Uyku Bozuklukları
Özet
Uyku, çocukların fiziksel, psikolojik ve bilişsel gelişimi için hayati bir fizyolojik ihtiyaçtır. Uyku döngüsü NonREM ve REM olmak üzere iki temel evreden oluşmakta, çocuklarda bu döngü yetişkinlere göre daha kısa sürdüğü için gece uyanmaları sık yaşanmaktadır. Çocukların büyüme hormonu salınımı, doku yenilenmesi, bağışıklık sistemi ve beyin gelişimi yeterli uyku kalitesiyle doğrudan ilişkilidir. Yaş gruplarına göre uyku süresi ve yapısı değişiklik göstermekte, bebeklikten adölesan döneme doğru toplam uyku ihtiyacı azalmaktadır. Çocukluk çağında insomnia, uyku ile ilişkili solunum bozuklukları (horlama, obstrüktif uyku apne sendromu), parasomniler (uyurgezerlik, uyku terörü, kabus bozuklukları), hipersomnia ve hareket bozuklukları gibi çeşitli uyku problemleri görülebilmektedir. Bu bozukluklar özellikle gelişimsel yetersizliği veya kronik hastalığı olan özel gereksinimli çocuklarda daha yaygındır. Uyku sorunlarının önlenmesinde ve yönetiminde uyku hijyeni kritik bir rol oynamaktadır. Sağlıklı bir uyku düzeni için ailelerin çocuklara rol model olması, tutarlı uyku rutinleri oluşturması, uyku öncesi kafeinli gıdalardan kaçınılması ve odada ekran barındırılmaması önerilmektedir. Uyku hijyeni uygulamalarına rağmen devam eden sorunlarda, akademik ve nörodavranışsal bozulmaları önlemek adına mutlaka bir sağlık profesyonelinden destek alınmalıdır.
Sleep is a vital physiological need for the physical, psychological, and cognitive development of children. The sleep cycle consists of two main stages, NonREM and REM, and since this cycle is shorter in children than in adults, night awakenings occur frequently. Growth hormone secretion, tissue regeneration, the immune system, and brain development in children are directly related to adequate sleep quality. Sleep duration and structure change according to age groups, with the total sleep requirement decreasing from infancy to adolescence. Various sleep problems such as insomnia, sleep-related breathing disorders (snoring, obstructive sleep apnea syndrome), parasomnias (sleepwalking, sleep terrors, nightmare disorders), hypersomnia, and movement disorders can be observed during childhood. These disorders are particularly more prevalent in children with special needs who have developmental disabilities or chronic illnesses. Sleep hygiene plays a critical role in preventing and managing these sleep issues. For a healthy sleep routine, it is recommended that parents act as role models, establish consistent bedtime routines, avoid caffeine before sleep, and keep screens out of the bedroom. If problems persist despite sleep hygiene practices, professional healthcare support must be sought to prevent academic and neurobehavioral impairments.
Referanslar
Oxford Dictionary. Sleep 2021 [Erişim: https://en.oxforddictionaries.com/definition/ sleep.
Shimko AN. Sleep in infancy: A concept analysis. J Pediatr Nurs. 2019;47:100-105. doi:10.1016/j.pedn.2019.05.001
Cimete G, Kuğuoğlu S, Çınar ND. Çocuk, Hastalık ve Hastane Ortamı. İçinde Conk Z, Başbakkal Z, Yılmaz HB, et al., (Ed.) Pediatri Hemşireliği. Ankara: Akademisyen Kitabevi; 2018. p. 101-157.
Yıldırım Sarı H. Çocuklarda uyku. Ege Üniversitesi Hemşirelik Fakültesi Dergisi. 2012;28(1):81-90
Paruthi S, Brooks LJ, D'Ambrosio C, et al. Consensus statement of the american academy of sleep medicine on the recommended amount of sleep for healthy children: Methodology and discussion. J Clin Sleep Med. 2016;12(11):1549-1561. doi:10.5664/jcsm.6288
Bathory E, Tomopoulos S. Sleep regulation, physiology and development, sleep duration and patterns, and sleep hygiene in infants, toddlers, and preschool-age children. Curr Probl Pediatr Adolesc Health Care. 2017;47(2):29-42. doi:10.1016/j.cppeds.2016.12.001
Hybschmann J, Topperzer MK, Gjaerde LK, et al. Sleep in hospitalized children and adolescents: A scoping review. Sleep Med Rev. 2021;59:101496. doi:10.1016/j.smrv.2021.101496
Vásquez AMP, Gordillo-Nieto SV, García-Colín E, et al. Sleep quality in children hospitalized due to respiratory diseases in the national institute of respiratory diseases (INER). Sleep Medicine. 2019;64. doi:10.1016/j.sleep.2019.11.857
Topan A, Gozen D. Effect of model-based training by nurses on the promotion of sleep patterns among students in the middle school. Journal of Turkish Sleep Medicine. Jun 2020;7(2):96-104. doi:10.4274/jtsm.galenos.2019.68077
Bora İH, Bican A. Uyku fizyolojisi. Turkiye Klinikleri J Surg Med Sci. 2007;3(23):1-6
Akıncı E, Orhan FÖ. Sirkadiyen ritim uyku bozuklukları. Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry. 2016;8(2). doi:10.18863/pgy.81775
Hale L, Kirschen GW, LeBourgeois MK, et al. Youth screen media habits and sleep: Sleep-friendly screen behavior recommendations for clinicians, educators, and parents. Child Adolesc Psychiatr Clin N Am. 2018;27(2):229-245. doi:10.1016/j.chc.2017.11.014
Mindell JA, Sadeh A, Wiegand B, et al. Cross-cultural differences in infant and toddler sleep. Sleep Medicine. 2010;11(3):274-280. doi:https://doi.org/10.1016/j.sleep.2009.04.012
Brockmann PE, Diaz B, Damiani F, et al. Impact of television on the quality of sleep in preschool children. Sleep Medicine. 2016;20:140-144. doi:https://doi.org/10.1016/j.sleep.2015.06.005
Örüm S. 6 -18 yaş arası primer baş ağrısı olan çocuklarda uyku bozuklukları ve yaşam kalitesinin değerlendirilmesi [Uzmanlık Tezi]. Edirne: Tırakya Üniversitesi Tıp Fakültesi; 2019.
Yiğit R, Üğücü G. Çocukluk Dönemlerinde Büyüme ve Gelişme. Antalya: Çukurova Nobel Tıp Kitabevi; 2020.
Shadman KA, Wald ER, Smith W, et al. Improving safe sleep practices for hospitalized infants. Pediatrics. 2016;138(3). doi:10.1542/peds.2015-4441
Moon RY, AAP Task Force On Sudden Infant Death S. SIDS and other sleep-related infant deaths: Evidence base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(5). doi:10.1542/peds.2016-2940
Gözün Kahraman Ö, Ceylan Ş. Determining the sleeping habits of toddlers aged 0-3. Journal of History Culture and Art Research. 2018;7(3). doi:10.7596/taksad.v7i3.1635
Liu X, Liu L, Owens JA, et al. Sleep patterns and sleep problems among schoolchildren in the United States and China. Pediatrics. 2005;115(Supplement_1):241-249. doi:10.1542/peds.2004-0815F
Keskin N, Tamam L. Uyku bozuklukları: Sınıflama ve tedavi. Arşiv Kaynak Tarama Dergisi. 2018;27(2):241-260. doi:10.17827/aktd.346010
Hiscock H, Davey MJ. Sleep disorders in infants and children. J Paediatr Child Health. 2018;54(9):941-944. doi:10.1111/jpc.12033
Durmuş H, Solak Y, Kaya E, et al. Prevalence of sleep disorders in primary school children and its relationship with obesity. Güncel Pediatri. 2021;19(3):303-310. doi:10.4274/jcp.2021.38980
Koçak Ü, Albayrak M, Erol R, et al. Evaluation of sleep patterns and sleep disturbances in children: A preliminary study in Kırıkkale. Turkish J Pediatr Dis. 2012;6(2):81-87
Sateia MJ. International classification of sleep disorders-third edition. Chest. 2014;146(5):1387-1394. doi:https://doi.org/10.1378/chest.14-0970
Sinha S, Jhaveri R, Banga A. Sleep disturbances and behavioral disturbances in children and adolescents. Psychiatr Clin North Am. 2015;38(4):705-721. doi:10.1016/j.psc.2015.07.009
Algın Dİ, Akdağ G, Erdinç OO. Quality Sleep and Sleep Disorders. Osmangazi Journal of Medicine. 2016;38(0). doi:10.20515/otd.40263
Trosman I, Ivanenko A. Classification and epidemiology of sleep disorders in children and adolescents. Child Adolesc Psychiatr Clin N Am. 2021;30(1):47-64. doi:10.1016/j.chc.2020.08.002
Şentürk Ö, Ulu Güzel KG. Çocuklarda bruksizm: Derleme. Selcuk Dent J. 2022;9:926-934. doi:10.15311/selcukdentj.421783
Lunsford-Avery JR, Bidopia T, Jackson L, et al. Behavioral treatment of insomnia and sleep disturbances in school-aged children and adolescents. Child Adolesc Psychiatr Clin N Am. 2021;30(1):101-116. doi:10.1016/j.chc.2020.08.006
Monzon A, McDonough R, Meltzer LJ, et al. Sleep and type 1 diabetes in children and adolescents: Proposed theoretical model and clinical implications. Pediatr Diabetes. 2019;20(1):78-85. doi:10.1111/pedi.12797
Schneider HE, Lam JC, Mahone EM. Sleep disturbance and neuropsychological function in young children with ADHD. Child Neuropsychol. 2016;22(4):493-506. doi:10.1080/09297049.2015.1018153
Tse AC, Yu C, Lee PH. Comparing sleep patterns between children with autism spectrum disorder and children with typical development: A matched case-control study. Autism. 2020;24(8):2298-2303. doi:10.1177/1362361320936827
Toper Korkmaz ö. Gelişimsel yetersizliği olan çocuklarda uyku sorunları ve davranışsal müdahale yöntemleri. Ankara Üniversitesi Eğitim Bilimleri Fakültesi Özel Eğitim Dergisi. 2018:1-24. doi:10.21565/ozelegitimdergisi.397343
Esbensen AJ, Hoffman EK, Beebe DW, et al. Links between sleep and daytime behaviour problems in children with Down syndrome. J Intellect Disabil Res. 2018;62(2):115-125. doi:10.1111/jir.12463
Lee T, Kim J, Park KJ, et al. Sleep difficulties and related behavioral problems in Korean preschool children. Sleep Med. 2021;87:119-126. doi:10.1016/j.sleep.2021.09.002
Austin KL, Gordon JE, O'Connell A. Preliminary evaluation of sleepwise program for children with sleep disturbance and developmental delay. Child & Family Behavior Therapy. 2013;35(3):195-211. doi:10.1080/07317107.2013.818886
Malow BA, Adkins KW, Reynolds A, et al. Parent-based sleep education for children with autism spectrum disorders. Journal of Autism and Developmental Disorders. 2014;44(1):216-228. doi:10.1007/s10803-013-1866-z
Moss AHB, Gordon JE, O’Connell A. Impact of Sleepwise: An intervention for youth with developmental disabilities and sleep disturbance. Journal of Autism and Developmental Disorders. 2014;44(7):1695-1707. doi:10.1007/s10803-014-2040-y
Singh K, Zimmerman AW. Sleep in autism spectrum disorder and attention deficit hyperactivity disorder. Semin Pediatr Neurol. 2015;22(2):113-125. doi:10.1016/j.spen.2015.03.006
Halal CS, Nunes ML. Education in children's sleep hygiene: Which approaches are effective? A systematic review. J Pediatr (Rio J). 2014;90(5):449-456. doi:10.1016/j.jped.2014.05.001
Mindell JA, Williamson AA. Benefits of a bedtime routine in young children: Sleep, development, and beyond. Sleep Med Rev. 2018;40:93-108. doi:10.1016/j.smrv.2017.10.007
Beattie JF, Koch SA, Bolden LB, et al. Neuropsychological consequences of sleep disturbance in children with epilepsy. Epilepsy Behav. 2016;57(Pt A):118-123. doi:10.1016/j.yebeh.2016.01.037
Stern M, Wagner MH, Thompson LA. Current and COVID-19 challenges with childhood and adolescent sleep. JAMA Pediatr. 2020;174(11):1124. doi:10.1001/jamapediatrics.2020.2784
Thomas JH, Burgers DE. Sleep is an eye-opener: Behavioral causes and consequences of hypersomnolence in children. Paediatr Respir Rev. 2018;25:3-8. doi:10.1016/j.prrv.2016.11.004
Sleep Foundation. Children and Sleep 2022 [Erişim: https://www.sleepfoundation.org/children-and-sleep.
