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Sleep Hygiene in Children - A Case Report
Sleep disorders are prevalent in pediatrics, affecting about 1 in 4 children after the first years of life. Can impact on attention and memory which are the functions of importance for child development, can being involved in increased hyperactivity, mood disorders and aggression. They may be of organic or behavioral etiology. Behavioral insomnia is based on sleep hygiene and treatment and precautionary measures, which uses a range of changes in habits of children and families, as well as environmental changes, providing to the patient with conditions suitable for a quality sleep.
Report a case
CR, male, 1 year and 7 months comes to outpatient clinic accompanied by his mother, complaining of nocturnal awakening and irritability. He had been using risperidone for 2 months as indicated by the neuropediatrician due to the difficulty in maintaining sleep and agitated and aggressive behavior during the day, without showing improvement in the period. He sleeps from 9pm to 7am, with awakening between 2 and 3am, when he has narrowed eyes, confused, not obeying the commands of parents.Denies snoring or stereotyped movements.He takes a nap about 1:30 after lunch, when he is awakened "to not affect night sleep". He does not have a well-established bedtime routine.We suggest letting him sleep for free in the afternoon nap to assess the actual need for sleep and the mother was advised about new routine. After 14 days, there was a significant improvement in daytime and sleep behavior. A consistent routine has been adopted with the child: after coming home from school, receives dinner, takes a shower and goes to the dimly lit room, where the mother tells stories until the child sleeps. The patient remained consistent at bedtime 21h and woke up at 6am, without awakening.He increased spontaneously about an hour in the afternoon nap (total 2h30).After one week of sleep hygiene, the mother reports having finished risperidone and chose not to give the medication again, considering the improvement of the child's overall behavior.
Sleep deprivation has consequences on child health, such as metabolic disorders, memory deficit, reduced cognitive performance and behavioral impairment.Recent studies show the negative effect on their ability to regulate behavior Therefore, it is essential to adopt adequate sleep hygiene measures before drug interventions for children with insomnia and behavioral alterations that do not delay neurological development.
Relato de Caso
UNISUL - Santa Catarina - Brasil
Nathalia Watanabe, Nathalia Watanabe, Thais Aparecida Nandi, Thais Aparecida Nandi, Thiago Demathé, Thiago Demathé