Çocuk ve Ergenlerde İnsomnia (Uykusuzluk) Bozukluğu
Özet
Çocuk ve ergenlerde insomnia (uykusuzluk), uykuya başlama ve uykuyu sürdürme güçlüğü olarak tanımlanan, fiziksel ve nöropsikolojik gelişimi doğrudan etkileyen hayati bir sorundur. Çocukların yaklaşık %30’unu etkileyen bu durum; bilişsel işlevlerde bozulma, akademik başarıda düşüş ve duygusal düzenleme sorunlarına yol açarak hem çocuğun hem de ailenin yaşam kalitesini düşürmektedir. İnsomnia tipleri yaş gruplarına göre farklılık göstermekte; çocukluk döneminde genellikle ebeveynlerin sınır koyma zorluklarından kaynaklanan "davranışsal insomnia" görülürken, ergenlikte ise yetersiz uyku hijyeni, gecikmiş uyku fazı ve psikofizyolojik etkenler ön plana çıkmaktadır. Depresyon, DEHB ve otizm gibi psikiyatrik durumlarla yüksek komorbidite gösteren insomnianın değerlendirilmesinde klinik öykü, uyku günlükleri ve altın standart olarak polisomnografi kullanılmaktadır. Tedavide öncelik; uyku hijyeni eğitimi ve "yok olma", "pozitif rutinler" gibi davranışçı terapilere verilmektedir. Davranışsal yöntemlerin yetersiz kaldığı durumlarda ise melatonin ve antihistaminik gibi farmakolojik seçenekler, uzman kontrolünde ve sınırlı süreyle tercih edilebilmektedir.
Insomnia in children and adolescents is defined as difficulty in initiating and maintaining sleep, representing a vital issue that directly impacts physical and neuropsychological development. Affecting approximately 30% of children, this condition leads to impaired cognitive functions, decreased academic success, and emotional regulation problems, thereby reducing the quality of life for both the child and the family. Types of insomnia vary by age group; while "behavioral insomnia," stemming from parental difficulties in limit-setting, is common in childhood, factors such as inadequate sleep hygiene, delayed sleep phase, and psychophysiological elements become prominent during adolescence. Insomnia shows high comorbidity with psychiatric conditions like depression, ADHD, and autism; its evaluation relies on clinical history, sleep diaries, and polysomnography as the gold standard. Treatment priority is given to sleep hygiene education and behavioral therapies such as "extinction" and "positive routines". In cases where behavioral methods are insufficient, pharmacological options like melatonin and antihistamines may be preferred under specialist supervision for a limited duration.
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