Assessment of Sleep Complaints in Children and Adolescents

By early school age, the average child has spent nearly half of his/her life asleep. In fact, it can be argued that sleep is the primary activity of the brain during early development. By two years of age, the average child has spent almost 10,000 hours (nearly 14 months) asleep (1). In these two years, the brain has reached 90% of adult size (2), and the child has attained remarkable complexity in areas such as physical abilities, cognitive skills and socioemotional development (3,4). Based on this evidence, a strong argument can be made that sleep must serve some essential aspect of brain function. Despite the ubiquity of this state in young children, the basic function of sleep and its relationship to development remain a mystery. Sleep-related problems occur frequently in children and adolescents. Numerous wellcontrolled studies have documented prevalence rates for significant sleep problems ranging from 20% to 30% in community samples as well as in pediatric clinic populations (5-11). In many cases, disturbed sleep is simply an isolated mild behavioral problem. In other cases, however, sleep-related symptoms may represent a serious disorder, such as narcolepsy (12), or may be one component in a larger set of behavioral or emotional symptoms (13). Also, the relationship between sleep and behavioral/emotional problems appears to be complex; behavioral and emotional problems can contribute to sleep disturbances and conversely, sleep difficulties can adversely affect mood and behavior. Given these complexities, careful assessment and appropriate treatment decisions are warranted when a youngster has any of the above described problems. ASSESSMENT OF SLEEP COMPLAINTS IN CHILDREN AND ADOLESCENTS