Table 2.

Sleep disorders

Name	Diagnostic criteria	Considerations	Treatment
Insomnia	DSM-510 Dissatisfaction with sleep quantity or quality, with complaints of difficulty initiating and/or maintaining sleep, accompanied by clinically significant distress or impairment in social, occupational or other important areas of functioning, which can occur independently or during the course of another mental disorder or medical condition ICSD-319 Persistent difficulty with sleep initiation, duration, consolidation or quality that occurs despite adequate opportunity and circumstances for sleep, and results in some form of daytime impairment. Subcategorised into chronic insomnia disorder, short-term insomnia disorder, other insomnia disorder, isolated symptoms and normal variants, excessive time in bed and short sleeper19,22	Paediatric insomnia Reports from young people and parents or carers need to be taken into consideration when assessing for insomnia23	Psychoeducation Behavioural management Pharmacotherapy
CRDs	Delayed sleep phase disorder Most common Typical sleep onset and wake time are more than 2 hours later than the age-related norm Causes difficulties waking up for school and lack of sleep Advanced sleep–wake phase disorder People tend to fall asleep and wake up more than 2 hours before their desired time Less common in those aged <18 years Irregular sleep–wake rhythm disorder Inconsistent sleep pattern	People with CRDs are unable to sleep and wake at the times required for normal work, school or social needs11	Sleep–wake scheduling Timed light exposure Melatonin
Sleep-related breathing disorders	OSA Snoring, unusual sleeping positions (e.g. hyperextended neck or seated with open mouth), sleep-related paradoxical breathing, night-time diaphoresis or enuresis, morning headaches, prolonged sleep time, difficulty waking, irritability and excessive daytime sleepiness	OSA is the most common sleep-related breathing disorder Affects 1–5% of children between 2 and 8 years of age24	Adenotonsillectomy is the primary treatment of this condition in those aged <8 years25 Continuous positive airway pressure therapy for older children25
Parasomnias	NREM parasomnias Confusion, automatic behaviours, difficulty awakening, minimal recall and often return to sleep after the event Sleepwalking More common in children than adults Can be associated with other parasomnias No distress to the child, but disrupts others26 Sleep terrors Episodes of partial, abrupt awakening from deep sleep, accompanied by inconsolable screaming and crying and autonomic arousal, but again, minimal recall for the child10 REM-related parasomnias Nightmares Typically occur in the last half of the sleep period1,27,28	NREM parasomnias Most common in children and are more likely in the first third of the night, during stage 3 sleep	Psychoeducation Behavioural management Treatment of comorbidities
		REM-related parasomnias Frequently encountered in childhood Often resolve in adolescence Common for all children but typically occur with recall and distress
Narcolepsy and hypersomnia	Narcolepsy Excessive daytime sleepiness, fragmented night sleep, sleep paralysis, vivid dreams and hypnagogic hallucinations	Narcolepsy Rare sleep disorder resulting from the loss of a specific population of hypocretinergic neurons It has a prevalence of 0.1%19 and the mean age of onset is 14 years About 70% of affected people have cataplexy	Psychoeducation Behavioural management Pharmacotherapy (stimulants)
	Primary hypersomnia in children Excessive sleep duration for developmental norms, impaired quality of wakefulness or sleep inertia29	Primary hypersomnia in children Has a prevalence of 0.8%29 May simply represent a slight delay in normal development30

ICSD-3, International Classification of Sleep Disorders, Third Edition; CRD, circadian rhythm disorder; OSA, obstructive sleep apnoea; NREM, non-rapid eye movement; REM, rapid eye movement.