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Behavioural insomnia — DCH MCQ

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ModerateBehavioural and emotionalBehavioural insomniaDCH

A 2-year-old wakes repeatedly at night and needs a parent to lie beside him to fall asleep. He is well and growing normally, but his father asks what feature would make the sleep problem more concerning. What is the most important red flag?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Loud snoring with witnessed pauses in breathing

Loud snoring with witnessed apnoeas suggests obstructive sleep apnoea and warrants clinical assessment. Sleep-onset association and crying during behavioural change are common in behavioural insomnia. The pearl is to screen for breathing, seizures, pain and safeguarding concerns before giving routine sleep advice.

Reference: NICE CKS Sleep disorders in children