![]() A bedtime routine is a set of predictable activities that occur in the hour before a child falls asleep. This includes developing a consistent bedtime routine, sleep schedule, and response to nighttime awakenings. Initial management may focus on improving sleep hygiene. Ĭhildhood insomnia is generally treated with behavioral interventions. Polysomnography is not typically employed, though it may be useful to asses for other contributing sleep disorders such as periodic limb movements of sleep (PLMS) and sleep apnea. Sleep diaries and actigraphy may be useful in capturing the child’s sleep patterns and sleep duration. Questionnaires and surveys may be utilized. Within this type, there are three subtypes - sleep-onset association type, limit-setting type, and mixed type (see Table Table2 2).Įvaluation for childhood insomnia involves a detailed sleep history, including information about the child’s sleep patterns and sleep environment. This is typically associated with difficulty with sleep initiation and sleep maintenance. The most commonly encountered type of childhood insomnia is behavioral insomnia of childhood (BIC). While no longer used as formal diagnoses, the insomnia subtypes remain clinically useful. The second edition of the ICSD delineated multiple insomnia subtypes, including a separate pediatric diagnosis. In the current third edition of the International Classification of Sleep Disorders (ICSD-3), insomnia is divided into three diagnostic categories: chronic insomnia, short-term insomnia, and other insomnia disorder. ![]() In children, this may result in behavioral issues such as hyperactivity and inability to concentrate. Childhood insomnia is typically characterized by bedtime resistance, inability to sleep independently, and/or frequent nighttime awakenings. The estimated prevalence of insomnia is between 25 and 40% in children 4–10 years of age and 11% in adolescents. Insomnia is defined as persistent difficulty with initiating sleep, maintaining sleep, or waking up with an inability to return to sleep despite adequate sleep opportunity and resulting in daytime impairment.
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