Undiagnosed sleep disorders in children from a hospital in Puebla, Mexico

Authors

  • Emely González-Mendoza <p>Instituto Mexicano del Seguro Social, &Oacute;rgano de Operaci&oacute;n Administrativa Desconcentrada Puebla, Hospital General de Zona No. 20 &ldquo;La Margarita&rdquo;, Servicio de Pediatr&iacute;a. Puebla, Puebla, M&eacute;xico.</p> http://orcid.org/0000-0001-8492-8137
  • Arturo García-Galicia <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional &ldquo;Manuel &Aacute;vila Camacho&rdquo;, Hospital de Especialidades, Jefatura de Divisi&oacute;n de Investigaci&oacute;n en Salud. Puebla, Puebla, M&eacute;xico.</p> http://orcid.org/0000-0003-2535-4967
  • María Guadalupe González-de la Rosa <p>Instituto Mexicano del Seguro Social, &Oacute;rgano de Operaci&oacute;n Administrativa Desconcentrada Puebla, Hospital General Regional No. 36 &ldquo;San Alejandro&rdquo;, Servicio de Pediatr&iacute;a. Puebla de Zaragoza, M&eacute;xico.</p> http://orcid.org/0009-0004-4470-9588
  • Velia Hernández-Márquez <p>Instituto Mexicano del Seguro Social, &Oacute;rgano de Operaci&oacute;n Administrativa Desconcentrada Puebla, Hospital General de Zona No. 20 &ldquo;La Margarita&rdquo;, Servicio de Pediatr&iacute;a. Puebla, Puebla, M&eacute;xico.</p> http://orcid.org/0000-0001-6641-479X
  • Diana López-García <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional &ldquo;Gral. de Div. Manuel &Aacute;vila Camacho&rdquo;, Unidad M&eacute;dica de Alta Especialidad Hospital de Especialidades de Puebla, Jefatura de Divisi&oacute;n de Investigaci&oacute;n en Salud, Puebla de Zaragoza, M&eacute;xico</p> http://orcid.org/0009-0006-4880-1415
  • Álvaro José Montiel-Jarquín <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional &ldquo;Manuel &Aacute;vila Camacho&rdquo;, Hospital de Especialidades, Jefatura de Divisi&oacute;n de Investigaci&oacute;n en Salud. Puebla, Puebla, M&eacute;xico.</p> http://orcid.org/0000-0003-0531-9611

DOI:

https://doi.org/10.5281/zenodo.14200128

Keywords:

Sleep, REM Sleep Behavior Disorde, Circadian Rhythm

Abstract

Background: Sleep-related problems are rarely discussed during the healthy children consultation. Up to 50% of children experience a sleep problem and 4% have an adequate diagnosis. The American Academy of Pediatrics considers the prevalence of sleep disorders to be 20-30%. These disorders can be triggered by multiple etiologies: from organic to behavioral and environmental disorders.

Objective: To identify the frequency and clinical characteristics of sleep disorders in children in a second level hospital in Mexico.

Material and methods: Observational, and prospective study. An extended Pediatric Sleep Questionnaire (PSQ) was administered to ambulatory pediatric patients aged 2 to 17 years. Those with a psychiatric diagnosis or known sleep disorder were excluded. Those who did not complete 33% of affirmative answers of the PSQ were eliminated. They were interviewed to corroborate sleep disorders. Descriptive statistics were used in tables and graphs for frequencies.

Results: 334 patients were included, and 82 corroborated the diagnosis. The most frequent disorders were periodic leg movements (36 patients, 44%), somniloquy (24, 29%), nocturnal awakenings (20, 24%), bruxism (18, 22%), nightmares (16, 19%), sleepwalking (15, 18%) and enuresis (14, 17%).

Conclusions: In this study we found a high presence of unidentified sleep disorders in the pediatric outpatient clinic, even higher than reported in similar studies.

Downloads

Download data is not yet available.

Author Biography

  • Arturo García-Galicia, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional &ldquo;Manuel &Aacute;vila Camacho&rdquo;, Hospital de Especialidades, Jefatura de Divisi&oacute;n de Investigaci&oacute;n en Salud. Puebla, Puebla, M&eacute;xico.</p>

    Médico Pediatra

    Adiestramiento en Neurología Pediátrica

    Maestro en Ciencias Médicas e Investigación.

    Investigador Asociado B del Instituto Mexicano del Seguro Social

References

Leung TNH, Wong KL, Chan AKC, et al. Common Childhood Sleep Problems and Disorders. Curr. Pediatr. Rev. 2024;20:27-42. Disponible en: https://europepmc.org/article/med/36043722

Licis A. Sleep-Wake Disorders in Childhood. CONTINUUM Lifelong Learning in Neurology. 2020;26(4):1034-69. doi:10.1212/CON.0000000000000897

Ordway MR, Condon EM, Ibrahim BB, et al. A systematic review of the association between sleep health and stress biomarkers in children. Sleep Med Rev. 2021;59:101494. doi: 10.1016/j.smrv.2021.101494

Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40-3. doi: 10.1016/j.sleh.2014.12.010

American Academy of Sleep Medicine. The International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual. 3rd ed. Westchester: American Academy of Sleep Medicine; 2014. Disponible en: https://aasm.org/wp-content/uploads/2019/05/ICSD3-TOC.pdf

Krishna J, Kalra M, McQuillan ME. Sleep Disorders in Childhood. Pediatrics In Review. 2023;44(4):189-202. doi: 10.1542/pir.2022-005521

Llaguno NS, Camargo VHG, Tsunemi MH, et al. The sleep of school children. Revista Da Sociedade Brasileira de Enfermeiros Pediatras. 2023. doi: 10.31508/1676-379320230041i

Vila MT, Torres AM, Soto BB. Versión española del Pediatric Sleep Questionnaire. Un instrumento útil en la investigación de los trastornos del sueño en la infancia. Análisis de su fiabilidad. Anales de Pediatría. 2007;66(2):121-8. doi: 10.1157/13098928

Chervin RD, Hedger K, Dillon JE, et al. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Medicine. 2000;1(1):21-32. doi: 10.1016/s1389-9457(99)00009-x

Carmona-Belda M, Caner-Faig M, Rúbies-Olives J, et al. Trastornos de sueño en niños. Protoc Diagn Ter Pediatr. 2022;1:93-101. Disponible en: https://www.aeped.es/sites/default/files/documentos/10.pdf

Quinteros-Hinojosa M, Diéguez-Pérez M. Survey of the Potential Association of Childhood Sleep Disorders with Sleep Bruxism. Científica Dent. 2019;16:14-20. Disponible en: https://coem.org.es/pdf/publicaciones/cientifica/ESPEC_ING20/02ChildhoodSleepDisorders.pdf

Oropeza-Bahena G, López-Sánchez JD, Granados-Ramos DE. Hábitos de sueño, memoria y atención en niños escolares. Rev Mex Neuroci. 2019;20(1):42-9. doi: 10.24875/RMN.M19000021

Joseph V, Nagalli S. Periodic Limb Movement Disorder. 2023 Feb 14. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan–.

Gurbani N, Dye TJ, Dougherty K, et al. Improvement of Parasomnias After Treatment of Restless Leg Syndrome/ Periodic Limb Movement Disorder in Children. Journal Of Clinical Sleep Medicine. 2019;15(05):743-8. doi: 10.5664/jcsm.7766

Deshpande P, Salcedo B, Haq C. Common Sleep Disorders in Children. Am Fam Physician. 2022;105(2):168-76. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35166510/

Kalantari N, McDuff P, Pilon M, et al. A. Self-reported developmental changes in the frequency and characteristics of somnambulistic and sleep terror episodes in chronic sleepwalkers. Sleep Med. 2022;89:147-55. doi: 10.1016/j.sleep.2021.12.008

Trosman I, Ivanenko A. Classification and Epidemiology of Sleep Disorders in Children and Adolescents. Child And Adolescent Psychiatric Clinics Of North America. 2020;30(1):47-64. doi: 10.1016/j.chc.2020.08.002

American Psychiatric Association. Manual Diagnóstico y Estadístico de los Trastornos Mentales DSM-5. 5a. ed. Madrid: Editorial Médica Panamericana; 2014.

Bruni O, Del Rosso LM, Melegari MG, et al. The Parasomnias. Child Adolesc Psychiatr Clin N Am. 2021; 30: 131-42. doi: 10.1016/j.sleep.2021.12.008

Alshahrani SM, Albrahim RA, Abukhlaled JK, et al. Parasomnias and associated factors among university students: A Cross-sectional study in Saudi Arabia. Cureus. 2023;15:e48722. doi: 10.7759/cureus.48722

Okeson JP. Etiology of Functional Disturbances in the Masticatory System. Management of Temporomandibular Disorders and Occlusion. 8th ed. Elsevier; 2020. pp. 102-131.

Köstner-Uribe S, Brunet-Echavarría J, Tapia-Vargas A. Trastornos de sueño asociados a bruxismo de sueño en niños entre 3 y 6 años de edad atendidos en la Clínica Odontológica de la Universidad Mayor de Santiago, Chile. Avances en Odontoestomatología. 2019;35(2):83-91. doi: 10.4321/s0213-12852019000200005

Ravet F. Parasomnias in children. Belgian Journal of Paediatrics. 2021;23(3):205-10. Disponible en: https://belgjpaediatrics.com/index.php/bjp/article/view/131/252

Petit D, Pennestri MH, Paquet J, et al. Childhood Sleepwalking and Sleep Terrors: A Longitudinal Study of Prevalence and Familial Aggregation. JAMA Pediatr. 2015;169(7):653-8. doi: 10.1001/jamapediatrics.2015.127

Rodriguez CL, Foldvary-Schaefer N. Clinical neurophysiology of NREM parasomnias. Handb Clin Neurol. 2019;161:397-410. doi: 10.1016/B978-0-444-64142-7.00063-1

Broughton R.J. The Parasomnias and Sleep Related Movement Disorders—A Look Back at Six Decades of Scientific Studies. Clin Transl Neurosci. 2022;6(1):3. doi: 10.3390/ctn6010003

Delrosso LM, Mogavero MP, Ferri R. et al. Restless Sleep Disorder (RSD): a New Sleep Disorder in Children. A Rapid Review. Curr Neurol Neurosci Rep. 2022;22: 395-404. doi: 10.1007/s11910-022-01200-y

García-Galicia A, González-Martínez MA, Ramírez-Salas MA, et al. Trastornos del sueño en niños de 2 a 16 años sin alteraciones del neurodesarrollo. An Med ABC. 2023;68(4):271-9. doi: 10.24875/AMH.M23000045

Lin C H, Chen C H, Hong SY, et al. Polysomnography Is an Important Method for Diagnosing Pediatric Sleep Problems: Experience of One Children’s Hospital. Children. 2021;8:991. doi: 10.3390/children8110991

Bhattacharjee R, Benjafield A, Blase A, et al. The accuracy of a portable sleep monitor to diagnose obstructive sleep apnea in adolescent patients. J. Clin. Sleep Med. 2021;17:1379-87. doi: 10.5664/jcsm.9202

Spruyt K. Neurocognitive Effects of Sleep Disruption in Children and Adolescents. Child Adolesc Psychiatr Clin N Am. 2021;30(01):27-45. doi: 10.1016/j.chc.2020.08.003

Published

2024-12-17 — Updated on 2025-06-16

Issue

Section

Original Articles