Divisione Pediatrica, Ospedale Belcolle, Viterbo
Key words: Sleep disorders, REM sleep, Insomnia
The author syntetizes current knowedge on sleep physiology, particulary regarding REM and non REM sleep. There are many physiological motor and autonomic phenomena related to sleep such as gestual activity, modifications of hearth rate, respiratory rate and temperature. They should not be seen as abnormalities. When evaluating the child with insomnia, paediatricians should take into account the different sleep requirements at different ages, as well as environmental factors such as rituals utilized to induce sleep, fears, and stress. In infants, insomnia may be caused by allergy. Airway obstruction due to hypertrophic tonsils or adenoids may cause severe sleep disturbances, and negatively affect the child during the day. Pharmacological treatment of sleep disorders should be limited to cases not-responders to behavioural approaches or to elimination diet. Ipersomnias (narcolepsia, catalepsia, ipnagogic allucinations) are very rare in children and differential diagnosis with epilepsia may be diffucult. Parasomnias (iactatio capitis, spasmus rutans, pavor nocturnus, sonnambulism, bruxism) are easy to recognize and need just reassurance.
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