Young children with psychiatric disorders who are undergoing clinical treatment may commonly have problems falling asleep, which can exacerbate their conditions, according to a new study.
“The most common sleep difficulties reported nationally for toddlers and preschoolers are problems of going to bed, falling asleep and frequent night awakenings – collectively, these problems are referred to as behavioral insomnias of childhood,” says John Boekamp, PhD, clinical director of the Pediatric Partial Hospital Program (PPHP) at Bradley Hospital in Providence, RI, says in a news release. “Sleep problems in young children frequently co-occur with other behavioral problems, with evidence that inadequate sleep is associated with daytime sleepiness, less optimal preschool adjustment, and problems of irritability, hyperactivity and attention.”
Boekamp studied young children with behavior problems because sleep problems in this group of children can be a cause – and effect – of behavioral and emotional disorders.
“Essentially, these young children might be caught in a cycle, with sleep disruption affecting their psychiatric symptoms and psychiatric symptoms affecting their sleep-wake organization,” says Boekamp.
The researchers looked at sleep disorders in children younger than age six with some sort of behavioral or emotional disorder, such as sleep onset insomnia (SOI) or night waking insomnia (NWI) in183 young children admitted to an early childhood psychiatric day treatment program. Sleep disorders – especially SOI – appeared frequently, and were much more frequent than previous studies done in communities. Forty-one percent of children were formally diagnosed with a sleep disorder.
Among the children, 41 percent met criteria for a sleep disorder; 23 percent met criteria for SOI and four percent for NWI. An additional 14 percent of the children met criteria for both SOI and NWI.
Children with these diagnoses were more likely to have problems sleeping:
- disruptive behavior
- problems with attention or mood.
“It is important for families to be aware of how important sleep is to the behavioral adjustment and well being of young children,” says Boekamp. “Sleep disorders may be unrecognized and under-diagnosed in young children, particularly when other behavioral or emotional problems are present.”
If children have behavior problems during the day, such as aggression and mood problems, difficulties with sleep should be specifically addressed by mental health providers. If they are sleepy, it may make daytime problem behaviors worse.
“This study is a great reminder that it’s critical for mental health providers working with young children and their families to ask about children’s sleep,” says Boekamp.”Simple questions about children’s sleep patterns, including how long it takes a child to fall asleep at night and how frequently a child awakens after falling asleep, may yield important information that is relevant to clinical care, even when sleep problems are not the primary focus of treatment.”