Sleep apnea and its resulting insomnia can affect kids' ability to wake up and concentrate in school, says Kathleen Pfeffer, a pediatric pulmonologist certified in sleep medicine.

"It's frustrating because teachers will often treat the children as if they're lazy because they're falling asleep in class, but if that's happening, it's time to see a doctor," she said.

While obstructive sleep apnea - a condition where the adenoids and tonsils obstruct the airway - is common, it is not the only cause of children's sleeplessness.

Judith Owens, director of the Pediatric Sleep Disorder Clinic at Brown University Medical School in Providence, R.I., estimates about 25 percent of all children have some type of sleep disorder during their childhood.

For 7-year-old Hailey Workman, an underlying muscle weakness was causing poor breathing and daytime fatigue, said her mother, Fiona Workman.

After seeing Pfeffer, Hailey was put on a continuous positive airway pressure (CPAP) machine that blows a constant stream of oxygen through her airways at night to keep them open.

"We ask her how she feels, and she says she sleeps throughout the night and she has more energy," Fiona Workman said.

Some children may have limit-setting sleep disorder, which occurs when parents don't set specific bedtimes or waking times, Owens found.

Pfeffer often finds this disorder in her patients.

"Waking up is key to good sleep. When the retina detects light, it sets the body's clock," Pfeffer said.

For many teenagers, a delayed insomnia occurs because their clocks are set to a later time. Teens often can't fall asleep until 3 a.m. because their bodies don't start producing the sleep-inducing chemical melatonin until then because they've delayed their internal clocks, by staying up late and sleeping in through the morning.

For infants, parent behavior most commonly affects their sleep habits. Many infants struggle with sleep onset association disorder, according to Owens. The disorder occurs when babies fall asleep only under specific conditions, such as when parents rock or feed them every time they wake up.

"Babies need to learn to self-soothe so they can fall back to sleep when they wake up at night," Pfeffer said.

She recommends the Ferber method, which includes a nurturing pre-bedtime routine such as rocking or singing, and then putting the child to bed when he or she is still awake.

The parent then leaves, and when the child wakes, the parent waits for a certain amount of time (usually a few minutes) and then checks on the baby without touching the child. As time goes on, the intervals between checks become longer.

After a week or so, the child learns that crying does not earn a big enough reward for the effort, and the child goes back to sleep, Pfeffer said.

"It's a really hard week, but after that, parents always tell me it was worth it."

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