睡得不好

凝女自上星期三開始，每晚都會無故大哭，每次哭鬧的時間都不同，有長有短，有大哭也有小哭，總是哭一會便會自己再瞓覺，瞓得不好。這兩日來，飲左竹蔗水，下一下火，希望凝女可以瞓得好啦。

最近睇左這篇關於睡眠的文章，其中提到的 sleep terrors，很有用，可以參考。
ABC of Paediatric Sleep Medicine
Summary

• On average, a 3-year-old sleeps 12 hours a day
  
• Sleep can be divided into light sleep stage (stages 1 and 2), deep sleep stage (stages 3 and 4) and rapid eye movement (REM)/dreamy stage.
  
• Sleep disordered breathings include primary snoring, upper airway resistance syndrome and obstructive sleep apnoea syndrome.
  
• Pediatric insomnia can be divided into sleep-onset association disorder and limit-setting sleep disorder.
  
• Children should be encouraged to sleep alone with consistent and firm bedtime schedule and routines.
  
• Sleep terrors are disordered arousals from stage III or IV that occur after 60 to 90 minutes of sleep. It is associated with violent behaviour and possible injury. However, it has a benign course and tends to resolve by 6- 8 years.
  
• Majority of children with sleepwalking, rhythmic movement disorder, and sleep bruxism do not require treatment.
  
• The treatment for primary nocturnal enuresis should include education and proper bedtime routines including correction of constipation, restriction of fluids after dinner and emptying of bladder before retiring.
  
• Star chart and enuretic alarm, emphasizing on self-responsibility and positive reinforcement, is the treatment of choice for motivated family and older children who are greater than 7 years of age.
  
• Desmopressin is associated with high relapse rate of enuresis on discontinuation of therapy.