Chapter 121 Helping visually impaired children to sleep
Sleep disturbances are increasingly common in Western societies due to changing lifestyles. In healthy children, these sleep difficulties tend to be transient and respond well to sleep hygiene techniques (environmental and behavioral promotion of healthy sleep). In contrast, in children with neurodevelopmental disabilities (including visual impairment) they tend to be more frequent, persistent, and severe and may not respond to sleep hygiene interventions.1 Although, over a hundred different sleep disorders can occur in childhood, circadian rhythm sleep disorders (CRSD) are by far the most common,2 followed by sleep disordered breathing,3 parasomnias,4 and restless legs syndrome.5 Most of these sleep disorders present differently from those seen in adults.
During the last 20−30 years major advances have been made in understanding sleep physiology. Sleep is a vital restorative neurological function. It is not surprising that severe, persistent sleep deprivation can lead to gradual loss of neurons in various areas of the brain, but more so in the frontal lobes where executive cognitive functions are generated. The behavioral manifestations of inadequate sleep include inattentiveness, aggressiveness, hyperactivity, impulsivity, and mood changes. Cognitive manifestations are impaired comprehension, deficits in reasoning, and memory formation. School failure is common. Health disturbances are also frequent such as impaired immunologic defenses resulting in more frequent infections and even cancer, cardiovascular difficulties, obesity and endocrine disturbances, tendency to accidents, and increased suicide rates among teenagers.2