Another Restless Night or Something More?: Five Signs of Sleep Disorders in School-Age Children with Special Needs

March 7, 2013
As Part of Sleep Awareness Week (March 3-10), Kennedy Krieger Expert Advises Parents on When to Seek Help and Tips for a Good Night’s Sleep

While sleep disturbances are common in all children at some point during childhood, the National Association of School Psychologists estimates that as many as 30 percent of children have restless nights serious enough to be diagnosed with a sleep disorder. For children with special needs, the likelihood of sleep disorders is even higher, due to factors such as physical and behavioral differences, and even side-effects from medication. 

Left untreated, sleep disorders can exacerbate existing conditions or cause additional health problems. While not all children with special needs who experience sleep disturbances will be diagnosed with a sleep disorder, experts point to early detection Jennifer Accardoof common signs as the key to improving sleep.

According to Dr. Jennifer Accardo, director of the Sleep Disorders Clinic and Lab at the Kennedy Krieger Institute in Baltimore, Md., parents know their child’s sleep patterns best and are often able to spot a more serious problem if they know the signs.

Signs of Sleep Problems in Children with Special Needs

  1. Snoring. Children who struggle to breathe or who noisily pause, gasp or choke in their nighttime breathing are at risk for obstructive sleep apnea. This treatable condition prevents a child from achieving deep, restful sleep and often results in daytime attention and behavior problems.
  2. Difficulty falling or staying asleep. Everyone has problems now and then, but chronic difficulty falling or staying asleep can make it hard for children to stay alert and focused during the day. Even children can have insomnia, and those with disabilities tend to struggle the most.
  3. Sleepwalking, night terrors and other nighttime activities. At some point, many children walk, talk or cry out in their sleep. Doctors call these occurrences parasomnias and if they happen often or over a long period of time, parents should seek help to find potential triggers.
  4. Sleeping too much. Children who have trouble waking up in the morning, getting to school on time or falling asleep during class have clear signs of a sleep problem.
  5. Needing parents to be in the room to fall asleep. If children are unable to fall asleep without their parents in the room, then it may be time to seek guidance.

“While a good night’s sleep is important for all children, it is especially critical for children with special needs,” says Dr. Accardo. “Parents can make small changes at home to help their child get a better night’s sleep and improve their performance in daytime activities, therapies and social interactions.”

Tips to Improve Sleep Patterns

  1. Make sleep a priority. Without a good night’s sleep, children may have difficulty participating fully in activities such as homework, sports and therapies.
  2. Develop a bedtime routine. Everyone needs this, even adults! A short set of calming activities helps children “wind down” to be ready for sleep.
  3. Keep schedules consistent between weekdays and weekends. Kids who stay up later and sleep in on weekends may find it hard to return to their regular schedules during the school week.
  4. In fact, keep schedules consistent every day! Going to bed and waking up around the same time daily trains your brain to account for the hours you need for other regular activities.
  5. Make the bedroom a restful place. TV and video games are not only distracting in the bedroom, but they also produce bright light that signals the brain to wake up.
  6. Sleep in the same place every night. Children who sleep on the couch, on the floor or in different beds have more trouble developing good sleep habits.
  7. Avoid caffeine. Caffeine in sodas, teas and coffees can keep children and adults awake.
  8. Put your child to bed when they are sleepy, but not yet fully asleep. Self-soothing is a fundamental skill for children. Putting children to bed before they are completely asleep gives them an opportunity to develop this skill.
  9. Address anxiety. Anxiety commonly affects children with disabilities, and makes sleep difficulties worse.
  10. Take note of sleep problem signs. Tracking patterns and signs can help your pediatrician or a sleep expert to more quickly identify the problem and offer solutions.

“If parents are concerned about their child’s sleep patterns and behaviors, they should consult with their pediatrician or a sleep expert,” says Dr. Accardo. “Sleep evaluations can be extremely beneficial in identifying causes and ultimately improving sleep for the entire family.”

About the Kennedy Krieger Institute


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Cynthia Chen