Sleep Issues
This includes problems such as nightmares, sleep terrors, difficulty falling asleep and frequent waking. These issues are more common during times of stress.
Nightmares: These are frightening dreams which waken the child. It is important to recognise that the child requires reassurance in order to return to sleep. It is important to return the child to bed, reassure them that the nightmare is not real, and for the care giver to remain calm. Prevention of future nightmares is by ensuring adequate sleep, and avoidance of frightening events, TV or stories before bed time. Most night time fears are self limited and do not indicate underlying psychological problems. Typically if serious emotional problems are present, then symptoms are also seen during the daytime. When night time fears persist or cause significant distress then medical or psychological intervention are recommended.
Night Terrors: These typically start with a terrifying scream, and the child is discovered sitting or standing with a look of panic on their face. When they wake there is no recollection of the event. The child is in fact still asleep during this arousal. Management involves allowing the episode to end with as little intervention as possible.
Most children have night terrors when they have had a disruption to their usual sleep schedule, and are overtired. Resumption of a good sleep routine is important to prevent recurrences.
Prevention of bedtime problems and night waking is best achieved by developing positive sleep habits, with consistent wind down routines before bed, appropriate bed time schedule, and encouraging the child to develop self-soothing skills to enable the child to fall asleep independently.
Possible Referral Sources
Maternal Infant and Child Health Nurse
General Practitioner
Paediatrician
Sleep clinic (Royal Children's Hospital
