Sleep Disorders In Children Research Articles

Behavioral and Sleep Disorders in Children and Adolescents following COVID-19 Disease: A Case-Control Study.

Recent studies show that neuropsychiatric disorders are the most frequent sequelae of COVID-19 in children. Our work aimed to evaluate the impact of SARS-CoV-2 infection on behavior and sleep in children and adolescents. We enrolled 107 patients aged 1.5-18 years who contracted COVID-19 between one year and one month prior to data collection, referred to the University of Campania Luigi Vanvitelli in Italy. We asked their parents to complete two standardized questionnaires for the assessment of behavior (Child Behavior CheckList (CBCL)) and sleep (Sleep Disturbance Scale for Children (SLDS)). We analysed and compared the results with a control group (pre-COVID-19 pandemic). In the COVID-19 group, the major results were found for sleep breathing disorders, sleep-wake transition disorders and disorders of initiating and maintaining sleep for the SDSC questionnaire, and internalizing scale, total scale and anxiety/depression for the CBCL questionnaire. The comparison of the CBCL results of the cases with the controls revealed statistically significant differences for the following items: internalizing scale, externalizing scale, somatic complaints, total score, thought problems [(p < 0.01)], anxious/depressed problems and withdrawn [(p < 0.001)]. COVID-19 has impacted children's and adolescents' mental health. Adolescents were the most affected patient group for internalizing problems, including anxiety and depression.

Relationship between disease activity index and sleep disorders in children with inflammatory bowel diseases.

The aim of the study was to assess the prevalence of sleep disturbance in pediatric IBD patients and evaluate the relationship between clinical features of IBD, disease activity, inflammatory markers and quality of sleep. A total of 99 patients who were followed-up with the diagnosis of IBD (44 Crohn's disease (CD), 55 Ulcerative colitis (UC)) between 2015-2020 and 80 healthy controls were enrolled in the study. The clinical and demographic characteristics, laboratory parameters and disease activities were obtained from medical reports retrospectively. Pittsburgh sleep quality index (PSQI) was administered to all participants. PSQI score was significantly higher in patient group than the control group (P < 0.001). The sleep time of patient group, especially patients with UC was later than the control group (P = 0.008). Sleep duration was longer in control group than the patient group (P < 0.001). A positive strong correlation was obtained in disease activity index (r = 0.886; P < 0.001) and abdominal pain (r = 0.781; P < 0.001) with PSQI scores of CD patients. Disease activity index, rectal bleeding, diarrhea and number of stool had statistically significant positive strong correlation with PSQI scores of UC patients (P < 0.001). Pediatric Crohn's disease activity index and Pediatric ulcerative colitis activity index were the only independent risk factors affecting sleep disturbances (80% sensitivity and 91.67% specificity, 93.1% sensitivity and %96.15 specificity, respectively). Conclusion: Increased disease activity has adverse effects on sleep quality. PSQI and PCDAI were strong tests for predicting sleep disorders in pediatric patients with IBD. What is Known: •Sleep disturbances are common complaint in inflammatory bowel disease (IBD), even in clinical remission. •Pittsburgh sleep quality index (PSQI) was used to evaluate the subjective sleep quality of patients. What is New: •PSQI and Pediatric Crohn Disease Activity index (PCDAI) were strong tests for predicting sleep disorders in pediatric patients with IBD. •PSQI and PCDAI scores correlated significantly with the severity of the sleep disturbances.

Порівняльний аналіз поширеності та структури порушень нічного сну в дітей з розладами нейророзвитку під час воєнного і мирного часу

The problem of sleep disorders in children is one of the most urgent in the practice of a pediatrician and has become especially acute during wartime, given the chronic effects of a significant number of stressors. The need to develop practical recommendations for improving the quality of sleep in children during wartime necessitated a comparative study of the frequency and structure of sleep disorders in children during wartime and peacetime. Purpose - to determine the frequency and structure of nighttime sleep disorders in children with neurodevelopmental disorders and healthy children in wartime and peacetime. Materials and methods. An online survey of parents of 529 children aged 1-7 years (26.8% of healthy children and 73.2% of children with neurodevelopmental disorders) was conducted in 2022 during wartime. A survey of parents of 1352 children under the age of 7 was conducted in 2002 in peacetime (as part of the Family and Children of Ukraine project), with a case-control comparison. Results. The overall prevalence of nighttime sleep disorders among all children in wartime was 93.6% in healthy children and 94.8% in children with neurodevelopmental disorders. Difficulties falling asleep were noted in 51.4% of healthy children and 56.8% of children with neurodevelopmental disorders; frequent nighttime awakenings - in 35.9% and 39.0% of children, respectively. Sleep disorders: snoring - in 16.2% and 18.9% of children; apnoea - in 9.9% and 14.9% of children. Parasomnias: night terrors - in 19.7% and 18.6% of children; sleepwalking - in 2.8% and 4.4% of children. Comparison of the frequency of nighttime sleep disorders in healthy children in peacetime (2002) and wartime (2022): half of healthy children had difficulty going to bed (51.4% vs. 47.2%); early waking (49.8% vs. 12.7%); frequent waking at night (47.3% vs. 35.9%); snoring (33.6% vs. 16.2%); increased daytime sleepiness - 5 times more often in 2002 (30.3% vs. 6.3%); every fourth child has nightmares (25.6% vs. 26.8%); prolonged falling asleep (23.5% vs. 51.4% in 2022). Conclusions. The overall prevalence of nighttime sleep disorders among all children in wartime was 94.5%. In children with neurodevelopmental disorders, early awakenings (29.2% vs. 12.7%), sleep apnoea (14.9% vs. 9.9%), increased daytime sleepiness (14.9% vs. 6.3%), and catalepsy (8.3% vs. 4.2%) were more common compared to healthy children. In wartime, the incidence of early wake-ups (49.8% vs. 12.7% in 2022), snoring (33.6% vs. 16.2% in 2022), and increased daytime sleepiness (30.3% vs. 6.3% in 2022) decreased among healthy children, but the incidence of falling asleep problems increased by 2 times (51.4% vs. 23.5% in the 2002). Children with neurodevelopmental disorders are a more vulnerable group that reacts negatively to the stressful conditions of martial law by increasing the frequency of nighttime sleep disorders. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.

Restless sleep disorder in children with epileptic and non-epileptic nocturnal attacks.

Restless sleep disorder (RSD) is an important sleep disorder characterised by the presence of frequent large muscle movements (LMM) during sleep, which may be comorbid to other conditions/diseases. In this study, we investigated the frequency and the characteristics of RSD among children who were evaluated by polysomnography (PSG) due to epileptic and non-epileptic nocturnal attacks. We analysed consecutively children younger than 18 years who were referred for PSG recording due to abnormal motor activities during sleep. The diagnosis of nocturnal events as sleep-related epilepsy was made based on the current consensus. Patients who were referred with suspicion of sleep-related epilepsy, but who were diagnosed to have non-epileptic nocturnal events and children with a definitive diagnosis of NREM sleep parasomnias were also enrolled. Sixty-two children were analysed in this study (17 children with sleep-related epilepsy, 20 children with NREM parasomnia, and 25 children with nocturnal events not otherwise classified [neNOS]). The mean number of LMM, LMM index, LMM-associated with arousal and its index were all significantly higher in children with sleep-related epilepsy. Restless sleep disorder was present in 47.1% of patients with epilepsy, 25% of patients with parasomnia, and in 20% of patients with neNOS. The mean A3 duration and the A3 index were higher in children with sleep-related epilepsy and RSD compared with those with parasomnia and restless sleep disorder. Patients with RSD had lower ferritin levels than those without RSD in all subgroups. Our study demonstrates a high prevalence of restless sleep disorder in children with sleep-related epilepsy, associated with an increased cyclic alternating pattern.

The effect of intensive rehabilitation treatment on sleep disorder in children with motor delays

BackgroundAlthough the importance of sleep problems has been increasingly emphasized due to the effects on children's development and children's and families' daytime behaviors, physical health, and quality of life, they have been overlooked in clinical practice. However, there have been few studies on the effects of rehabilitation on sleep problems. Therefore, in this study, we investigated the effects of an intensive rehabilitation program on sleep problems in children with developmental delays (DD).MethodsWe included 36 children with DD (30 outpatients, 6 inpatients) and their caregivers who completed all items on the Sleep Disturbance Scale for Children. Of the children with DD, 19 (59.3%) had cerebral palsy (CP) and 13 (40.7%) had DD of non-CP origins, of which 6 (18.8%) had prematurity, 4 (12.5%) had genetic causes, and 3 (9.4%) had an unknown origin. Changes in sleep problems after the intensive rehabilitation program were evaluated using a paired or unpaired t-test, depending on the distribution of the continuous variables.ResultsAfter the intensive rehabilitation program, in 36 children with DD, there was a significant improvement in the difficulty in initiating and maintaining sleep (DIMS) sub-score (p < 0.05). However, there was no significant improvement in the total score or other sub-scores, such as those for sleep breathing disorders (SBD), disorders of arousal (DA), sleep–wake transition disorders (SWTD), disorders of excessive somnolence (DOES), and sleep hyperhidrosis (SH). In the subgroup analysis according to the cause of DD, children with CP had a significant improvement in DIMS and DOES sub-scores (p < 0.05).ConclusionThe intensive rehabilitation program, consisting of more than two sessions per day, effectively alleviated sleep problems in children with DD, especially in those with CP. Among the sleep problems, the intensive rehabilitative program was most effective at improving the DIMS. However, further prospective studies with a larger number of patients with DD and a more standardized protocol are necessary to generalize this effect.

Restless Legs Syndrome and Restless Sleep Disorder in Children.

Restless legs syndrome (RLS) affects 2% of children presenting with symptoms of insomnia, restless sleep, decreased quality of life, and effects on cognition and behavior. The International RLS Study Group and the American Academy of Sleep Medicine have published guidelines for the diagnosis and treatment of RLS in children. Restless sleep disorder has been recently identified in children and presents with frequent movements during sleep and daytime symptoms with polysomnography findings of at least 5 large muscle movements at night. Treatment options for both disorders include iron supplementation, either oral or intravenous with improvement in nighttime and daytime symptoms.

MtCLSS: Multi-Task Contrastive Learning for Semi-Supervised Pediatric Sleep Staging.

The continuing increase in the incidence and recognition of children's sleep disorders has heightened the demand for automatic pediatric sleep staging. Supervised sleep stage recognition algorithms, however, are often faced with challenges such as limited availability of pediatric sleep physicians and data heterogeneity. Drawing upon two quickly advancing fields, i.e., semi-supervised learning and self-supervised contrastive learning, we propose a multi-task contrastive learning strategy for semi-supervised pediatric sleep stage recognition, abbreviated as MtCLSS. Specifically, signal-adapted transformations are applied to electroencephalogram (EEG) recordings of the full night polysomnogram, which facilitates the network to improve its representation ability through identifying the transformations. We also introduce an extension of contrastive loss function, thus adapting contrastive learning to the semi-supervised setting. In this way, the proposed framework learns not only task-specific features from a small amount of supervised data, but also extracts general features from signal transformations, improving the model robustness. MtCLSS is evaluated on a real-world pediatric sleep dataset with promising performance (0.80 accuracy, 0.78 F1-score and 0.74 kappa). We also examine its generality on a well-known public dataset. The experimental results demonstrate the effectiveness of the MtCLSS framework for EEG based automatic pediatric sleep staging in very limited labeled data scenarios.

Early screening and treatment methods of pediatric sleep-disordered breathing(SDB) in dental office

Pediatric sleep-disordered breathing(SDB) is a common sleep disorder in children caused by obstruction of upper airway during sleep. It is often unrecognized early in life and causes various complications, including abnormal craniofacial growth and oral muscle dysfunctions. Dentist can play a significant role in managing SDB by early screening SDB risk factors and timely referring for diagnosis. SDB risk factors can be easily screened in dental office through medical history, sleep history, physical factors, sleep questionnaire, and cephalometric x-ray. In case of abnormal craniofacial development, rapid maxillary expansion, oral appliances, and myofunctional therapy can be used to reduce SDB symptoms and restore normal craniofacial development and muscular tones. Understanding continuous interaction between oral-facial muscle tone, maxillary-mandibular growth and development of SDB is important in managing pediatric SDB. The ultimate goal of pediatric SDB treatment is to change mouth breathing to nasal breathing, and a multidisciplinary approach in medicine and dentistry is necessary.

Sleep pattern and sleep disorders in school-going children aged 6-12 years and its association with screen time: a cross-sectional study from South Kerala during the COVID-19 pandemic

Background: Poor sleep quality in school children can negatively impact their neurocognitive abilities and academic achievement. Increased screen time was shown to interfere with children’s sleep habits and disrupts their sleep pattern. This study aimed to understand the sleep patterns and sleep disorders in school children and the influence of screen time on sleep in children during the COVID-19 pandemic. Methods: This cross-sectional observational school-based study was done on 443 children aged 6-12 years. Data was collected through parent filled online questionnaire having a proforma and child sleep habit questionnaire (CSHQ), a validated questionnaire to assess sleep disorders in children Results: Out of 443 children studied, the average sleep duration of the study population was 9:06 hours ±42:18 min and, 34.3% of the children slept less than 9 hours per day. The prevalence of sleep disorders was found to be 76.52%. Significant screen time after 8 PM was observed in 65.9% and 62.2 % of children had a total screen time of more than 2 hours. Increased screen time after 8 PM, delayed bedtime and wake-up time in children and also contributed to sleep disorders. Bedtime resistance and daytime sleepiness were more commonly observed in children with increased screen time. Conclusions: Sleep disorders in children are more predominant than sleep deprivation. Increased screen time before bed was found to alter sleep patterns in children and increases bedtime resistance, daytime sleepiness, and sleep disorders.

Prevalence and pattern of sleep disorders in childhood

Background: Sleep disorders are very common in the population of children, with prevalence rates ranging from 25-40%, and they are often persistent. The aetiology of sleep problems is very complicated and depend on many varied factors. Psychological factors concerning family life and general state of health have a significant impact on children. Methods: A hospital based descriptive study was carried out among 1024 children visiting the paediatric outpatient departments of Madras medical college, Chennai and Al-Ameen medical college and hospital, Vijayapura over a period of 1 year from March 2022 to March 2023. An appropriate questionnaire was formulated that had to be filled by parents and those children with sleep problems interviewed and assessed using appropriate statistical methods. Results: Out of 1164 questionnaires, 1024 (88.97%) were filled completely and returned. The 497 (48.54%) boys and 527 (51.46%) girls were included in this study. Of the 1024 children, 621 (60.64%) had no sleep related problems. The 403 (39.36%) had one or more sleep related problem, which included 211 (52.36%) boys and 192 (47.64%) girls. Male children were more commonly affected with sleep disorders and there is statistically significant difference at 5% level among males and females in having sleep disorders (p&lt;0.05). Conclusions: Most of the children studied had only 1 of sleep disorders of which males outnumbered females. Sleep disorders were predominantly found in the age group of 7-10 years among which most common sleep related disorder was nocturnal enuresis. The study also showed that sleep walking is usually associated with another sleep disorder.

N°212 – Restless sleep in pediatric population: A new sleep disorder in children

N°212 – Restless sleep in pediatric population: A new sleep disorder in children

Chronotype and sleep disorders in children with epilepsy.

The circadian rhythm can affect the frequency and resistance of epileptic seizures. In this cross-sectional study, we examined the impact of chronobiology and sleep disturbances on children with epilepsy. One hundred and twenty-five children and adolescents (55 patients and 70 controls) were included in the study. All participants were asked to complete the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), Sleep Disturbances Scale for Children (SDSC), Childhood Chronotype Questionnaire (CCQ). According to the CCQ results, controls had longer sleep duration (median 595 vs. 570), lower morningness-eveningness scores (median: 28 vs. 30), and higher rates of the morningness (12.9% vs. 1.8%) and intermediate (74.3% vs. 60%) chronotypes. The children and adolescents with epilepsy scored significantly higher in the Sleep breathing disorders (p = .001), Disorders of arousal nightmares (p = .044), Sleep-wake transition disorders (p = .037), Disorders of excessive somnolence (p = .001), and total SDCS (p = .046) scores. According to the RCADS-CV results, the children with epilepsy scored significantly higher in all subscales in comparison to controls (p < .05). Children and adolescents with epilepsy had shorter sleep duration were more likely to be evening-oriented and had more significant sleep disturbance symptoms compared to controls.

What if children affected by sleep disorder and aggression could regulate their emotions?

ABSTRACT The present study examined whether emotion regulation plays a mediating role in the relationship between aggressive behavior and sleep disorders in young children. Data were collected during pandemic via the Sleep Disturbance Scale for Children, the Aggression Tendency Scale and the Emotion Regulation Check List from 662 mothers with children aged 36–72 months. The data were tested with Pearson product-moment correlation coefficient and structural equation model analyses after the normality test. It was seen that there was a positive relationship between the aggressive behaviors of children and their sleep disorders. However, it was understood that both aggressive behaviors and sleep disorders of children had a negative and significant relationship with their emotion regulation skills. While children’s sleep disorders have an important predictive power in the emergence of aggressive behaviors, the mediating role of emotion regulation skills has eliminated the significance in this predictive power.

The Italian contribution to pediatric sleep medicine: A scientometric analysis

We conducted the first scientometric analysis to quantitatively assess the scientific contribution of researchers from Italian institutions in the field of pediatric sleep medicine. We searched Science Citation Index Expanded from Web of Science (WOS) Science Citation up to November 3rd, 2022. Bibliometrix R packages (3.1.4) and CiteSpace (6.0.R2) were used to extract and analyze co-citation reference networks, co-occurring keyword networks, co-authorship network, co-cited institutions, and co-cited journals. We retrieved a total of 2499 documents, published between 1975 and 2022. Co-cited reference networks showed four main clusters of highly cited topics: evidence synthesis of publications on sleep disorders in children and adolescents, sleep and neurological disorders, non-pharmacological treatments of sleep disturbances, and sleep and Covid-19 in youth. Co-occurring keyword networks showed an earlier focus on the neurophysiology of sleep/neurological disorders, followed by a trend on the association of sleep disturbances to neurodevelopmental disorders and behavioral aspects. Co-authorship network showed that Italian researchers in the field of pediatric sleep medicine tend to be highly collaborative internationally. Overall, Italian researchers have provided a crucial contribution to pediatric sleep medicine across a number of specific topics, spanning from neurophysiology to treatment, and from neurological to behavioral/psychopathological aspects.

Genetic and neural mechanisms of sleep disorders in children with autism spectrum disorder: a review.

The incidence of sleep disorders in children with autism spectrum disorder (ASD) is very high. Sleep disorders can exacerbate the development of ASD and impose a heavy burden on families and society. The pathological mechanism of sleep disorders in autism is complex, but gene mutations and neural abnormalities may be involved. In this review, we examined literature addressing the genetic and neural mechanisms of sleep disorders in children with ASD. The databases PubMed and Scopus were searched for eligible studies published between 2013 and 2023. Prolonged awakenings of children with ASD may be caused by the following processes. Mutations in the MECP2, VGAT and SLC6A1 genes can decrease GABA inhibition on neurons in the locus coeruleus, leading to hyperactivity of noradrenergic neurons and prolonged awakenings in children with ASD. Mutations in the HRH1, HRH2, and HRH3 genes heighten the expression of histamine receptors in the posterior hypothalamus, potentially intensifying histamine's ability to promote arousal. Mutations in the KCNQ3 and PCDH10 genes cause atypical modulation of amygdala impact on orexinergic neurons, potentially causing hyperexcitability of the hypothalamic orexin system. Mutations in the AHI1, ARHGEF10, UBE3A, and SLC6A3 genes affect dopamine synthesis, catabolism, and reuptake processes, which can elevate dopamine concentrations in the midbrain. Secondly, non-rapid eye movement sleep disorder is closely related to the lack of butyric acid, iron deficiency and dysfunction of the thalamic reticular nucleus induced by PTCHD1 gene alterations. Thirdly, mutations in the HTR2A, SLC6A4, MAOA, MAOB, TPH2, VMATs, SHANK3, and CADPS2 genes induce structural and functional abnormalities of the dorsal raphe nucleus (DRN) and amygdala, which may disturb REM sleep. In addition, the decrease in melatonin levels caused by ASMT, MTNR1A, and MTNR1B gene mutations, along with functional abnormalities of basal forebrain cholinergic neurons, may lead to abnormal sleep-wake rhythm transitions. Our review revealed that the functional and structural abnormalities of sleep-wake related neural circuits induced by gene mutations are strongly correlated with sleep disorders in children with ASD. Exploring the neural mechanisms of sleep disorders and the underlying genetic pathology in children with ASD is significant for further studies of therapy.

Assessment of Sleep Disorders in Children with Transfusion-Dependent Hemoglobinopathies

Purpose: The aim of this study was to compare sleep problems between children with transfusion-dependent hemoglobinopathies and healthy controls.Methods: This study was a case-control survey of children with transfusion-dependent hemoglobinopathies. The sample consisted of 175 children in the patient group and 175 healthy children in the control group, with an age range of 8 to 18 years. Subjects were recruited from the Children’s Hospital of Mansoura University between February and July 2022. Children with transfusion-dependent hemoglobinopathies received consultations at the Department of Pediatric Hematology. The Children’s Sleep Habits Questionnaire (CSHQ) was used to evaluate sleep problems in both groups.Results: The mean age of the patient group was 11.22±2.39 years, and 52.57% (n=92) were girls. The control group had a mean age of 11.30±2.16 years, and 50.86% (n=89) were boys. The overall score (&lt;i&gt;P&lt;/i&gt;=0.007) and the night waking (&lt;i&gt;P&lt;/i&gt;=0.013), sleep duration (&lt;i&gt;P&lt;/i&gt;=0.009), and sleep-disordered breathing (&lt;i&gt;P&lt;/i&gt;=0.029) subscores were all substantially and statistically significantly higher in children with transfusion-dependent hemoglobinopathies than in healthy children.Conclusion: As children with transfusion-dependent hemoglobinopathies have more sleep problems than healthy children, more detailed studies are needed.

Sleep Disorders in Childhood

Sleep Disorders in Childhood

Common sleep disorders in children: assessment and treatment.

Pediatric sleep disorders are a common, mainly among children with pre-existing disabilities, neurological conditions, and neurodevelopmental disorders. The consequences are variable, and sleep disorders may be associated with deficits in neurocognitive performance and growth failure. Rising awareness about sleep disorders among pediatricians will improve the early diagnosis and management of these disorders. This review describes normal sleep patterns in infants and children and provide a recent update on common sleep disorders that improve the diagnosis and treatment of children with sleep disorders.

Sleep Disturbances in Children and Adolescents with Autism Spectrum Disorder: An Overview for Clinicians

Background: Sleep disorders in autism spectrum disorders (ASD/SD) are distinct, broad, and highly variable clinical entities that ubiquitously affect core symptomatology, development of comorbid disorders, and overall quality of life for affected children and families. High genetic predisposition and the presence of co-occurring disorders present significant challenges in assessment and appropriate interventions. Objective: The study aimed to review the best available evidence and address the clinical gaps in the knowledge about sleep disorders in children and adolescents with autism spectrum disorders. Methods: The review provides a comprehensive literature search of 1622 articles and summarizes 110 selected for empirical evidence to methodically consider critical aspects of sleep disorders in ASD for informing clinicians of useful information. Results: Clinicians have insufficient guidance and support to effectively manage sleep disruptions in ASD youth in practice. Prevalence of sleep disruption in ASD, close to 80%, is characterized by unique subtypes, including but not limited to obstructive sleep apnea, circadian rhythm disorders, and sleep-related movement disorders. Greater awareness of sleep disruption, its neurodevelopmental basis, scope, and impact allows for improved treatment and prevention efforts of these conditions, and is critical for clinical practice and future research. The bidirectional nature of disruptive sleep and ASD is considered a major area requiring further clarification. Conclusion: Clinician-friendly screening tools are needed for everyday office practice to identify ASD/SD conditions and interventions, and mitigate harmful effects. Psychoeducational and cognitive-behavioral approaches for improving and supporting healthy sleep hygiene, considered the first line of treatment, are detailed. The weak database for the use of psychopharmacologic agents is summarized, and the strength of prescribing prolonged-release melatonin for optimal results is described. The promise of other medications is discussed.

Consensus recommendations on sleeping problems in Phelan-McDermid syndrome

Early onset sleep problems and disorders are very common in individuals with Phelan-McDermid Syndrome (PMS) with rates of up to 90%. These sleep problems and disorders cannot be taken lightly. Not only do they have a major impact on the health, behaviour, functioning and learning opportunities of affected individuals, they can also have detrimental effects on the well-being and resilience of parents and caregivers, ultimately affecting the physical health, mental health and well-being of the whole social system.In this review we aim to understand the types and frequencies of sleeping problems in PMS as the basis for recommendations on their management and treatment and to provide general guidelines for clinicians and practitioners. We conducted an in-depth literature search, summarised findings, and participated in a series of consensus meetings with other consortium members - experts on PMS and stakeholders - to agree on guidelines and recommendations. In parallel, a world-wide survey was created and distributed amongst parents to include their perspective.Our literature search found only four articles specifically focused on sleeping problems in PMS, although some other articles mentioned prevalence and associated factors. Country-specific prevalence rates ranged between 24% and 46%, whereas our parental survey reported 59%. The main problems reported involved difficulty falling asleep and numerous night awakenings, with being restless in sleep, night-time incontinence, and tooth grinding also commonly reported. Only a small number of individuals had undergone a sleep study monitored by a specialist. Bedtime resistance normally decreases with age, but sleep-onset delay, sleep anxiety, parasomnias, problems falling and remaining asleep remain throughout lifespan, with total sleep time improving during adulthood. However, this improvement was also accompanied by a substantial increase in parasomnias. Ultimately, an increase in sleep disorders in children correlates with increased sleep disorders and daytime sleepiness in parents/caregivers.No study to date has focused on the underlying causes of sleeping problems in PMS, but comorbid mental health conditions, somatic causes, or (poly)pharmacy have been proposed as triggers for sleeping disturbances. Currently there is no PMS-specific treatment for sleeping problems, and current recommendations are mostly based on individuals with intellectual disability and/or neurodevelopmental conditions.