Obstructive Sleep Apnea | Snoring, unusual sleep positions, sleep-related paradoxical breathing, morning headaches, daytime sleepiness | 1-5% | Adenotonsillectomy, continual positive airway pressure, nasal steroids |
Sleepwalking | Walking during sleep, difficult to awaken during episode, eyes open, confusion or agitation, unusual or dangerous behaviours | 17% in children | Reassurance (usually resolves spontaneously), increased total sleep time, scheduled awakenings, bedroom/house safety |
Confusional arousals | Inappropriate behaviour, slurred speech, confusion after awakening | 17% in 3-13 yr olds, 4.2% in those over 15 | Reassurance (usually resolves spontaneously), increased total sleep time, scheduled awakenings, bedroom/house safety |
Sleep terrors | Intense fear, screaming/crying, difficult to awaken from episode, potentially dangerous activities | 1-6.5% | Reassurance (usually resolves spontaneously), increased total sleep time, scheduled awakenings, bedroom/house safety |
Nightmares | Unpleasant dreams, increased sympathetic response (increased heart rate, increased respiratory rate), reluctance to sleep, may be associated with mood disorders | 10-50% | Reassurance (usually resolves spontaneously), increased total sleep time, scheduled awakenings, bedroom/house safety, cognitive behavioural therapy |
Behavioural insomnia of childhood | Difficulty falling asleep or staying asleep if certain conditions are not present (i.e. parent rocking the child to sleep), frequent night-time awakenings, bedtime refusal, frequent night-time awakenings, refusal to return to sleep after awakening | 10-30% | Prevention, parental education, and extinction techniques are effective |
Delayed sleep phase disorder | Difficulty falling asleep and waking up at socially acceptable times (at least a two-hour delay), “Night owl” | 7-16% in adolescents | Sleep hygiene education, regular sleep-wake schedule, avoidance of bright lights before bedtime, melatonin, bright light therapy |
Restless legs syndrome | Urge to move the legs with associated discomfort, often begins in the evening, worsens with rest, eases with movement, may be associated with iron deficiency | approximately 2% | Avoidance of stimulants such as nicotine and caffeine, discontinue offending medications (antihistamines, selective serotonin reuptake inhibitors, and tricyclic antidepressants),iron replacement |