Hypersomnia in children: what is this childhood sleep disorder

Hypersomnia in children is a sleep disturbance which can occur in early stages of development. As its name indicates, it consists of excessive sleep that can significantly affect a person's daily activities. It is the sleep disturbance opposite to insomnia.

Although it may be temporary, hypersomnia usually causes a lot of discomfort and can also be an indicator or precursor. for the development of long-term sleep disorders, therefore, it is important to address this alteration in a manner timely.

In this article we will see what hypersomnia is in children, what are its characteristics and causes, and finally some of the most recommended treatments.

Related article: "Hypersomnia: types, symptoms, causes and treatments"

What is hypersomnia in children?

Hypersomnia (or primary hypersomnia) is a Non-Organic Sleep Disorder, also known as non-organic hypersomnia, according to the ICD (International Classification of Diseases, WHO).

This sleep disorder can be developed by both adults and children. In general terms, childhood hypersomnia is characterized by the presence of

excessive daytime sleepiness, that is, due to the inability of children to stay awake.

Some indicators could be, for example, if the child falls asleep at school, he seems to be sleepy, or you have a hard time paying attention to daily activities that require a pace that is appropriate for your age.

Related to the above, some difficulties that are associated with hypersomnia in children are poor performance school, the presence of mood disorders, and alterations of the immune system, the endocrine system or the metabolic.

When hypersomnia occurs around adolescence, can even lead to the use of stimulants (such as caffeine) or depressants (such as alcohol), because they are used as tools to maintain wakefulness or to stimulate sleep.

• You may be interested: "The 6 stages of childhood (physical and mental development)"

Symptoms and WHO diagnostic criteria

It is estimated that, on average, a newborn sleeps 16 hours. The infant sleeps 12 to 14 hours; a child who is 3 to 5 years old sleeps 11 hours; and between 9 and 10 years of age, the child sleeps around 10 hours.

From adolescence and into adulthood, it is estimated that a person sleeps 7 to 8 hours a day. Due to this progressive decrease in hours of rest, Late childhood is considered the stage where our sleep has the best quality.

However, it may happen that the hours of sleep that the child has seem not to be enough for him to achieve adequate rest and maintain the corresponding activities while awake.

If this also occurs for a long time, we can suspect that it is hypersomnia. For its diagnosis, the WHO considers the following criteria:

• Excessive drowsiness or daytime sleep attacks, which appear after an adequate night's sleep.
• Very long transition period from sleep to wakefulness, that is, pronounced and lasting difficulty in waking up.
• It occurs daily for a month or more and causes severe discomfort or significantly interferes with the child's daily activities.
• There are no other symptoms that together can be diagnosed as narcolepsy or sleep apnea.
• There is no neurological or medical alteration that explains the drowsiness.

As there are no organic factors or medical diseases that explain drowsiness, the presence of hypersomnia may be an indicator that there is a more global psychological alteration. For example, hypersomnia is often related to the development of mood or depressive disorders.

Possible causes

The causes of sleep disorders vary according to the age of the person. Some may be physiological, other causes may be psychological. and others may be related to the habits of the child himself and his family.

1. Changes in brain activity

The brain functions under three fundamental periods: wakefulness, REM sleep (rapid eye movements) and non-REM sleep. During each period, the brain remains active and responds to external stimuli in different ways.

The periods that regulate activity during sleep are REM sleep and non-REM sleep, which alternate in different phases every 80-100 minutes. REM sleep, which is regulated by the activation of the noradrenergic system, and its phases increase in duration as dawn approaches.

One of the causes of hypersomnia and other sleep disorders may be natural changes in the physiology of the brain. For example, as development and chronological age increase, the depth and continuity of sleep change considerably; waking states are greater, and some of the phases of REM sleep and Non-REM sleep decrease.

2. Psychological and social factors

Many times sleep disorders in children are related to stressful events that have not been adequately managed, but It also has to do with more specific issues such as how caregivers direct the activities that occur before and after the birth. dream.

For example, sleep disorders in children under 2 years of age may be related to parenting styles and with parental responses to child sleep-related behaviors. An even more specific example is the way parents are involved in their child's sleep and wakefulness (at bedtime).

At school age, which is usually from 3 years old, sleep disorders are usually related to the way we set limits at bedtime. They are also related to previous habits that stimulate children in different ways, for example, watching TV, tablets, or reading stories can have different consequences on rest.

Likewise, hypersomnia and other sleep disorders May be linked to emotional exhaustion and chronic medical conditions that cause nocturnal awakenings.

How to evaluate and what is the treatment?

To evaluate hypersomnia in childhood, it is necessary to know the child's sleep history, that is, to have access to a detailed description of the frequency, cycles and circumstances or habits associated with rest, and periods of activity and inactivity.

Likewise, it is necessary to know possible medical diseases, trauma or infections; and the activities you carry out during the day (for example, your eating schedule).

This is important because it allows us to detect if the dream has been modified from an early age or if it is related to a specific event. The most effective technique to find out this is through an interview with caregivers and educators., and even towards the same child depending on age.

For treatment, it is important to consider that sleep is regulated by internal synchronizers (such as melatonin, temperature body or cortisol), and by external synchronizers (such as light and dark, sounds, habits or events stressful).

The latter are the ones that largely determine the functioning of the former, and are also the easiest to modify. Therefore, one of the ways to treat hypersomnia in children is modify external synchronizers, which will ultimately impact the internal synchronizers.

Bibliographic references

• Perez, H. (2016). Sleep throughout life. In Martínez, J. and Lozano, J. (Coords). Insomnia. Guidelines for action and monitoring. BMI: Madrid
• Amaro, F. (2007). Sleep disorders in childhood and adolescence. Retrieved May 9, 2018. Available in http://www.paidopsiquiatria.cat/files/trastornos_del_sueno.pdf.
• Montañés, F. and Taracena, L. (2003). Treatment of insomnia and hypersomnia. Medicine, 8(102): 5488-5496.