Sleep and Psychiatric Disorders in Children and Adolescents–>(Sleep Disorders. 5.) Edited by Anna Ivanenko. 415 pp., illustrated. New York, Informa Healthcare, 2008. $199.95. ISBN 978-1-4200-4807-0.
The focus of this book is not limited to sleep difficulties in children and adolescents with psychiatric disorders. About half of the 28 chapters deal with such problems as autism, anxiety disorders, and attention deficit–hyperactivity disorder (ADHD); the other chapters provide a wealth of information on such topics as normal sleep development, insomnia in children, and the influence of family, society, and school on sleep and sleep problems in children and adolescents.
The authors of the first nine chapters in the book review the importance of sleep for the development and functioning of infants, children, and adolescents. In chapter 1, Dean Beebe presents a model for understanding the interdependence of sleep, behavior, the family, and the physical and social environment. The review of normal sleep and development in infants and toddlers is a background for understanding difficulties in getting the child to sleep and recurrent night wakening. Each child grows, develops, and sleeps in a unique environment; chapters on cross-cultural comparisons of sleep practices and the importance of family functioning will help readers to understand variations in normal sleep and provide potential points of intervention for sleep disorders.
In their fascinating chapter on school start times and adolescent behavior and learning, Edward O’Malley and Mary O’Malley present important information on changes in circadian rhythm with development, historical information about progressively earlier start times in high schools, and data that demonstrate the benefits of delayed school start times. Clearly, sleep specialists need to talk to school administrators and school boards about these issues. Practical advice on how to evaluate sleep problems in clinical and school settings is given in two chapters. Useful techniques range from questionnaire studies, to abbreviated or screening studies such as nocturnal oximetry, to laboratory polysomnography and detailed multichannel overnight recording.
Insomnia is extraordinarily common in children and adolescents, and more so in those with psychiatric disorders or certain types of coexisting illnesses. The estimated prevalence of insomnia in children and adolescents is 20 to 30%. In her thoughtful chapter, Judith Owens reviews pharmacologic treatments for pediatric insomnia, presents guidelines for starting medication, and discusses the pros and cons of specific pharmacologic agents. Nonpharmacologic interventions are nearly always the first line treatment for childhood sleep disorders, and these approaches are discussed in the subsequent chapter. Another useful chapter discusses the use of melatonin in children with ADHD and other neurodevelopmental disorders.
There are chapters on narcolepsy, restless legs syndrome and periodic limb movement disorder, autism, depression, anxiety, and substance abuse. In chapter 12, Suresh Kotagal reviews the pathogenesis, diagnosis, and treatment of narcolepsy and points out that symptoms may often become apparent in adolescence, with definitive diagnosis being delayed for 5 to 10 years. The prevalence of ADHD in school-age children is estimated to be 8 to 10%; 25 to 50% of children with ADHD have sleep disorders, and coexisting psychiatric diseases are common among these children. Moreover, ADHD is frequently treated with psychotropic medications that can affect sleep. In their chapter, Samuele Cortese and Michel Lecendreux explore these complex interactions and give recommendations for the modification of treatment. The book’s editor, Anna Ivanenko, discusses sleep and mood disorders in chapter 20. Sleep problems are common in children and adolescents with major depression, bipolar disorder, and seasonal affective disorder, and Ivanenko takes a critical look at the literature on these problems, summarizes the available data, and points out the paucity of well-designed studies that address treatment options.
This book deserves a place on the shelf of pediatric sleep specialists, pediatric psychiatrists and psychologists, and developmental medicine specialists. It will also be useful as a reference for pediatricians and other child health specialists who are frequently asked about sleep problems in infants, children, and adolescents.
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