pediatrics
Sleeping Behaviors in Infants and Children
Evaluation
History is focused on the child’s sleeping environment, consistency of bedtime, bedtime routines, and parental expectations. A detailed description of the child’s average day can be useful. The history should probe for stressors in the child’s life, such as difficulties in day care or school, as well as exposure to unsettling television programs and caffeinated beverages (eg, sodas). Reports of inconsistent bedtimes, a noisy or chaotic environment, or frequent attempts by the child to manipulate parents by using sleep behaviors suggest the need for lifestyle changes. Extreme parental frustration suggests tension within the family or parents who are having difficulty being consistent and firm. A sleep diary compiled over several nights may help identify unusual sleep patterns and Sleep Problems in Children (eg, Careful questioning of older children and adolescents about school, friends, anxieties, depressive symptoms, and overall state of mind often reveals a source of a sleep problem. Examination and diagnostic testing generally yield little useful information. 