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Insomnia

Summary

Insomnia is a common sleep disorder that affects the ability to fall asleep, stay asleep, or get restful sleep. It can cause daytime fatigue, irritability, difficulty concentrating, and mood changes.

Children and adolescents may struggle with insomnia due to stress, anxiety, irregular sleep routines, or underlying medical conditions. Identifying the cause is essential for effective management. 

Diagnosis and When to Seek Help

Insomnia is typically diagnosed through a detailed discussion of sleep habits, routines, and any difficulties falling or staying asleep. A sleep diary or wearable sleep tracker may help assess sleep patterns.

Parents should consult a doctor if their child:

  • Struggles to fall asleep or wakes frequently at night for more than three nights a week.
  • Feels tired, irritable, or has difficulty focusing during the day.
  • Experiences anxiety, depression, or behavioral issues linked to poor sleep.
  • Has a known medical condition (e.g., asthma, ADHD) that might affect sleep. 

Management

Treatment depends on the cause and severity of insomnia. The first-line approach is improving sleep habits and using behavioral techniques:

  • Establish a Consistent Sleep Routine: Encourage a regular bedtime and wake-up time, even on weekends.
  • Limit Screen Time Before Bed: Blue light from screens can interfere with melatonin production, making it harder to fall asleep.
  • Create a Calm Sleep Environment: Ensure a quiet, dark, and comfortable room. Avoid caffeine and heavy meals before bedtime.
  • Encourage Relaxation Techniques: Reading, deep breathing, or guided meditation can help ease anxiety before bed.

For chronic or severe insomnia, cognitive behavioral therapy for insomnia (CBT-I) is the most effective treatment. In some cases, melatonin supplements or medication may be considered under medical supervision. 

Follow-Up and Monitoring

  • Keep a sleep diary to track progress.
  • Reassess sleep routines regularly and adjust as needed.
  • Seek professional help if insomnia persists despite lifestyle changes.

With proper management, most children and adolescents can overcome insomnia and develop healthy sleep habits. 

History and Exam

Key diagnostic factor

  • Presence of risk factors
  • Sleep partner complaints
  • Delayed sleep onset
  • Multiple or long awakenings

Other diagnostic factors

  • Impairment of functioning
  • Accidents
  • Decreased sleep time
  • Daytime napping

Risk factors

  • Female sex
  • Advanced age
  • Chronic medical conditions
  • Chronic pain

Diagnostic Investigations

1st investigations to order

  • Sleep diary
  • Pittsburgh sleep quality index (PSBI)
  • Insomnia severity index (ISI)
  • Standford sleepiness scale (SSS)

Investigations to consider

  • Polysomnography (PSG)
  • Actigraphy
  • Thyroid-stimulating hormone (TSH)
  • FBC and iron studies

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    Other Related Conditions

    Obstructive Sleep Apnoea

    Parasomnia (night terrors)

    Narcolepsy

    Delayed Sleep Phase

    Restless leg syndrome

    Behavioural sleep conditions

    Rhythmic movement disorder

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      Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

      In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

      Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

      Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections. 

      At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

      Fees generally cover:

      • Initial consultation and history gathering
      • Testing sessions where your child will complete various fun and interactive tasks
      • Liaison with schools or health professionals as needed
      • Comprehensive case analysis and report preparation
      • Feedback sessions with families and, where applicable, educators or other professionals

      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

      What’s the next step?

      Please phone reception for a discussion about your needs or email psychology@offspringhealth.com