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Re: 4 year old w/extreme anxiety

Posted by spot on September 06, 2002 at 10:26:12:

In Reply to: 4 year old w/extreme anxiety posted by tired mama on September 05, 2002 at 18:47:55:

well, the fact that this began suggests that it is possibly based in anxiety and fears. However, the consistant wakings, crying-while-not-awake (night terrors), and 'nightmares' also suggest to me a sleep disorder of some kind. Whether the effects of a sleep disorder have led to anxiety or visa versa can only be evaluated by a sleep specialist. Especially because I don't know that you can be sure it is only nightmares; there is such a thing as hypnogogic hallucinations which is essentially dreaming just as you are falling asleep. Technically, you are awake and know you are, but these 'dreams' are very vivid and typically 'nightmarish' or frightening. They are associated with rare disorders like Narcolepsy, but can be experienced by ANYONE who is sleep deprived.

My take on your post:
1. Get a second opinion ASAP. Mostly because your sleep concerns + habitual, disruptive snoring in a child should NOT be dismissed. Of all sleep problems, only a few actually disrupt the nature and quality of sleep causing daytime effects and other functioning problems. Of children, 80% of the time it Obstructive Sleep Apnea or Sleep Disordered Breathing. (Because of the relation to the recent move, consider allergies as being a trigger too). Many cities run a Children's Sleep Apnea clinic in recognition of the effects if left untreated. Children with sleep dyssomnias - disfunction of sleep - fuction in a state of sleep deprivation. Boys seem to show a greater effect on their behaviour. Symptoms that would suggest this state include: ADD/ADHD symptoms (inattentiveness, hyperactivity, etc), increased anxiety level especially related to sleep and bedtime, persistant need for naps beyond age 3-4, emotional lability (very sensitive/easy to tears/flooded with emotion), persistant night events such as night terrors, hallucinations, etc.

While this may not be the case with your son, it is important to have this checked for him, due to the snoring you describe. If it is the case, for example SDB, then appropriate treatment and support will benefit him FAR more than behavioural therapies.

Another alternative, in the meantime, is to inquire about a short course of benedryl or melatonin (1-2 weeks) to calm him and help him to both go to sleep and maintain sleep. While this wouldn't treat any serious sleep problem, it may help him to repeat a ritual of going to sleep/bedtime more relaxed and help him to cope with the related anxiety. Only a pediatrician/sleep specialist can advise if this is appropriate, but I'd go to a different doctor that didn't dismiss my concerns. Also keep a log of all event, foods, habits, mood, sleep, etc for a couple weeks - it can go a long way to establish patterns of behaviour or reinforce the need for medical intervention.

I've sort of moved over to the Narcolepsy forum, because that is what we believe my son will be diagnosed with, but it is extremely rare for a child. Search forum3 for similar posts (there's lots on SDB) and posts from Monica, whose children had that. And search online for more information.

good luck to you

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Archived Children's Sleep Forum4 viewing only. To post a new topic go to the Children's Sleep Forum Homepage.
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  • Sleep Deprivation due to Sleep Apnea and insufficient sleep are common and can present as insomnia, narcolepsy, or idiopathic hypersomnia. In infants and children sleep problems commonly present themselves as ADD or ADHD.


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