T, Kero P (2004) Sleep of excessively crying infants: a 24-hour ambulatory sleep polygraphy study. Pediatrics 114:592–600

    Article  PubMed  Google Scholar 

  14. Kuhn BR, Weidinger D (2000) Interventions for infant and toddler sleep disturbance: a review. Child Fam Behav Ther 22:33–50

    Article  Google Scholar 

  15. Lehtonen L, Korhonen T, Korvenranta H (1994) Temperament and sleeping patterns in colicky infants during the first year of life. J Dev Behav Pediatr 15:416–420

    Article  PubMed  CAS  Google Scholar 

  16. Macknin ML, Piedmonte M, Jacobs J, Skibinski C (2000) Symptoms associated with infant teething: a prospective study. Pediatrics 105:747–752

    Article  PubMed  CAS  Google Scholar 

  17. MacLean JE, Fitzsimons D, Hayward P et al (2008) The identification of children with cleft palate and sleep disordered breathing using a referral system. Pediatr Pulmonol 43:245–250

    Article  PubMed  CAS  Google Scholar 

  18. Mandell DL, Yellon RF, Bradley JP et al (2004) Mandibular distraction for micrognathia and severe upper airway obstruction. Arch Otolaryngol Head Neck Surg 130:344–348

    Article  PubMed  Google Scholar 

  19. Martin J, Hiscock H, Hardy P et al (2007) Adverse associations of infant and child sleep problems and parent health: an Australian population study. Pediatrics 119:947–955

    Article  PubMed  Google Scholar 

  20. Mindell JA, Kuhn B, Lewin DS et al (2006) Behavioral treatment of bedtime problems and night wakings in infants and young children—an American academy of sleep medicine review. Sleep 29:1263–1276

    PubMed  Google Scholar 

  21. Mindell JA, Telofski LS, Wiegand B, Kurtz ES (2009) A nightly bedtime routine: impact on sleep in young children and maternal mood. Sleep (in press)

  22. Montgomery-Downs HE, Gozal D (2006) Snore-associated sleep fragmentation in infancy: mental development effects and contribution of secondhand cigarette smoke exposure. Pediatrics 117:E496–E502

    Article  PubMed  Google Scholar 

  23. Nguyen BH, Perusse D, Paquet J et al (2008) Sleep terrors in children: a prospective study of twins. Pediatrics 122:e1164–e1167

    Article  PubMed  Google Scholar 

  24. Owens JA (2009) Pharmacotherapy of pediatric insomnia. J Am Acad Child Adolesc Psychiatry 48:99–107

    Article  Google Scholar 

  25. Owens JA, Babcock D, Blumer J et al (2005) The use of pharmacotherapy in the treatment of pediatric insomnia in primary care: rational approaches. A consensus meeting summary. J Clin Sleep Med 1:49–59

    PubMed  Google Scholar 

  26. Palmstierna P, Sepa A, Ludvigsson J (2008) Parent perceptions of child sleep: a study of 10, 000 Swedish children. Acta Paediatr 97:1631–1639

    Article  PubMed  Google Scholar 

  27. Pelayo R, Dubik M (2008) Pediatric sleep pharmacology. Semin Pediatr Neurol 15:79–90

    Article  PubMed  Google Scholar 

  28. Sadeh A (2004) A brief screening questionnaire for infant sleep problems: validation and findings for an Internet sample. Pediatrics 113:E570–E577

    Article  PubMed  Google Scholar 

  29. Sadeh A (2005) Cognitive-behavioral treatment for childhood sleep disorders. Clin Psychol Rev 25:612–628

    Article  PubMed  Google Scholar 

  30. Sadeh A, Dark I, Vohr BR (1996) Newborns’ sleep-wake patterns: the role of maternal, delivery and infant factors. Early Hum Dev 44:113–126

    Article  PubMed  CAS  Google Scholar 

  31. Sadeh A, Flint-Ofir E, Tirosh T, Tikotzky L (2007) Infant sleep and parental sleep-related cognitions. J Fam Psychol 21:74–87

    Article  PubMed  Google Scholar 

  32. Sadeh A, Mindell JA, Luedtke K, Wiegand B (2009) Sleep and sleep ecology in the first 3 years: a web-based study. J Sleep Res 18:60–73

    Article  PubMed  Google Scholar 

  33. Sisk EA, Heatley DG, Borowski BJ et al (1999) Obstructive sleep apnea in children with achondroplasia: surgical and anesthetic considerations. Otolaryngol Head Neck Surg 120:248–254

    Article  PubMed  CAS  Google Scholar 

  34. Tasker RC, Dundas I, Laverty A et al (1998) Distinct patterns of respiratory difficulty in young children with achondroplasia: a clinical, sleep, and lung function study. Arch Dis Child 79:99–108

    Article  PubMed  CAS  Google Scholar 

  35. Wake M, Hesketh K, Lucas J (2000) Teething and tooth eruption in infants: a cohort study. Pediatrics 106:1374–1379

    Article  PubMed  CAS  Google Scholar 

  36. Waters KA, Forbes P, Morielli A et al (1998) Sleep-disordered breathing in children with myelomeningocele. J Pediatr 132:672–681

    Article  PubMed  CAS  Google Scholar 

  37. Weissbluth M, Davis AT, Poncher J (1984) Night waking in 4- to 8-month-old infants. J Pediatr 104:477–480

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors have no financial conflict of interest to report.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Avi Sadeh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sadeh, A., Sivan, Y. Clinical practice. Eur J Pediatr 168, 1159–1164 (2009). https://doi.org/10.1007/s00431-009-0982-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-009-0982-4

Keywords

Navigation