Sleep and Circadian Rhythms

Sleep and circadian disruptions negatively impact health outcomes and quality of life for children and their families. Children and adolescents with serious, life-threatening illnesses are at increased risk of sleep and circadian disorders due to their disease and its medical treatment, and this at a time when they are at greatest need of care that supports their health and quality of life. This chapter discusses common pediatric sleep and circadian disorders, current research on these disorders among children living with a variety of life-threatening illnesses, and environmental and psychosocial factors contributing to sleep disorders (and vice-versa). Finally, assessment and pharmacological and nonpharmacological management of sleep and circadian disturbances is reviewed. While effective treatments are lacking for many aspects of palliative care, sleep and circadian disorders are largely treatable and have tremendous potential to improve the health and quality of life of these children.