Jodi Whitaker

Normal Bedtime Battles, or Pediatric Sleep Disorder?

Published: Oct 8, 2012

LEXINGTON, Ky. (Oct. 9, 2012) — The following column appeared in the Lexington Herald-Leader on Sunday, Oct. 7.


By Dr. Zoran Danov


Bedtime can be a struggle for both tired parents and resistant children. Adequate and quality sleep is important for children to remain healthy during childhood and into adolescence and adulthood. While bedtime battles are common in many households, for some children there could be something else at work: About  20 percent of children suffer from some sort of sleep disorder.


Sleep disorders include - but are not limited to - sleep apnea and behavioral insomnia of childhood.


Sleep apnea is a condition in which there is a regular, momentary stopping of breath during sleep. These stoppages can lead to sleep disruptions and also falls in blood oxygen levels. Some warning signs of sleep apnea in children are:

  • High blood pressure.
  • Weight gain.
  • Dry or sore throat in the morning.
  • Morning headaches.
  • Snoring or stoppages in breath during sleep.
  • Undue sleepiness during the day or difficulty falling asleep.

Tonsillectomy and adenoidectomy are both helpful in resolving obstructive sleep apnea. When those measures fail, positive airway pressure devices are used for those with sleep apnea, providing a gentle airflow to prop open the airway during sleep so as to avoid waking up during the night.  A small mask fitted over the nose and mouth provides the airflow and is secured with straps around the head.


There are several types of behavioral insomnia of childhood, in which the child refuses or resists going to bed, falls asleep later than normal or is awake for prolonged periods of time during the night, prompting parental mediation.


There are other general warning signs that may not necessarily point to one of the mentioned childhood sleep disorders but should still be addressed by a physician. Some of these warning signs include: sleepwalking, anger or temper problems, restless legs, night or sleep terrors, unusual sleeping schedule , snoring and lack of energy


There are several ways to diagnose a sleep problem. As in any disorder, patient history and physical exams are the most important first steps in reaching a diagnosis. Some sleep disorders require additional tests, such as a polysomnography, a multiple sleep latency test or a maintenance of wakefulness test. Such disorders can be effectively treated to ensure that your child stays healthy. If you think your child may be suffering from a sleep disorder, contact your pediatrician.


Even if no disorder is present, encourage healthy sleeping habits in children by making sure they:

  • Maintain a healthy weight
  • Have a consistent bedtime routine--go to bed and wake up at the same time every day
  • Avoid or limit late afternoon naps for children past preschool age
  • Utilize the bedroom for sleep only; all other activities like homework and playtime should be done outside the bedroom
  • Exercise regularly during the day but not in the evening
  • Avoid television, computer and video game usage one to two hours before bedtime

Dr. Zoran Danov is Medical Director of the Pediatric Sleep Program at University of Kentucky Good Samaritan Hospital.



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