Main sleep problems sleeplessness

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The revised International Classification of Sleep Disorders (ICSD-R) was outlined in Ch.a.ptei..4.:1.4..1. This system has much in its favour but it is primarily based on the sleep disorders seen in adults. Its overall structure is appropriate for use with children but only some of the disorders described are relevant to them. The point has already been made that various aspects of basically the same disorder can be very different in children compared with adults. This important point is not made clear in the ICSD-R, as it stands.

In keeping with the earlier accounts of sleep disturbance in adults, the following selective account of sleep disorders in children and adolescents is organized according to the three main types of sleep complaint: sleeplessness, excessive sleepiness, and the parasomnias. Childhood psychiatric and medical conditions in which sleep disturbance is a prominent feature have already been mentioned. The emphasis is placed on the differential diagnosis of sleep complaints and also on points of particular relevance to psychiatric practice.

The breakdown of problems and disorders according to age should not be interpreted too strictly as there is considerable overlap between the different age groups. In addition to the specific treatments mentioned for particular sleep disorders, the promotion of adequate sleep, regular sleep habits, and the other sleep hygiene principles referred to in ChapteL4.14..1 are important. Evidence for the effectiveness of psychological treatments for sleeplessness is reviewed in detail elsewhere.(34,35)

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