Pediatric Sleep-Wake Disorders: A Review of Clinical Presentations, Comorbidities, and Management Approaches

Öz

Sleep is a fundamental neurobiological process for optimal brain function. In recent years, sleep-wake disorders in children and adolescents have received increasing attention due to their significant impact on physical health, cognitive development, and emotional well-being. These disorders, including insomnia, obstructive sleep apnea, restless legs syndrome, and narcolepsy, present in diverse ways and pose considerable challenges in terms of both diagnosis and treatment. Despite growing research interest, such conditions remain under-recognized and frequently overlooked in pediatric populations. The etiology is multifactorial, often involving behavioral, environmental, developmental, and neurobiological factors. Sleep disturbances in children can lead to impaired academic performance, mood dysregulation, hyperactivity, and family stress. Diagnosis requires a thorough clinical evaluation, including sleep history, parental reports, and, when necessary, actigraphy or polysomnography. Management is typically multidisciplinary, pharmacologic therapy is reserved for moderate to severe cases, when non-pharmacological approaches are insufficient or in the presence of specific underlying conditions. This review provides a comprehensive overview of the pathophysiology, prevalence, classification, diagnostic challenges, and treatment strategies associated with sleep-wake disorders in children and adolescents. The aim is to enhance early recognition, clarify distinctions between normal variations, problematic behaviors, and diagnosable disorders, and highlight the potential long-term consequences of untreated sleep disturbances.

Anahtar Kelimeler

• sleep disorder
• insomnia
• child

Çocukluk Çağı Uyku-Uyanıklık Bozuklukları: Klinik Sunumlar, Komorbiditeler ve Yönetim Yaklaşımlarının Gözden Geçirilmesi

Öz

Uyku, optimal beyin fonksiyonu için gerekli olan temel bir nörobiyolojik süreçtir. Son yıllarda çocuklarda ve ergenlerde uyku-uyanıklık bozuklukları, fiziksel sağlık, bilişsel gelişim ve duygusal refah üzerindeki önemli etkileri nedeniyle giderek daha fazla ilgi görmeye başlamıştır. Uykusuzluk, obstrüktif uyku apnesi, huzursuz bacak sendromu ve narkolepsiyi de içeren bu bozukluklar farklı şekillerde ortaya çıkmakta ve hem tanı hem de tedavi açısından önemli zorluklar yaratmaktadır. Artan araştırma ilgisine rağmen, bu tür durumlar pediatrik popülasyonda yeterince tanınmamakta ve sıklıkla gözden kaçırılmaktadır. Etiyoloji multifaktöriyeldir ve genellikle davranışsal, çevresel, gelişimsel ve nörobiyolojik faktörleri içerir. Çocuklarda uyku bozuklukları, akademik performansta bozulmaya, duygudurum düzensizliğine, hiperaktiviteye ve aile stresine yol açabilir. Tanı, uyku öyküsü, ebeveyn raporları ve gerektiğinde aktigrafi veya polisomnografi içeren kapsamlı bir klinik değerlendirme gerektirir. Tedavi genellikle çok disiplinlidir, farmakolojik tedavi, farmakolojik olmayan yaklaşımların yetersiz kaldığı veya belirli altta yatan durumların varlığında, orta ila şiddetli vakalar için saklı tutulmaktadır. Bu derleme, çocuk ve ergenlerde uyku-uyanıklık bozuklukları ile ilişkili patofizyoloji, prevalans, sınıflandırma, tanısal zorluklar ve tedavi stratejileri hakkında kapsamlı bir genel bakış sunmaktadır. Amaç, erken tanıyı geliştirmek, normal varyasyonlar, problemli davranışlar ve teşhis edilebilir bozukluklar arasındaki ayrımları netleştirmek ve tedavi edilmeyen uyku bozukluklarının potansiyel uzun vadeli sonuçlarını vurgulamaktır.

Anahtar Kelimeler

• uyku bozuklukları
• uykusuzluk
• çocuk

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