Pattern and significance of sleep disorders and behaviours in children compared with adults

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Some sleep behaviours which are developmentally usual in children are abnormal in adults and require investigation. Examples are nocturnal enuresis and repeated napping. Certain sleep disorders are seen exclusively in children (e.g. sleeplessness caused by infantile colic). Others, such as settling problems and confusional arousals, occur primarily in children (see later).

Dyssomnias caused by extrinsic factors (mainly child-rearing practices) are particularly common in early childhood. Those attributable to circadian sleep-wake rhythm disorders (especially the delayed sleep-phase syndrome) occur at all ages, but are considered to be particularly common in adolescence.

Many of the parasomnias (such as headbanging, sleepwalking, or night terrors) are more common in childhood where generally they represent a temporary developmental phase without pathological significance. In contrast, it is often claimed (but not well demonstrated) that the same behaviours in adults are often a manifestation of psychological problems.

Some sleep disorders thought to be confined to adulthood are now recognized in children. While much attention has been paid to OSA in adults, it is now thought that at least 1 per cent of children have this condition to some degree. Narcolepsy starts by the age of 15 years in at least one-third of cases. Even REM sleep behaviour disorder (once thought to be confined to elderly males), or something similar, has been reported in children and adolescents. (:!i>

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