How to Help a Son or Daughter with Sleep Problems

Among adults and children alike, sleep disorders and disorders are increasing in Chile. This is confirmed by various local specialists, who point to the Covid-19 pandemic and the havoc it has caused in our habits as the main cause.

“We have a very high rate of sleep disorders,” says Pablo Brockmann, a pediatrician at the UC Christus Health Network Sleep Center. The situation is particularly complex in the case of infants: according to the specialist, at least two thirds of this segment of the population – which extends between the first month and a year and a half – “sleep poorly”.

In the case of girls, boys and adolescents, “it is estimated that around 25 to 30% suffer from sleep disorders of all kinds,” adds Rosario Fernández, clinical psychologist specializing in children’s sleep at Clínica Somno.

Good sleep is essential at all stages of life, but it is even more important during childhood. Sleep plays an essential role in physical and neuropsychological development: it strengthens the immune system, consolidates memory and improves learning capacity. It also helps maintain hormonal balance, restore energy for each day, improve neural connections, regulate mood, behavior and emotions.

Luis Pino, director of psychology at the University of the Americas (UDLA), states that up to two years of life, sleep has “direct effects” on brain anatomy, that is, on the formation of the brain, “since in the act “During sleep, the tissues are consolidated and repaired.”

The consequences of insufficient sleep, in terms of quality and quantity, can be observed on a daily basis. “It usually causes irritability in young children and excessive sleepiness, headaches, difficulty paying attention, poor school performance and behavioral effects – such as bad behavior, depression or anxiety -, significantly affecting their quality of life”, adds Katalina Bertrán, head of the pediatrics department. Sleep Unit of the Clínica Alemana de Santiago.

Conflicts also often appear at bedtime. “This doesn’t happen because he doesn’t want to sleep, but rather because sleeping causes him a series of problems,” explains Pino. This is why episodes of crying, violence, aggression and snoring occur.

This snow can crecercer hasta adultez, perpetuando el conflicto with sueño and intervene directly in the vital function: it has been demonstrated that if it lasts little and badly it will favor conductas the impulsiveness, enfermedades like the hypertensión, and it will arouse the expectations of life.

According to Rosario Fernández, sleep problems and disorders during childhood can be classified into three categories:

• The child who has difficulty falling asleep: In this group appear disorders such as insomnia – which can appear from 6 months -, restless legs syndrome – named after the need to move the limbs during sleep – and phase delay syndrome.

Brockmann maintains that sleep lag is very common among pre-teens and adolescents. “They fall asleep and wake up very late.” Some patients, he says, take up to three hours to fall asleep.

For his part, Pino says that 30% of girls and boys will suffer from insomnia, at least initially, which will require “elements of medical intervention.”

• The child who presents abnormal events during sleep: This category includes parasomnias such as sleepwalking, often associated with night terrors and nightmares. “Sleepwalking can affect other behavioral areas of the person’s life,” says Pino. Some patients talk often during sleep, a phenomenon that affects circadian rhythms – the natural biological, physical, mental and behavioral development in a 24-hour cycle – as well as interrupting and preventing the evolution of sleep phases: the passage of REM sleep to non-REM sleep. REM and vice versa throughout the night.

Also in this segment is obstructive sleep apnea, a disorder that involves blockage of the upper airway, reducing or stopping airflow. Brockmann assures that this is another of the alterations that has increased its post-pandemic incidence.

• The child who falls asleep during the day: here, the main disorder detected is narcolepsy. It is, according to Pino, “a state of excessive sleep, in which boys and girls can even fall asleep suddenly in everyday situations, even in class.” It is a chronic disease that can seriously affect quality of life, but there is treatment.

Even more unusual is seeing cases of hypersomnia, a disorder that causes a lot of sleepiness during the day, even when people slept well the night before. This also generally causes serious difficulties upon waking up. Its cause remains a mystery to medicine.

Brockmann states that they are not fully known. However, they are multifactorial and among them are schedule flexibility and post-pandemic changes in habits.

“In pediatrics, the main factor in these problems is what we call poor sleep hygiene: not having a consistent and organized schedule, spending too much time in front of screens – smartphones, tablets, television, video games -, using the room to study and have an inadequate environment to sleep,” adds Katalina Bertrán.

The use of screens appears to be one of the greatest complexities. Excessive use of these devices “is not good for us,” says UC network pediatrician Christus. “Lately, some direct problems associated with neurological development in children under five years of age have been described due to the use of screens,” adds Luis Pino.

The ideal is to avoid these devices for most of the day, especially in the hours before bed.

When a girl or boy has frequent sleep problems, it’s not just him who suffers. Fathers, mothers and caregivers enter into a complex dynamic that can even affect their mental health.

“If a child does not sleep, he will cooperate less the next day with development and education instructions. Therefore, parents will experience difficulties with opposition, irritability, poor concentration and understanding,” explains Luis Pino. This usually leads parents to “high frustration,” full of anxiety and emotional decisions, generating the opposite effect: more stress and conflict at bedtime.

In many cases, “a vicious circle is generated by increased anxiety within the family and increased sleep disturbances in the child, deterioration of their habits or changes to their schedules,” adds Pablo Brockmann.

“It is very difficult to manage children’s sleep problems, because it has a significant impact on the quality of life of parents,” adds Rosario Fernández. The clinical psychologist comments that, very often, children’s lack of sleep “is experienced as if it would last forever”. And this leads to “learned despair”.

At the same time, Fernández formulates cold words: “In practice, everything has a solution. » And call to consult specialists in the field in time. “It is essential to break this chain of bad sleep,” he says.

Between stress, lack of sleep and despair, common mistakes begin to appear in the search for solutions. One becomes saturated with information, much of which comes from unreliable sources and/or is not relevant to each family’s particular context.

“Today it’s full of coaches of sleep on social networks, books and information on the Internet which, instead of having a positive result, harm parents: they create anxiety and very excessive expectations regarding the sleep of their children”, explains Brockmann. ” “Every child is different and goes through a clear process of neurological development. Many disorders can progress in a benign manner,” he adds.

Rosario Fernández maintains that “knowing the sleep of a baby and a child provides tools to reduce expectations and try to realize a good family dream”, which takes into consideration “the process of maturation of the sleep of the son or the girl “.

For example, not so long ago it was believed that an infant should sleep long and hard during the night. And if that wasn’t the case, we were faced with a mess. “The parents thought there was a problem when they saw that their baby was waking up several times during the night. Today we know that this is not the case in the majority of cases: babies have physiological awakenings that are not necessarily pathological,” explains Fernández.

Although maintaining less stable schedules is necessary for good sleep hygiene, science has recently relaxed the canon of adequate sleep hours, understanding that there are significant variables between cultures and families.

According to World Sleep Society the recommended daily sleep range based on age group is as follows:

• 3-12 months : 2 p.m. to 3 p.m.
• 1-3 years : 12 to 14 hours
• 3-5 years : 11 a.m. to 1 p.m.
• 6-12 years old: 10 to 11 a.m.
• 12-18 years old: 8.5 to 9.5 hours

On the other hand, Pablo Brockmann calls for “never treating yourself or using melatonin indiscriminately”. Likewise, he advises avoiding falling into stress and “imposing external norms and beliefs on the family, instead of understanding the processes as something physiological.”

There American Academy of Pediatrics gives the following advice:

• Maintain a comfortable temperature in the bedroom : hopefully close to 20°C.
• Have a bedtime schedule and routine : reading stories, giving company or taking a bath with lukewarm water, while avoiding screens and games that activate them.
• Maintain similar sleep schedules during the weekend
• Get used to falling asleep in your own crib or bed from a young age. : The older they are, the more complex it will be to get them used to sleeping alone in their room.
• Prevent the child from falling asleep in your arms: also in the car or in another bed.
• Avoid using a bottle to fall asleep
• If it calms you, use a pacifier.
• Allow the use of transitional objects: for example, a teddy bear.
• Make sure children are comfortable and safe : Use a firm mattress and avoid pillows or objects that could pose a suffocation hazard.
• As hard as it may be to resist, don’t return to your daughter or son’s room every time they call you. : Unless it is a case of illness or pain, it is advisable to promote independence and autonomy in sleep.