This is part one of a two-part article on sleep disorders in children and young adults. The first part will be dedicated to common sleep disorders of early childhood and preadolescence and the second part will discuss sleep disorders in adolescence and in the teenage years.

Childhood sleep disorders are common, and most children “grow out” of their sleep problem.

The sleep need in young children is greater than that of adults. Newborns need 16 to 20 hours of sleep. This amount typically decreases to 12 hours by 1 to 3 years of age, and by 6 to 12 years of age 10 to 11 hours of sleep is usually required.

Adequate sleep is essential for normal development. In fact, during the deepest stages of sleep is when growth hormone is secreted by the brain. Studies have shown that sleep disorders in children make them shorter than their normal-sleeping peers.

In very young children, the most common sleep problem is sleep onset association disorder. This is a phenomenon where the child or baby associates an object or ritual to the initiation of sleep.

These objects or rituals can include a teddy bear, a favorite blanket, nighttime feeding, or the simple presence of Mom or Dad. The major problem with these associations is what happens when they are not present at the initiation of sleep. The result can be a significant struggle to achieve sleep.

This is the reason most pediatricians recommend allowing the baby to learn how to initiate sleep on their own, so-called self soothing. This goal can be achieved by putting babies to bed when they are drowsy, but still awake.

Over time they will learn how to fall asleep on their own. If an association disorder has developed, such as with Mom for sleep onset, a technique of night after night moving a chair farther and farther from the baby’s crib until Mom is out of the room is often successful. Helping to teach your child to initiate sleep independently will help them to be better sleepers throughout childhood and into adulthood.

Also common in younger children is the phenomenon of sleep walking and sleep talking. Sleep walking is present in 15 to 40 percent of children.

By adulthood, the prevalence of sleep walking decreases to 1 percent. Sleep walking occurs when parts of the brain are awake and other parts are asleep. Since sleep walking most often occurs in deep sleep, termed slow wave sleep, it is sometimes difficult to awaken a sleep walker.

The best remedy for sleep walking is to make the bedroom and home environment as safe as possible and to secure outside access points to keep children from walking outside. Because these events tend to occur at a similar time each night, there is some success of awakening the child with an alarm 20 minutes or so prior to the typical event time. This can disrupt the sleep rhythm enough that the sleep walking may significantly decrease. As a final treatment option, medications can be taken to suppress the deep sleep stage, but these are only used if there is risk of injury.

Two other phenomenons that occur during sleep in children are nightmares and night terrors. These two entities are quite distinct. Whereas nightmares occur mostly in the dream stage of sleep, also called rapid eye movement sleep, night terrors occur during slow wave sleep (also the stage of most sleep walking and talking). Because of the profound depth of slow wave sleep, it can be very difficult to rouse a child from a night terror. If one is able to awaken the child from a night terror, typically the child will have no recollection of the episode.

This is quite different from a nightmare where it is usually easy to awaken the child and they will have vivid memory of the dream content. Sleep terrors tend to occur at a similar time each night, especially prominent in the first third of the night. The technique mentioned above of setting an alarm for 20 minutes or so prior to the event can be helpful.

Nightmares typically occur in the latter two thirds of the night. Fortunately, most children respond well to reassurance and typically no further intervention is needed.

Difficulty initiating sleep is most effectively treated by nonmedication means. The treatment is called cognitive behavioral therapy, CBT. This treatment consistent of a variety of principles and is best administered by a psychologist or other trained therapist.

Two of the most important components of CBT are practicing good sleep habits such as a seven-day a-week regular bed and wake time, and limiting the time spent in bed not sleeping. For most children the biggest culprit is computer or television in bed. Computer and TV screens can be particularly harmful when it comes to sleep because they emit high amounts of blue wavelength light.

If your child is experiencing a chronic sleep problem and especially if it is interfering with daytime function, you should discuss this with your primary care provider to see if referral to a sleep specialist or sleep testing would be beneficial.

Mark D. Reploeg, M.D. is the head of sleep medicine at The Corvallis Clinic and is the medical director of the nationally accredited Samaritan Sleep Disorders Center. Dr. Reploeg and his colleagues treat both children and adults with all forms of sleep disorders.