Common concerns
My child snores. Should I be concerned?
Yes, especially if the snoring is present most nights, is present much of the night, and is loud enough to be heard outside of the bedroom. There should also be concern if the child usually sleeps with his or her mouth open or clearly has trouble breathing (chest gets sucked while breathing and there are gasps, snorts, or squeaky sounds).
Children should be able to breathe quietly with mouth closed most of the time, except, perhaps, when ill. The snoring indicates an obstruction somewhere, usually at the back of the throat. But just from watching, it may be difficult to tell just how much trouble there is—that is, whether your child is breathing okay with a little snoring, or suffering from obstructive sleep apnea (with inadequate breathing and sleep disruption). You would be best to discuss this with your doctor, who should examine your child and possibly refer him or her to an ENT (ear, nose and throat) specialist (also called an otolaryngologist) for further assessment, or to our Center for evaluation and possible overnight sleep study.
The most common cause of significant breathing difficulties in a snoring child is enlargement of tonsils or adenoids (spongy tissues at the back of the throat). If indicated, this tissue can be removed surgically. Other common causes include abnormal facial structure, low muscle tone, and obesity. In these cases, other treatments may be called for. The most common non-surgical treatment is nighttime CPAP usage, which is highly effective.
My teenager goes to bed at a decent hour, but has trouble falling asleep quickly and then has difficulty waking in the morning. Why?
The usual cause is a late or delayed sleep phase caused by late wakings on the weekend. The late weekend wakings become internalized, setting the biological clock on a late schedule and leaving the child unready to fall asleep at an appropriate hour and unready to wake at the time necessary to go to school.
The solution requires consistent wake-up times every day (weekday and weekend) as the bedtime gets adjusted to a regular time early enough to allow for sufficient sleep. This should be easy to accomplish until adolescence; then it may become more difficult partly for biological reasons and partly because of children’s desires to be more independent and to stay up very late on weekends as well as to sleep in whenever they can.
My child talks in his sleep or appears to sleep walk. Is this normal or dangerous?
Sleep talking is normal and common and certainly is not a sign of anything worrisome. Most sleep talking takes place between sleep states, during a partial waking as your child is moving about and getting ready to fall back into deeper sleep again. It typically does not occur during a dream. After the waking is more complete, the child settles back to sleep.
Sleepwalking occurs in the same setting, but instead of just talking, a child gets up and moves about. Occasional events are common in young children, and the main job of parents is to assure a safe environment. Little should be necessary except to lead the child back to bed. Frequent events or events where the child could hurt himself (such as running about wildly) may have different triggers related to habits, schedules and personality. Various therapies are possible. Such symptoms should be discussed with your doctor. If questions remain, referral to the sleep center should be considered.
Is it OK for a child to sleep in the same bed with their parents?
Yes, at least after the first six months and if certain precautions are followed. When bed sharing is chosen, ideally this choice should be the parents’, not the child’s. If co-sleeping fits into the parents’ philosophy and desires, there should be no problem as long as conditions are safe.
This is especially a concern for young infants who might be safer sleeping adjacent to the parents’ bed until they are bigger. In fact, a task force of the American Academy of Pediatrics recently concluded bed sharing was potentially risky for young infants, saying “that bed sharing, as practiced in the United States and other Western countries, is more hazardous than the infant sleeping on a separate sleep surface and, therefore, recommends that infants not bed share during sleep.” (For the full statement of the Academy, click here).
Some of the conditions known to increase risk of problems include improper bedding and parental alcohol intake and smoking.
When there is bed sharing, parents may have to adapt to a schedule that fits their child more than themselves, and they may have to accept both the loss of privacy and their child’s (possibly considerable) nighttime restless body movements. Finally, parents should decide how long (until what age) they want their child sleeping with them, and have plans for how to move their child to his or her own bed when that point is reached.
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