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Pediatric Sleep Disorders Philip K. Capp, MD a , Phillip L. Pearl, MD a, * , Daniel Lewin, PhD b a Department of Neurology, Children’s National Medical Center, 111 Michigan Avenue NW, George Washington University School of Medicine and Health Sciences, Washington, DC 20010-2970, USA b Department of Psychology, Children’s National Medical Center, 111 Michigan Avenue NW, George Washington University School of Medicine and Health Sciences, Washington, DC 20010-2970, USA Di sturbe d sl ee p in a chil d is an issue of unde rstandable conc ern for parents and a common reason for visits to a primary care clinician. Despite the prevalence of sleep disorders in children, there is a great disparity in phy sic ian tra ini ng in sle ep medici ne and ski ll in diagno sing and tre ati ng sleep disorders [1]. The sleep disorders that commonly present from infancy through adolescence range in severity from transient diﬃculties settling at night to life-threatening conditions that are essential targets for prevention and early intervention by clinicians. This article begins with a review of sleep architecture in children and progresses chronologically through sleep disorders in infancy, childhood, and adolescence. Pediatric sleep architecture Sleep architecture is deﬁned as the organization and relatively reliable cycling of sleep stages within the nighttime sleep period. A brief review of sleep ar ch itecture is useful for th e ensuin g di scussion of co mmonly en co untere d sl ee p di st ur ba nces in ch il dr en . Of pa rt ic ul ar in te rest to cli nic ian s are the normal change s in sleep architecture tha t beg in in the fetal stage and continue to evolve through adolescence and into adulthood. Wakefulness is characterized by the presence of alpha waves (8–13 Hz frequency) over the posterior brain regions on electroencephalogram (EEG). The dis appear anc e of alpha activit y and the eme rge nce of a low-voltage mixed-frequency EEG heralds the onset of stage 1 non–rapid eye movement * Corresponding author. E-mail address: [email protected] (P.L. Pearl). 0095-4543/05/$ - see front matter Ó 2005 Elsevier Inc. All rights reserved. Prim Care Clin Office Pract 32 (2005) 549–562

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