Children and sleep disturbance: A case for psychiatric intervention?

From birth through adolescence changes occur in children's sleep architecture, schedule, and duration including several key interactions in the concomitance of sleep/wake domains and child development. Research investigating the suspected affiliation between inefficient sleep and mental dysfunction in children has been largely enigmatic. We constructed a 111-item questionnaire relative to sleep disturbance in all ages and a 12-item questionnaire specific to pediatrics to use in conjunction with nocturnal polysomnography (PSG), and medical chart reviews of children under the age of 17 referred to our institution for evaluation of SDs. We analyzed these data to create a characterization specific to children/youth ( n  = 57; age 1–16 mean 9.28; 36 male, 21, female). Examples of findings reveal a characterization distinctive from the general demographic of adults who are referred for sleep studies. For example, 55.6% presented with disabilities ranging from neurological to neuromuscular; 73.3% reported learning disabilities; 66.7% possessed a range of behavioral control challenges; half used prescribed medications for psychiatric issues (despite a paucity of psychiatric evaluation). Another example, is that post-PSG, 69.6% of this sample were diagnosed with abnormal sleep architecture which was statistically related to medication use. These data revealed a pattern of children being more likely to be referred for a professional sleep study in the presence of significant medical symptomatology. Although we found some similarities when comparing this children/youth group to adults, we also found striking differences that were opposite when comparing the age groups.