Up to 10% of children starting school suffer from sleep disturbances and these may lead to poor performance or behavioral difficulties. In the current edition of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2007; 105[47]: 809-14), the child and adolescent psychiatrist Gerd Lehmkuhl and his colleagues present the results of a study from Cologne, Germany.
The authors have as yet interviewed 1388 children starting school and their parents from all parts of Cologne. They investigated the sleeping behavior, factors such as noise or light in the sleeping environment, and the volunteers' daily activity. They also recorded current behavioral abnormalities, including emotional problems, hyperactivity, and problems with contemporaries. The conflict situation every evening was also stressful for brothers and sisters. The most frequent problem reported by the parents was that their children had difficulty falling asleep or staying asleep. The problems were at least twice as frequent if the children went to bed at variable times. Although was no problem if the children watched television before going to bed, children with a television set in their room woke up more frequently during the night. Infections, allergies and, particularly, stress within the family led to problems in falling asleep or staying asleep. The children were then tired, irritable, and restless during the following day. As sleeping difficulties are often not the primary reason for visiting the pediatrician, they must be recorded during routine investigations. This makes it possible to distinguish between typical developmental difficulties and abnormal sleep disturbances.
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