Sleep-Wake Disorders in Childhood

Amy Licis, MD, MSCI Sleep Neurology p. 1034-1069 August 2020, Vol.26, No.4 doi: 10.1212/CON.0000000000000897
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PURPOSE OF REVIEW The presentation of sleep issues in childhood differs from the presentation in adulthood and may be more subtle. Sleep issues may affect children differently than adults, and distinct treatment approaches are often used in children.

RECENT FINDINGS Sodium oxybate was approved by the US Food and Drug Administration (FDA) in October 2018 for an expanded indication of treatment of sleepiness or cataplexy in patients with narcolepsy type 1 or narcolepsy type 2 aged 7 years or older, with side effect and safety profiles similar to those seen in adults. Restless sleep disorder is a recently proposed entity in which restless sleep, daytime sleepiness, and often iron deficiency are observed, but children do not meet the criteria for restless legs syndrome or periodic limb movement disorder.

SUMMARY Children’s sleep is discussed in this article, including normal sleep patterns and effects of insufficient sleep. Sleep disorders of childhood are reviewed, including insomnia, obstructive sleep apnea, restless legs syndrome, parasomnias, narcolepsy, and Kleine-Levin syndrome. Children with neurologic issues or neurodevelopmental disorders frequently have sleep disorders arising from an interaction of heterogeneous factors. Further attention to sleep may often be warranted through a polysomnogram or referral to a pediatric sleep specialist. Sleep disorders may cause indelible effects on children’s cognitive functioning, general health, and well-being, and awareness of sleep disorders is imperative for neurologists who treat children.

Address correspondence to Dr Amy Licis, 660 S Euclid Ave, Campus Box 8111, Department of Neurology, Washington University School of Medicine, St Louis, MO 63110,

RELATIONSHIP DISCLOSURE: Dr Licis has received personal compensation for serving as a moderator for Pediatric Update.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Licis discusses the unlabeled/investigational use of medications, none of which are approved by the US Food and Drug Administration for pediatric use except for sodium oxybate and amphetamines for the treatment of narcolepsy.

© 2020 American Academy of Neurology.