It may be hard to determine if your child has a sleep disorder, but there are some questions that can be helpful to assess whether a problem exists. These can be remembered with the simple acronym “BEARS” and can help to identify any sleep disorders that may be present.
B is for Bedtime Problems
There may be many problems that only exist around bedtime. If your child insists that he or she is not sleepy, it may be a fight to get them into bed. They may need a regular bedtime routine or have issues related to behavioral insomnia. This is often the time that parental boundaries become tested and separation anxiety may become evident.
E is for Excessive Daytime Sleepiness
Children require more sleep than adults and often take naps during the day. However, children who are sleeping enough at night should not require naps after they transition to school. Falling asleep in quiet situations, difficulty with concentration or attention, or even hyperactivity may suggest excessive sleepiness. This could be due to insufficient sleep or an underlying sleep disorder.
A is for Awakenings During the Night
The number of times a child awakens during sleep will vary, and tends to decrease as the child ages. Infants will wake often and may require frequent consolation. Toddlers and preschool-aged children should be able to self-soothe and fall back to sleep. Older children should be able to sleep through the night without wakening. If awakenings do occur, the nature of these events should be clarified. Is it due to a night mare or night terror? Does bedwetting occur? Is the sleep environment the problem? Understanding the frequency and what triggers the awakenings can be helpful.
R is for Regularity and Duration of Sleep
As with adults, it is important to keep a regular sleep schedule as part of the basic guidelines for better sleep. This helps to reinforce the natural circadian rhythms of our bodies. If you are uncertain about your child’s sleep, a sleep diary may help to document your child’s sleep patterns. It will also clarify if they are getting adequate rest. Sleep deprivation is a common cause of sleepiness in children and is something that is easily remedied.
S is for Snoring
Children should not chronically snore. If their airway becomes crowded with enlarged tonsils or adenoids, or as a result of obesity, it may lead to the vibration of snoring. Unfortunately, an obstructed airway may also cause sleep apnea. This can have serious consequences, including effects on growth, so children who frequently snore should be brought to their doctor for further evaluation.
Source: Mindell, JA et al. “A clinical guide to pediatric sleep: diagnosis and management of sleep problems.” Philadelphia: Lippincott Williams & Wilkins, 2003.