What to do if a child has insomnia?

Insomnia in children is common, but true insomnia is rare. The task of parents is to understand in time when the situation can be corrected on their own, and when it is time to seek treatment from a doctor, after all, normal sleep is necessary for children for harmonious development, growth, mental health.

About the problem

Difficulty falling asleep is a widespread problem: both adults and children face it from time to time. But usually such cases have quite explainable reasons, obvious to the parents - the child is overexcited, tired, slept too much during the day, is sick, unwell, etc. Such cases are not considered pathology, difficulties with falling asleep are harmless. Once the problem is fixed, sleep is restored and you don't need to do anything about it.

There is another insomnia, for which special terms have been coined in medicine - insomnia or dyssomnia. To understand why a child does not sleep normally, one should clearly know what stages sleep consists of in general:

shallow sleep - the process of falling asleep;
transition to deep phase - the movement of the oculomotor muscles stops, the electrical impulses of the brain decrease, the heartbeat slows down;
deep dream - the recovery phase, in which we see dreams, delta waves gradually begin to prevail, and if a person wakes up at this stage, he cannot understand for a long time where he is and who he is in general;
fast phase - movement of the oculomotor muscles resumes, the body prepares for awakening, the brain becomes active.

Childhood (as well as adult) insomnia is always associated with certain disorders that occur in the recovery or rapid phase.

Insomnia is a sleep disorder associated either with its short duration or with a violation of its quality, observed in a child for a long time. The disorder can occur in children of all ages, even in infants and newborns, but less often in babies.

How does it manifest?

Calling any violation insomnia is wrong. According to medical recommendations, the painful state of sleep disturbance can be talked about only when the child has significant difficulty falling asleep for a long time, he cannot sleep soundly all night, often wakes up and again cannot fall asleep again.

To make an appropriate diagnosis for the baby, the doctor takes into account the repetition of such manifestations with a frequency of at least three times a week for one month.

All symptoms of insomnia are divided into several groups according to the time of their onset.

Presomnicheskie

It is difficult for a child to fall asleep (the process takes more than 30 minutes), while the baby may look tired, he feels like going to bed, but as soon as he is in bed at the appointed hour, he cannot fall asleep.

At this stage, the baby may be looking for a comfortable position for a long time, “fiddling”, may complain that something itches or itches (psychosomatic manifestations or “mind games”).

Intrasomnic

Sleep is of poor quality, and deep sleep does not occur or it is insufficient in time. Any, even a quiet extraneous sound, can instantly interrupt the child's sleep, after which it can be very difficult for him to fall asleep again. Often, nightmares, a desire to empty the bladder, and a rapid heart rate are observed. This also includes "restless legs syndrome" - with it, the baby constantly touches his legs in a dream.

Post-somnolent - symptoms that are essentially a consequence of insomnia. They appear after the child wakes up. This is lethargy, lack of tone, vigor, concentration and attentiveness. The child is drowsy, inhibited, he has sudden mood swings, headaches.

Causes

If the symptoms of sleep disturbance appear almost immediately after birth, it is probably a congenital physiological predisposition due to the organization of the child's nervous system.

In all other children and adolescents, the causes can also be acquired neurological disorders, diseases of the nervous system, and pathologies of internal organs.

Insomnia often develops as a reaction of the nervous system to severe stressThis is especially true for children in the "critical" periods of development and formation of the nervous system - at 2-3 years old, at 6-8 years old and with the onset of puberty - in girls from 10 years old, in boys from 11-12 years old.

Insomnia is often observed as a symptom of neurosis, psychosis, depression, and panic disorder. Any acute and chronic respiratory ailments, in which free breathing at night is difficult, can cause insomnia.

Children with lesions of the central nervous system, brain tumors, schizophrenia, epilepsy in about 75% of cases suffer from prolonged insomnia.

If no such diagnoses have been established in the baby's medical record, then possible external causes of sleep disturbances should be considered. These include:

life in a big city, noise from the street at night, light on signs, that is, insufficient darkening;
frequent change of time zones (if the child travels a lot with his parents);
taking some psychotropic drugs;
drinking strong tea or coffee, as well as a large amount of chocolate before bed;
stuffiness in the bedroom and uncomfortable bed;
overeating before falling asleep;
an abundance of impressions shortly before bedtime, too active and active games;
lack of normal physical activity;
violation of the regime, when the share of daytime sleep takes more time than necessary.

Insomnia can begin in a perfectly healthy child who has all the conditions for normal sleep, if the psychological climate in the family is tense (quarrels, parental divorce, violence).

Kinds

Harmless, physiological insomnia, which everyone has from time to time, is called transient, that is, passing, temporary. Indeed, it can last no more than a few nights. Then a healthy body will take its toll, and the child will begin to sleep normally. In some cases, transient insomnia lasts up to 2-3 weeks, and then it is called short-term.

Sleep disturbances for more than a month are a chronic form that definitely needs treatment. Caused by objective reasons, insomnia is called physiological or situational, and chronic forms are called permanent.

There are also three degrees of severity:

the first - mild, episodes of sleep disturbance are rare, non-systematic;
second - medium, symptoms are moderate;
third - severe, repeated every night, the child's health is significantly impaired.

Insomnia is called idiopathic if its cause has not been established. By the way, in 80% of cases, the true root cause cannot be found, since it can lie in the emotional and psychological field, and therefore the problem is often considered psychosomatic.

What to do?

If the child has situational insomnia, nothing needs to be done. It will be enough to clearly understand what situation caused the sleep disturbance, and to do everything possible to reduce its effect on the child's psyche. But in the case of short-term and chronic insomnia, parents cannot do without medical help. Which doctors to go to, obviously - a neurologist and a pediatrician.

Specialists will collect a detailed anamnesis, analyze the child's health, ask parents to keep a so-called sleep diary, in which parents will have to indicate how long it took the child to fall asleep, how long he slept before waking up, was he able to fall asleep after waking up if it happened in the middle of the night , whether the dream was restless, whether there were nightmares. By the way, such a diary helps to understand whether an "owl" is a child or a "lark".

Interesting fact: "Owls" and "larks" are philistine terms. In medicine, both (early rise and craving for a late rise) are considered a violation of the circadian rhythm, that is, both "owl" and "lark" are one hundred percent pathology if, after waking up, a person experiences postsomnic disorders.

Based on the results of keeping a diary, an EEG, polysomnography, consultation with a doctor-somnologist can be prescribed.

Treatment

First of all, parents of a child suffering from insomnia are advised to attend to sleep hygiene. It means that:

the baby should go to bed every night at the same time;
daytime sleep should be minimized (up to 1 hour for a preschooler) and completely excluded for school-age children;
increased daytime activity;
airing the bedroom before bed;
elimination of active games and watching TV before bedtime;
the use of a soothing massage and water treatments before going to bed.

If all this does not help to normalize falling asleep and the duration of night rest, physiotherapy is prescribed - for example, treatment with high intensity white light.

Medications are mainly prescribed for the chronic form, as well as for the acute form, if the above measures have not had an effect. Sleeping pills seem like a simple and logical solution - drank and fell asleep. But it’s not that simple. Hypnotics are addictive and have a lot of side effects. Therefore, they try to prescribe herbal remedies for children, for example, motherwort, preparations based on peony, mint, oregano.

In severe cases, the child may be prescribed antipsychotics, antidepressants. With a tendency to allergies, it can be prescribed and antihistamine "Diphenhydramine", but in strict individual dosages.

The problem can often be solved without medication, by working with a child. psychotherapist, psychologist, psychosomat. Folk remedies can also help, for example, "Sleepy pouch" filled with dried herbs (lavender, lemon peels, chamomile flowers). It is attached to the headboard so that the child can smell the herbs.