Sleep in Children with Psychiatric and Behavioral Problems

Abstract

Sleep is commonly affected in psychiatric and behavioral pediatric disorders, contributing to children's disability and parental burden. Difficulties initiating and maintaining sleep, often non-restorative in quality, frequent parasomnias, such as disorders of arousals, enuresis, and nightmares; sleep-related movement disorders such as bruxism, restless legs syndrome (RLS), and periodic limb movement during sleep (PLMS); snoring; and sleep apnea may all interfere with sleep consolidation and daytime performance both at school and daycare. Alterations of slow-wave sleep (SWS), both in terms of macro- and microstructural aspects, are common to almost all disorders, whereas rapid eye movement (REM) sleep is more impacted by mood and autism spectrum disorders (ASDs), often correlating with relational and emotional profiles rather than with cognitive problems. In said disorders, subjective complaints always override objective findings from all-night actigraphic or polysomnographic (PSG) recordings. In particular, sleep latency (SL) and total sleep time (TST) are severely affected only in the acute manic and psychotic phases and in early ASDs, whereas infranight awakenings and slow-wave sleep (SWS) fragmentation appear to be the hallmarks of these disorders, reflecting an impaired maturational process affecting mostly the frontal lobes and their connectivity. (PsycINFO Database Record (c) 2017 APA, all rights reserved)