Classification and Epidemiology of Sleep Disorders in Children and Adolescents

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Key points

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    Sleep disorders are included in several major classifications systems such as the International Classification for Sleep Disorders, 3rd Edition (ICSD-3), the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), and the International Classification of Diseases, 10th Edition, the Clinical Modification (ICD-10-CM).

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    Sleep disorders are highly prevalent in children of all ages.

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    Higher prevalence of sleep disorders is documented in pediatric patients with special medical,

Classification systems for sleep disorders

The International Classification for Sleep Disorders, 3rd Edition (ICSD-3)1 is a comprehensive classification system that includes several nosologic categories, such as insomnias, parasomnias, hypersomnias, sleep-related breathing disorders, circadian-rhythm disorders, sleep-related movement disorders, and other sleep disorders. Behavioral insomnia of childhood is a distinct subtype of insomnia to emphasize its pathophysiology in children. Other ICSD-3 insomnia subtypes include

Insomnia Disorder

Pediatric insomnia is generally defined as “a repeated difficulty with sleep initiation, duration, consolidation, or quality that occurs despite age-appropriate time and opportunity for sleep and results in daytime functional impairment for the child and/or family.”5 It is common in young children, with both bedtime difficulties and frequent night waking reported in 20% to 30% of children younger than 3 years6,7 and 25% to 50% of preschool-aged children.7, 8, 9, 10 One study reported nighttime

Prevalence of sleep disturbances in children with psychiatric disorders

Sleep disorders are far more frequently reported among children and adolescents with coexisting psychiatric morbidities. Only a handful of studies, however address the prevalence of sleep problems in psychiatric cohorts of children. In one of the earlier studies, sleep complaints in children evaluated at a mental health clinic were compared to sleep symptoms reported by parents of children from the general population.148 This study found a significantly greater prevalence of nightmares and

Summary

Several classification systems of sleep disorders are currently available for use with pediatric populations. Sleep disorders are highly prevalent in children and adolescents and significantly affect their neurocognitive, emotional, and behavioral development. Children with medical, neurodevelopmental, and psychiatric disorders have a significantly higher rate of sleep-related problems that can persist over time if not properly treated. Thus, it is critical for mental health professionals to

Clinics care points

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    Apply ICSD-3 or DSM-5 classification systems for diagnosing older children and adolescents and DC:0–5 to diagnose infants and toddlers.

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    Given the high prevalence rates of sleep disorders among children and adolescents with medical, neurodevelopmental, and psychiatric disorders, routinely assess for sleep problems in youth presenting with these concerns.

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    Early identification and treatment of disrupted sleep improves daytime functioning, academic performance, and behavioral and emotional regulation.

Disclosure

The authors have nothing to disclose.

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