Websites on childhood sleep disorders

Dr Keith Barnard recommends websites relating to this week's Clinical Review.

Parasomnias
The first thing that strikes you on visiting this website is the startling purple colour - more likely, I would have thought, to keep you awake than induce sleep.

This website relates specifically to the parasomnias. These are described as a group of acute, undesirable, episodic physical phenomena that usually occur during sleep and are of three different types.

One is characterised by occurring during slow-wave sleep. This erudite scientific approach is then enlightened by the statement that parasomnias can also be described as 'strange things that go bump in the night'.

Most parasomnias are precipitated or perpetuated by stress. Sleepwalking and night terrors are part of the spectrum of slow-wave sleep disorders. In a contrary move to the demystifying of medical terminology, it appears that the current vogue in night terrors is to call them 'pavor nocturnus'. To some this might sound even more terrifying than the common name.

Why go there: interesting stuff.
Downside: the ghastly purple.
Information from: Canadian Sleep Society.
Address: www.css.to/sleep/disorders/parasomnia.htm

Sleep questionnaires
Pity about the name of this site, Kidzzzsleep, which sounds as if it is a remedy peddled in the small ads of a tabloid. It actually contains helpful support for doctors and patients, prepared by Dr Judith Owens.

The website is a bit of a dog's breakfast, but the reason to visit is to see the various sleep questionnaires that are freely available for download, together with instructions on how to use them.

You have to go to 'Research' then 'Instruments' to find them.

Why go there: questionnaires are free.
Downside: awful design.
Information from: Kidzzzsleep.
Address: www.kidzzzsleep.org

Night Terrors
Night terrors (I'm not going to use the fancy name) have been mentioned before, and as they cause much distress it is worth looking into them further.

This article in eMedicine is unusually succinct and contains all you need to know. It also says that medication is rarely indicated and usually provides no long-term help to patients. It then proceeds to produce a table to tell you how to do it. Only one drug is involved: imipramine.

Why go there: more detail on a difficult problem.
Downside: none.
Information from: eMedicine.
Address: www.emedicine.com/ped/topic1608.htm

Patient Information
I had to go to the US to find a decent patient information leaflet and even this one is not great because it is too wordy. The average patient would probably fall asleep reading it. At least they then won't be able to hear their child complaining about being awake.

Why go there: covers everything.
Downside: takes too long about it.
Information from: University of Michigan.
Address: www.med.umich.edu/1libr/yourchild/sleep.htm

Dr Barnard is a former GP in Fareham, Hampshire

Website of the week
Sleep disorders in children have become a more scientific subject in the last 30 years. Now it is a speciality in its own right with sleep laboratories and other gadgetry. This site offers the best overview of the subject area and is presented as an easily readable PDF with helpful graphs. One interesting graph shows the amount of sleep normally required from birth to age 18. A list of questions that are helpful in determining the nature of the problem, and some good common-sense advice as well as bed time resistance is discussed.

Why go there: a good overview.
Downside: some treatment options are not covered.
Information from: American Academy of Family Physicians.
Address: www.aafp.org/afp/20010115/277.pdf

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