eMedicine Specialties > Pediatrics: Developmental and Behavioral > Medical Topics

Sleep Disorder: Problems Associated With Other Disorders: Follow-up

Author: Dennis A Nutter, Jr, MD, Consulting Staff, Department of Psychiatry, Northeast Georgia Medical Center
Coauthor(s): Guy K Palmes, MD, Program Director, Assistant Professor, Department of Psychiatry, Section of Child and Adolescent Psychiatry, Wake Forest University; Benyam Tegene, MD, Fellow, Department of Psychiatry, Wake Forest University Baptist Medical Center
Contributor Information and Disclosures

Updated: Apr 4, 2007

Follow-up

Prognosis

  • Dyssomnias
    • The treatment of primary insomnia often is difficult.
    • Associated anxiety is often responsive to psychotherapy.
    • Narcolepsy is a lifelong illness.
    • Cataplexy, hypnagogic hallucinations, and sleep paralysis may diminish in frequency over time.
    • Tonsillectomy and adenoidectomy relieve symptoms in about 70% of patients with OSAS. CPAP is indicated for patients who partially respond to surgery or in whom surgery is contraindicated.
    • The success of DSPS treatment depends to a large extent on how much the adolescent is motivated. The new schedule needs to be maintained rigidly in order to avoid relapse of DSPS.
  • Parasomnias
    • Most children with parasomnias outgrow this condition when younger than 10 years or demonstrate a progressive decrease to comparable prevalence to that of the adult population.
    • Approximately 88% of all enuretic children outgrow this condition by the time they are aged 13 years. The prevalence of enuresis in patients aged 13 years is 2%, which is similar to the prevalence rate in the adult population.
  • Sleep disorder related to a general medical condition: Prognosis depends on treatment of underlying medical condition.
  • Sleep disorder related to a substance use: Prognosis depends on treatment of the addiction.

Patient Education

  • Because human beings spend a third of their time sleeping, emphasize the need for good sleep hygiene to children, adolescents, and their families. Sleep hygiene includes the following:
    • Keeping the room quiet, dark, and comfortable
    • Practicing a simple bedtime ritual that includes voiding
    • Limiting time spent in bed
    • Not eating or drinking heavily for about 3 hours before bedtime
    • Maintaining the bedroom for sleeping only
    • Removing distractions, such as TV
    • Avoiding medications
    • Considering the effect of sleep partners (including pets)
    • Maintaining a consistent sleep schedule
    • Avoiding naps
    • Exercising regularly
    • Taking a hot bath or drinking something warm before bedtime
  • For excellent patient education resources, visit eMedicine's Sleep Disorders Center. Also, see eMedicine's patient education articles Disorders That Disrupt Sleep (Parasomnias), Night Terrors, Narcolepsy, REM Sleep Behavior Disorder, Periodic Limb Movement Disorder, and Sleeplessness and Circadian Rhythm Disorder.
 


More on Sleep Disorder: Problems Associated With Other Disorders

Overview: Sleep Disorder: Problems Associated With Other Disorders
Differential Diagnoses & Workup: Sleep Disorder: Problems Associated With Other Disorders
Treatment & Medication: Sleep Disorder: Problems Associated With Other Disorders
Follow-up: Sleep Disorder: Problems Associated With Other Disorders
References
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References

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  4. Challamel M, Cochat P. Enuresis: Pathophysiology and Treatment. Sleep Medicine Reviews. 1999;(3):313-324.

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Further Reading

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Keywords

associated problems in select sleep disturbances, dyssomnias, parasomnias, medical-psychiatric disorders, hypersomnia, insomnia, narcolepsy, obstructive sleep apnea syndrome, OSAS, periodic limb movements in sleep, PLMS, sleepwalking, somnambulism, bruxism, teeth grinding, grinding teeth, nightmares, night mares, sleep terrors, primary nocturnal enuresis, rhythmic movement disorders, confusional arousals, delayed sleep phase syndrome, DSPS, sleep disorders, sleep problems, rapid eye movement, REM, nonrapid eye movement, non-REM, NREM, circadian sleep-wake cycle, circadian rhythm

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Contributor Information and Disclosures

Author

Dennis A Nutter, Jr, MD, Consulting Staff, Department of Psychiatry, Northeast Georgia Medical Center
Dennis A Nutter, Jr, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry and American Psychiatric Association
Disclosure: Nothing to disclose.

Coauthor(s)

Guy K Palmes, MD, Program Director, Assistant Professor, Department of Psychiatry, Section of Child and Adolescent Psychiatry, Wake Forest University
Disclosure: Nothing to disclose.

Benyam Tegene, MD, Fellow, Department of Psychiatry, Wake Forest University Baptist Medical Center
Benyam Tegene, MD is a member of the following medical societies: American Medical Association and American Psychiatric Association
Disclosure: Nothing to disclose.

Medical Editor

Chet Johnson, MD, Medical Director, Child Development Unit, Department of Pediatrics, Professor, University of Kansas Medical Center
Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Nothing to disclose.

Managing Editor

Caroly Pataki, MD, Associate Program Director, Clinical Associate Professor, Department of Psychiatry and Biobehavioral Sciences, Division of Child and Adolescent Psychiatry, Neuropsychiatric Institute and Hospital, UCLA
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry
Disclosure: Nothing to disclose.

CME Editor

Carrie Sylvester, MD, MPH, Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry
Disclosure: Nothing to disclose.

Chief Editor

Murray M Kappelman, MD, Professor, Departments of Pediatrics and Psychiatry, University of Maryland School of Medicine
Murray M Kappelman, MD is a member of the following medical societies: Ambulatory Pediatric Association and American Academy of Child and Adolescent Psychiatry
Disclosure: Nothing to disclose.

 
 
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