9.7 EMOTIONAL AND BEHAVIORAL PROBLEMS ASSOCIATED WITH SLEEP DISORDERS IN CHILDREN

Abstract

The possible connection between sleep disorders in children and adolescents and emotional and behavioral disorders is considered. Data are provided on the connection between disturbances in the duration and integrity of sleep with increased emotional reactivity and lability, high levels of anxiety, and symptoms of depression. The connection between the clinical symptoms of attention/deficit hyperactivity disorder, aggressiveness, and poor academic performance with sleep disorders, including sleep-disordered breathing, restless leg syndrome, and periodic limb movement, is discussed. Data are provided on characteristic polysomnographic changes detected against the background of the discussed emotional and behavioral disorders in children. A possible pathophysiological basis for the identified associations is given. Practical recommendations for examining children with complaints of emotional and behavioral disorders for possible concomitant sleep disorders are substantiated.

Key words: children, parasomnias, sleep breathing disorders, behavioral disorders, attention/deficit hyperactivity disorder, sleep, emotional disorders.

Sleep and wakefulness represent a continuum of different functional states brain. This is why individual pathological conditions can manifest themselves differently in conditions sleep and wakefulness, and the possible connection between sleep disorders deserves great practical interest with neurobehavioral and emotional disorders detected in the waking state in children.

Sleep disorders in children are associated with so-called internalized psychological changes, that is, those associated with them suffer from emotional disorders. Sleep disorders are combined with other sleep disorders, frequent wakefulness at night and lack of sleep, increased emotional reactivity (i.e. the ability to react emotionally to changes in the environment) [1] and increased emotional instability [2]. A child's emotional reactivity greatly affects his behavior, which is what educators, teachers and parents pay attention to, and increased emotional reactivity among schoolchildren is often combined with aggressive behavior [3].

The opposite relationship is also possible, in which primary emotional disturbances lead to sleep disorders. It is believed that the predisposition to internalize psychological conflicts lead to a higher level of emotional stress, which in turn provokes a state of excessive increase in activity (hyperarousal). Such psychophysiological shifts prevent the onset of sleep and are detected in most patients suffering from insomnia, by which we mean repeated violations sleep initiation, duration, consolidation and quality [4].