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Sleep Disorders

It is common for children who have a serious illness to have problems sleeping. Having trouble falling asleep, waking up in the night, being restless during sleep, and feeling sleepy during the day are frequent complaints. Many patients also have related side effects such as fatigue and problems with learning and memory.

Adequate sleep is essential for health and well-being. Without good sleep, it is hard to do daily activities. Patients may have problems keeping up at school or work. Emotional or behavioral changes such as irritability, moodiness, hyperactivity, or defiance are also common. 

Sometimes, sleep problems can be treated by taking steps to improve sleep habits. Other patients may need treatment for a specific sleep disorder.

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Types of sleep disorders

Children and teens with certain medical conditions are at higher risk for specific sleep disorders such as insomnia, hypersomnia, narcolepsy, sleep apnea, and restless legs syndrome.

Diagnosis of sleep disorders

A variety of tests are used to assess sleep problems and diagnose specific sleep disorders. These include:

  • Patient and family interview or questionnaire to assess symptoms
  • Medical history and physical exam
  • Review of medicines to find out if sleep problems might be a side effect of certain drugs
  • Sleep and activity diary
  • Blood tests to look for changes in blood counts, hormones, and organ function
  • Tests to measure sleep behaviors:

Sleep study (polysomnography)

An overnight sleep study, or polysomnography, measures different body functions during sleep. Special monitors are used to record brain waves, movement, heart rate, breathing, and oxygen levels during overnight sleep. Polysomnography is often performed at a sleep medicine center or hospital. Some measures may be done at home using a portable sleep monitor.

Little african american boy asleep in hospital bed with relative out of focus in background

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Multiple sleep latency test (MSLT)

A multiple sleep latency test (MSLT) measures how long it takes a patient to fall asleep during the day. The patient is given 4 or 5 nap opportunities over an 8-hour time period. Testing occurs in a dark, comfortable room, and nap periods are scheduled and timed. For each nap opportunity, the time it takes to fall asleep (sleep latency) is recorded. The time is compared to what is normally expected based on age. 

Actigraphy

Actigraphy measures movement over time using a small device (actigraph) usually worn on the wrist or ankle. The device records activity throughout the day and night to give information about a person’s activity and sleep patterns. Actigraphy is often used along with other measures such as sleep logs. Medical actigraph devices are more accurate and provide more detailed information. Although common smartwatches and fitness trackers are often used to track sleep, they do not provide accurate information on sleep/wake patterns and should not be used to make decisions about a patient’s sleep.

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Reviewed: June 2019