History of sleep disorders in children and adolescents

Those of an historical inclination might be interested in the provenance of present-day practice and research in children's sleep disorders. There is, in fact, not much to say, and what can be said is a patchwork of historical, literary and clinical references which illustrates that children's sleep disorders have long been recognized but without any systematic study until recent times.

The starting-point might best be described as ‘prescientifically paediatric’. In The Boke of Chyldren (1545), Thomas Phaire included in his list of ‘the manye grevous and perilous diseases’ with which children of his day were afflicted ‘terrible dreames and feare in the slepe’ (caused by ‘the arysing of stynkyng vapours out of ye stomake into the fantasye, and sences of the brayne’) and also ‘pissing in the bedde’. To what extent Phaire's suggested remedies would meet the requirements of present-day evidence-based practice is doubtful. For example, his observations of childhood nightmares were accurate, but the treatments he recommended included ‘a lytle pouder of the seedes of peonie and sometimes triacle’. ‘The poudered wesande [windpipe] of a cocke’ and ‘the stones of an hedgehogge poudred’ were some of his recommendations for bedwetting.

To do justice to Phaire, it must be said that at least he was drawing attention to the special medical problems of the young at a time when, in general, few if any concessions were made to children, who were viewed as small adults and dealt with accordingly (Pinchbeck & Hewitt, 1969).