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Children
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Current Advances in Paediatric Sleep Medicine
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Current Advances in Paediatric Sleep Medicine

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Pulmonary and Sleep Medicine".

Deadline for manuscript submissions: 30 August 2025 | Viewed by 10906

Special Issue Editors

Prof. Dr. Ekkehart Paditz

E-Mail Website
Guest Editor
Center for Applied Prevention (Zentrum für Angewandte Prävention), Dresden, Germany
Interests: paediatric sleep medicine; differential diagnostics; melatonin; history of medicine
Prof. Dr. Silke Anna Theresa Weber

E-Mail Website
Guest Editor
1. Health Technology Assessment Unit, Hospital das Clínicas da Faculdade de Medicina de Botucatu, Botucatu, Brazil
2. Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Medical School (FMB) of São Paulo State University, Botucatu, Brazil
Interests: sleep apnea

Special Issue Information

Dear Colleagues,

Children with suspected sleep disorders should be referred to a qualified paediatrician, as they perform an important gatekeeper function. We invite you to keep raising awareness of this issue so that the right course can be initiated at an appropriately early time. We welcome current reviews, studies and case descriptions from the fields of child and adolescent psychiatry, paediatric pneumology, otorhinolaryngology, orthodontics, neonatology, genetics, clinical pharmacology, epidemiology, health economics, the history of medicine and other specialist areas.

Prof. Dr. Ekkehart Paditz
Prof. Dr. Silke Anna Theresa Weber
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • paediatric sleep medicine
  • infant sleep
  • adenoidectomy
  • tonsillotomy
  • orthodontic appliances
  • non-hospital ventilation
  • cognitive behavioural therapy
  • melatonin
  • epistemology
  • differential diagnostics

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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13 pages, 944 KiB  
Article
Characteristics of Children and Adolescents with Insomnia and Comorbid Nightmares—A Secondary Analysis of Clinical Samples with an Age Range from 0 to 18 Years
by Angelika A. Schlarb, Isabel Brandhorst, Barbara Schwerdtle, Maria Zschoche, Andrea Kübler and Karolin Teichmüller
Children 2025, 12(2), 129; https://doi.org/10.3390/children12020129 - 24 Jan 2025
Viewed by 1180
Abstract
Background: Insomnia disorder in childhood and adolescence has severe implications on overall well-being and development. Age-specific treatments for insomnia disorder with cognitive behavioral interventions (CBT-I) are available and effective. Nightmare disorder also has severe consequences in children and adolescents. However, less is known [...] Read more.
Background: Insomnia disorder in childhood and adolescence has severe implications on overall well-being and development. Age-specific treatments for insomnia disorder with cognitive behavioral interventions (CBT-I) are available and effective. Nightmare disorder also has severe consequences in children and adolescents. However, less is known about children with insomnia (I) and comorbid nightmare disorder (I + N). Methods: In this retrospective study, data from 499 children and adolescents with insomnia disorder were included. The prevalence of a comorbid nightmare disorder (I + N) was calculated within three subsamples (toddlers and preschoolers 0.5–4 years, elementary school children 5–10 years, and adolescents 11–18 years). Differences between children with insomnia (I) and those with additional nightmare disorder (I + N) regarding age, sex, family background, sleep quality (SOL, WASO, TST, and SE) based on sleep logs, behavior sleep problems (based on interviews), and behavioral problems (CBCL and YSR) were calculated within each age group. Results: The overall prevalence of additional nightmares or nightmare disorder in children or adolescents with insomnia was 15–24%. We found various clinically relevant differences between I and I + N for each age group; for example, there were more sleep onset association problems in I + N elementary school children, prolonged SOL of 56 min, and about 50 min less TST and SE of 76.8% in I + N adolescents. However, most statistical tests were not significant. Especially sleep parameters but also emotional burden were more pronounced in I + N groups than in the I groups. Toddlers and preschoolers with I + N were significantly older than those with only I, had another family situation (e.g., divorced parents) significantly more often, and I + N adolescents were statistically more often anxious and depressed. Discussion: Descriptively, I + N children and adolescents seemed to be more impaired than those with insomnia only. However, a comorbid nightmare disorder cannot be recognized by insomnia-specific sleep parameters. Therefore, diagnostic procedures for insomnia should always screen for nightmares but also other sleep disorders. If necessary, CBT-I should be supplemented with nightmare-specific interventions. Full article
(This article belongs to the Special Issue Current Advances in Paediatric Sleep Medicine)
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Review

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17 pages, 360 KiB  
Review
Influence of Sensory Needs on Sleep and Neurodevelopmental Care in At-Risk Neonates
by Axel Hübler
Children 2025, 12(6), 781; https://doi.org/10.3390/children12060781 - 16 Jun 2025
Viewed by 722
Abstract
Objective: The development of a normal sleep–wake rhythm in the first weeks of life depends on the physiological sensory needs of the newborn as well as the environment surrounding them. This includes, for example, avoiding pain, exposure to bright light at night and [...] Read more.
Objective: The development of a normal sleep–wake rhythm in the first weeks of life depends on the physiological sensory needs of the newborn as well as the environment surrounding them. This includes, for example, avoiding pain, exposure to bright light at night and high noise levels. In high-risk newborns, this process can be influenced by immaturity of the central and peripheral nervous systems, therapeutic strategies and the work organization of an intensive care unit. Methods: This study used a narrative review to examine the literature on the interrelationship of sensory modalities on sleep–wake behavior in the context of neonatal intensive care. The current Cochrane reviews on cycled lighting’s effect on premature infants’ circadian rhythm development and noise or sound management in the neonatal intensive care unit, as well as the World Health Organization (WHO) global position paper on kangaroo mother care, were included. Results: An extensive body of literature relates to fetal and neonatal development of the five sensory modalities: touch, taste, smell, hearing and sight. In contrast, there is a lack of evidence regarding the choice of optimal lighting and suitable measures for noise reduction. Since 2023, the WHO has recommended that, from the moment of birth, every “small and sick” newborn should remain in skin-to-skin contact (SSC) with their mother. Developmental support pursues a multimodal approach with the goal of fostering early parent–child bonding, including the child’s needs and environmental conditions. Discussion: The implementation of early SSC and attention to the sleep–wake cycle require systemic changes in both the obstetric and neonatal settings to ensure seamless perinatal management and subsequent neonatal intensive care. Since there is a lack of evidence on the optimal sensory environment, well-designed, well-conducted and fully reported randomized controlled trials are needed that analyze short-term effects and long-term neurodevelopmental outcomes. Full article
(This article belongs to the Special Issue Current Advances in Paediatric Sleep Medicine)
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Other

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14 pages, 2086 KiB  
Protocol
Orofacial Myofunctional Therapy: Investigating a Novel Therapeutic Approach for Pediatric Obstructive Sleep Apnea in Children with and Without Down Syndrome—A Study Protocol
by Jolien Verbeke, Iris Meerschman, Karlien Dhondt, Els De Leenheer, Julie Willekens, Kristiane Van Lierde and Sofie Claeys
Children 2025, 12(6), 737; https://doi.org/10.3390/children12060737 - 6 Jun 2025
Viewed by 1857
Abstract
Background/Objectives: Pediatric obstructive sleep apnea (OSA) is a prevalent medical condition, affecting 1–5% of non-syndromic children and 30–90% of children with Down syndrome. Given the severity of the condition and the associated health risks, early and effective treatment is crucial. However, current treatment [...] Read more.
Background/Objectives: Pediatric obstructive sleep apnea (OSA) is a prevalent medical condition, affecting 1–5% of non-syndromic children and 30–90% of children with Down syndrome. Given the severity of the condition and the associated health risks, early and effective treatment is crucial. However, current treatment modalities are often invasive or suffer from poor patient adherence. Additionally, adenotonsillectomy, the first-line treatment in pediatric OSA, seems not to be effective in every child, leaving children with residual OSA postoperatively. These challenges are particularly pronounced in high-risk populations, such as children with Down syndrome, highlighting the need for alternative therapeutic strategies. Therefore, a protocol is presented to evaluate the effectiveness of orofacial myofunctional therapy (OMT) as a treatment for OSA in two pediatric populations: (1) Non-syndromic children aged 4–18 years: 10 weeks of OMT. (2) Children with Down syndrome aged 4–18 years: 20 weeks of OMT. Effects of the OMT program will be evaluated on: sleep parameters (e.g., obstructive Apnea–Hyponea Index (oAHI), snoring frequency); orofacial functions (e.g., breathing pattern, tongue position at rest); quality of life outcomes. Methods: A pretest–posttest design will be used to evaluate the effectiveness of OMT in both children with and without Down syndrome and OSA. Both objective measures and patient-reported outcomes are being collected. Results: OMT is expected to improve orofacial functions, reduce OSA severity and symptoms, and enhance quality of life in both non-syndromic and syndromic children. Conclusions: This multidisciplinary research protocol, involving collaboration between ENT specialists and speech-language pathologists, aims to provide a comprehensive understanding of the potential benefits of OMT in treating OSA. Full article
(This article belongs to the Special Issue Current Advances in Paediatric Sleep Medicine)
16 pages, 729 KiB  
Systematic Review
Obstructive Sleep Apnea in Pediatrics and Adolescent Women: A Systematic Review of Sex-Based Differences Between Girls and Boys
by Sofía Romero-Peralta, Cristina Rubio, María Castillo-García, Pilar Resano, Miguel Alonso, Esther Solano-Pérez, Laura Silgado, Esther Viejo-Ayuso, Leticia Álvarez-Balado and Olga Mediano
Children 2024, 11(11), 1376; https://doi.org/10.3390/children11111376 - 12 Nov 2024
Viewed by 1997
Abstract
Background/Objectives: Obstructive sleep apnea (OSA) is marked by repetitive occurrences of upper airway (UA) obstruction during sleep. Morbidities impacting the metabolic, cardiovascular (CV) and neurological systems are correlated with OSA. Only a few studies have described the existence of different characteristics depending on [...] Read more.
Background/Objectives: Obstructive sleep apnea (OSA) is marked by repetitive occurrences of upper airway (UA) obstruction during sleep. Morbidities impacting the metabolic, cardiovascular (CV) and neurological systems are correlated with OSA. Only a few studies have described the existence of different characteristics depending on sex and, to date, the girl phenotype in OSA pediatrics is not well known. The objective of this systematic review is to identify the specific phenotype of OSA in pediatric and adolescent females compared to males. Methods: A systematic review was performed. The terms “pediatric sleep apnea” and “sex differences” were used to look for publications using PubMed, the Cochrane Library and Web of Science. Inclusion criteria: (1) peer-reviewed journal articles written in English; (2) investigations conducted on individuals diagnosed with OSA; and (3) investigations providing information about sex differences. Exclusion criteria: (1) studies carried out with individuals aged 18 years and older; (2) studies involving a sample size of fewer than 10 patients; and (3) editorials, letters and case reports. Results: Fifteen studies were included and classified in sections related to sex-based differences. Conclusions: Limited information related to sex-based OSA differences in the pediatric population exists. These differences are conditioned by hormonal status, and are minimal in the premenarcheal period. Moreover, adolescent women present a lower prevalence of obesity and craniofacial alterations, lower OSA severity related to higher UA area and earlier tonsil regression. Hyperactivity is more frequent in boys. Some studies pointed to a higher risk of high diastolic blood pressure in girls than in boys. Full article
(This article belongs to the Special Issue Current Advances in Paediatric Sleep Medicine)
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30 pages, 2014 KiB  
Systematic Review
Postnatal Development of the Circadian Rhythmicity of Human Pineal Melatonin Synthesis and Secretion (Systematic Review)
by Ekkehart Paditz
Children 2024, 11(10), 1197; https://doi.org/10.3390/children11101197 - 29 Sep 2024
Cited by 7 | Viewed by 4266
Abstract
Introduction: According to current knowledge, at birth, the pineal gland and melatonin receptors are already present and the suprachiasmatic nucleus is largely functional, and noradrenaline, the key pineal transmitter, can be detected in the early foetal period. It is still unclear why the [...] Read more.
Introduction: According to current knowledge, at birth, the pineal gland and melatonin receptors are already present and the suprachiasmatic nucleus is largely functional, and noradrenaline, the key pineal transmitter, can be detected in the early foetal period. It is still unclear why the pineal gland is not able to start its own pulsatile synthesis and secretion of melatonin in the first months of life, and as a result, infants during this time are dependent on an external supply of melatonin. Method: The causes and consequences of this physiological melatonin deficiency in human infancy are examined in a systematic review of the literature, in which 40 of 115 initially selected publications were evaluated in detail. The references of these studies were checked for relevant studies on this topic. References from previous reviews by the author were taken into account. Results: The development and differentiation of the pineal gland, the pinealocytes, as the site of melatonin synthesis, and the development and synaptic coupling of the associated predominantly noradrenergic neural pathways and vessels and the associated Lhx4 homebox only occurs during the first year of life. Discussion: The resulting physiological melatonin deficiency is associated with sleep disorders, infant colic, and increased crying in babies. Intervention studies indicate that this deficiency should be compensated for through breastfeeding, the administration of nonpooled donor milk, or through industrially produced chrononutrition made from nonpooled cow’s milk with melatonin-poor day milk and melatonin-rich night milk. Full article
(This article belongs to the Special Issue Current Advances in Paediatric Sleep Medicine)
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