Whenever a woman becomes pregnant, she is often told to take the opportunity to sleep well before giving birth because after childbirth the children's sleep can be complicated, in some cases, giving rise to a dreaded insomnia that not only the little ones suffer, but also their parents.
The Spanish Association of Pediatrics (AEP) defines insomnia as that difficulty falling asleep or maintaining sleep that lasts over time and causes drowsiness during the day, discomfort or even nervousness in the child and that also makes them have the feeling that sleep has not been restful. It is considered chronic when it lasts for more than 3 months, and at least 3 days a week.
Dr. Francisco Segarra is director of the Dr. Estivill Sleep Unit of the Hospital Universitari General de Catalunya (Barcelona) and an expert in childhood sleep, and maintains in this sense that it is normal for children to wake up at night, especially the youngest . But he qualifies that as the minors grow older, these awakenings should decrease. "Childhood insomnia affects 30% of children between 3 months and 5 years of age and, of this figure, 5% responds to medical causes, while the remaining 25% responds to behavioral habits, that is, to what ' allow' or teach our children," warns Dr. Segarra.
Normally, according to the specialist, this is due to the fact that the child, when he goes to his parents' bed, talks about his problem or uses elaborate reasoning, easily credible by the parents who, frequently, succumb to his demands because they occur late at night. at dawn. "Children, when asked, report difficulty falling asleep, 'fears at night', for example, but in reality what these arguments give off is an insecurity in their sleep habit," says Dr. Segarra.
With this, Dr. Segarra explains that the evolution of childhood insomnia due to incorrect habits is produced towards a deterioration in sleep habits that manifests itself differently in children older than 5 years: "The clinical characteristics of the pathology consist of: difficulty initiating sleep alone or long sleep onset latency (more than half an hour), waking up at night with visiting parents (usually they are no longer called), and demand for 'co-sleeping' (sleeping in bed with the parents). parents)".
Consequently, the director of the Dr. Estivill Sleep Unit of the Hospital Universitari General de Catalunya details that the child feels insecure when sleeping, just as it happens with any other habit that has not been learned correctly, because it has always been had trouble sleeping. "The difficulty to fall asleep generates anxiety and this anxiety increases the difficulties to sleep and a vicious circle is created from which the child does not know how to get out. He refuses to go to sleep at other children's houses, he does not want to go to colonies or summer camps , and the fact of going to bed is not pleasant for him, because the inevitable anticipatory anxiety has set in," remarks this expert in childhood sleep.
In any case, Dr. Segarra warns that this pathology in the long term can have repercussions in the intellectual sphere, so that children can develop problems with school performance, the result of poor sleep. But its consequences can also be observed in the affective sphere, continues the expert, since the irregular situation of their sleep causes them to feel different or inferior to other children; At the same time, there can be an increase in behavioral problems, irritability and impulsivity.
"In parents and siblings, if there are any, it causes a clear dissatisfaction, concern for the situation and inability to resolve it, since they have tried everything, from good words to punishments. The daytime repercussions are important, both for children and for parents", considers this infant sleep specialist.
In these cases, Dr. Segarra indicates that the treatment is different from that carried out in younger children, since in the older child the behaviors developed around his bad habit make the approach more complex. "Normally, we also find altered behavior in the parents' behavior in relation to the problem, which makes the treatment more complex. Therefore, it is essential to carry out the therapeutic approach jointly between the parents and the child", he defends.
Furthermore, the sleep specialist at the Hospital Universitari General de Catalunya confirms that "scientific evidence shows that behavioral treatments are the treatment of choice in these cases, since they help to reduce resistance, as well as the anxiety that children present to going to bed and nocturnal awakenings with the inability to fall asleep again on their own.
In people over five years of age, the most effective behavioral treatments are those based on exposure with Positive Reinforcement, adequate sleep routines, as well as Paradoxical Intention, a technique used to eliminate anticipatory anxiety, which is what makes it difficult to fall asleep. . It is also important to educate parents so that they can intervene as co-therapists, says Dr. Francisco Segarra.
