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Paediatric Insomnia

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Paediatric Sleep Disorders

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Abstract

Insomnia is a prevalent sleep problem, affecting approximately one-third of the children in the general population. Despite its high prevalence, paediatric insomnia is often unrecognized and untreated in clinical practice. It is commonly associated with other neurodevelopmental and psychiatric comorbidities, such as autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD). If left untreated, paediatric insomnia may be linked to a constellation of negative impacts in the affected child, including an increased risk of health-related problems (e.g., obesity/overweight, pain, fatigue), psychological issues (e.g., anxiety, depression), interpersonal problems (e.g., poor family relationships, peer problems) and impaired daytime functioning (e.g., poor alertness, impaired school performance), as well as elevated levels of family stress and impaired parental mental health and quality of life. Several factors may contribute to paediatric insomnia, including genetic influence, hyperarousal and hypersensitivity, circadian issues, poor sleep hygiene, comorbid medical conditions, and psychosocial and behavioural factors. A thorough assessment is essential to inform the treatment of insomnia in children and adolescents. Actigraphy can provide a continuous and objective estimation of sleep-wake patterns, and is a useful tool in the assessment of paediatric insomnia. Behavioural interventions are usually recommended as the first-line treatment and there has been limited evidence to support the efficacy and safety of medications for treating paediatric insomnia. The current chapter provides an overview of paediatric insomnia, including the classification and diagnostic criteria, prevalence, consequences, and factors associated with childhood insomnia, as well as its assessment and management.

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References

  1. Brown KM, Malow BA. Pediatric insomnia. Chest. 2016;149(5):1332–9. https://doi.org/10.1378/chest.15-0605.

    Article  Google Scholar 

  2. Zhang J, Lam SP, Li SX, et al. Long-term outcomes and predictors of chronic insomnia: a prospective study in Hong Kong Chinese adults. Sleep Med. 2012;13(5):455–62. https://doi.org/10.1016/j.sleep.2011.11.015.

    Article  Google Scholar 

  3. Martin J, Hiscock H, Hardy P, Davey B, Wake M. Adverse associations of infant and child sleep problems and parent health: an Australian population study. Pediatrics. 2007;119(5):947–55. https://doi.org/10.1542/peds.2006-2569.

    Article  Google Scholar 

  4. Roberts RE, Roberts CR, Duong HT. Chronic insomnia and its negative consequences for health and functioning of adolescents: a 12-month prospective study. J Adolesc Health. 2008;42(3):294–302. https://doi.org/10.1016/j.jadohealth.2007.09.016.

    Article  Google Scholar 

  5. Mindell JA, Emslie G, Blumer J, et al. Pharmacologic management of insomnia in children and adolescents: consensus statement. Pediatrics. 2006;117(6):e1223–32. https://doi.org/10.1542/peds.2005-1693.

    Article  Google Scholar 

  6. American Academy of Sleep Medicine. The international classification of sleepdisorders: diagnostic and coding manual. 2nd ed. Westchester, IL: American Academy of Sleep Medicine; 2005. https://books.google.com.hk/books?id=M8yIPQAACAAJ.

    Google Scholar 

  7. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Westchester, IL: American Academy of Sleep Medicine; 2014. https://books.google.com.hk/books?id=deLPoAEACAAJ&dq.

    Google Scholar 

  8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013. https://books.google.com.hk/books?id=EIbMlwEACAAJ.

    Book  Google Scholar 

  9. Zhang J, Chan NY, Lam SP, et al. Emergence of sex differences in insomnia symptoms in adolescents: a large-scale school-based study. Sleep. 2016;39(8):1563–70. https://doi.org/10.5665/sleep.6022.

    Article  Google Scholar 

  10. Fricke-Oerkermann L, Plück J, Schredl M, et al. Prevalence and course of sleep problems in childhood. Sleep. 2007;30(10):1371–7.

    Article  Google Scholar 

  11. Mindell JA, Sadeh A, Wiegand B, How TH, Goh DY. Cross-cultural differences in infant and toddler sleep. Sleep Med. 2010;11(3):274–80. https://doi.org/10.1016/j.sleep.2009.04.012.

    Article  Google Scholar 

  12. Liu X, Liu L, Wang R. Bed sharing, sleep habits, and sleep problems among Chinese school-aged children. Sleep. 2003;26(7):839–44. https://doi.org/10.1093/sleep/26.7.839.

    Article  Google Scholar 

  13. Hysing M, Heradstveit O, Harvey AG, Nilsen SA, Bøe T, Sivertsen B. Sleep problems among adolescents within child and adolescent mental health services. An epidemiological study with registry linkage. Eur Child Adolesc Psychiatry. 2020:1–11. Published Online.

    Google Scholar 

  14. Richdale AL, Schreck KA. Sleep problems in autism spectrum disorders: prevalence, nature, & possible biopsychosocial aetiologies. Sleep Med Rev. 2009;13(6):403–11. https://doi.org/10.1016/j.smrv.2009.02.003.

    Article  Google Scholar 

  15. Vélez-Galarraga R, Guillén-Grima F, Crespo-Eguílaz N, Sánchez-Carpintero R. Prevalence of sleep disorders and their relationship with core symptoms of inattention and hyperactivity in children with attention-deficit/hyperactivity disorder. Eur J Paediatr Neurol. 2016;20(6):925–37. https://doi.org/10.1016/j.ejpn.2016.07.004.

    Article  Google Scholar 

  16. Hammerschlag AR, Stringer S, De Leeuw CA, et al. Genome-wide association analysis of insomnia complaints identifies risk genes and genetic overlap with psychiatric and metabolic traits. Nat Genet. 2017;49(11):1584.

    Article  CAS  Google Scholar 

  17. Wing YK, Zhang J, Lam SP, et al. Familial aggregation and heritability of insomnia in a community-based study. Sleep Med. 2012;13(8):985–90. https://doi.org/10.1016/J.SLEEP.2012.04.013.

    Article  CAS  Google Scholar 

  18. Brescianini S, Volzone A, Fagnani C, et al. Genetic and environmental factors shape infant sleep patterns: a study of 18-month-old twins. Pediatrics. 2011;127(5):e1296–302.

    Article  Google Scholar 

  19. Bartel KA, Gradisar M, Williamson P. Protective and risk factors for adolescent sleep: a meta-analytic review. Sleep Med Rev. 2015;21:72–85.

    Article  Google Scholar 

  20. Sadeh A, Tikotzky L, Scher A. Parenting and infant sleep. Sleep Med Rev. 2010;14(2):89–96.

    Article  Google Scholar 

  21. Peng X, Yuan G, Ma N. Cosleeping and sleep problems in children: a systematic review and meta-analysis. Sleep Biol Rhythms. 2019;17(4):367–78. https://doi.org/10.1007/S41105-019-00226-Z.

    Article  Google Scholar 

  22. Gregory AM, Cox J, Crawford MR, et al. Dysfunctional beliefs and attitudes about sleep in children. J Sleep Res. 2009;18(4):422–6. https://doi.org/10.1111/J.1365-2869.2009.00747.X.

    Article  Google Scholar 

  23. Wiggs L, France K. Behavioural treatments for sleep problems in children and adolescents with physical illness, psychological problems or intellectual disabilities. Sleep Med Rev. 2000;4(3):299–314. https://doi.org/10.1053/SMRV.1999.0094.

    Article  Google Scholar 

  24. Chan NY, Chan JWY, Li SX, Wing YK. Non-pharmacological approaches for management of insomnia. Neurotherapeutics. 2021;18(1):32–43. https://doi.org/10.1007/S13311-021-01029-2.

    Article  Google Scholar 

  25. Owens JA, Rosen CL, Mindell JA. Medication use in the treatment of pediatric insomnia: results of a survey of community-based pediatricians. Pediatrics. 2003;111(5 Pt 1):e628–35. https://doi.org/10.1542/peds.111.5.e628.

    Article  Google Scholar 

  26. Schnoes CJ, Kuhn BR, Workman EF, et al. Pediatric prescribing practices for clonidine and other pharmacologic agents for children with sleep disturbance. Clin Pediatr (Phila). 2006;45(3):229–38. https://doi.org/10.1177/000992280604500304.

    Article  Google Scholar 

  27. Russo RM, Gururaj VJ, Allen JE. The effectiveness of diphenhydramine HCI in pediatric sleep disorders. J Clin Pharmacol. 1976;16(5–6):284–8. https://doi.org/10.1002/J.1552-4604.1976.TB02406.X.

    Article  CAS  Google Scholar 

  28. Merenstein D, Diener-West M, Halbower AC, et al. The trial of infant response to diphenhydramine: the TIRED study—a randomized, controlled, patient-oriented trial. Arch Pediatr Adolesc Med. 2006;160(7):707–12. https://doi.org/10.1001/ARCHPEDI.160.7.707.

    Article  Google Scholar 

  29. Ingrassia A, Turk J. The use of clonidine for severe and intractable sleep problems in children with neurodevelopmental disorders—a case series. Eur Child Adolesc Psychiatry. 2005;14(1):34–40. https://doi.org/10.1007/S00787-005-0424-4.

    Article  Google Scholar 

  30. Ming X, Brimacombe M, Chaaban J, et al. Autism spectrum disorders: concurrent clinical disorders. J Child Neurol. 2008;23(1):6–13. https://doi.org/10.1177/0883073807307102.

    Article  Google Scholar 

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Authors and Affiliations

  1. Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong SAR

    Xiao Li & Shirley Xin Li

  2. The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR

    Shirley Xin Li

Authors
  1. Xiao Li
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  2. Shirley Xin Li
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Correspondence to Shirley Xin Li .

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Editors and Affiliations

  1. Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong

    Albert Martin Li

  2. Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China

    Kate Ching-ching Chan

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© 2022 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

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Li, X., Li, S.X. (2022). Paediatric Insomnia. In: Li, A.M., Chan, K.Cc. (eds) Paediatric Sleep Disorders. Springer, Singapore. https://doi.org/10.1007/978-981-19-5791-8_6

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  • DOI: https://doi.org/10.1007/978-981-19-5791-8_6

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-5790-1

  • Online ISBN: 978-981-19-5791-8

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