Patient's question:
Detailed medical condition and consultation purpose: My son doesn't like to sleep. He doesn't sleep during the day and only falls asleep very late at night. Even when he does sleep, he's restless and keeps turning over. Sometimes he gets nosebleeds. Could you please explain what this could be and what should be done?Doctor's answer:
Hello: Based on the child's condition, it is unlikely that not liking to take naps is a symptom of an illness, but nosebleeds should be actively investigated for their cause.Children are more prone to nosebleeds between the ages of 4 and 10, and over 90% of them occur in the anterior inferior part of the nasal septum. The anterior inferior part of the nasal septum has a vascular network composed of arteries and veins. The mucosa here is thin, and the veins lack valves, which is medically referred to as the "easily bleeding area of the nose." Due to its anterior location, it is easily injured and prone to bleeding when subjected to external force.
There are many causes of nosebleeds, both local and systemic. Local causes include nasal trauma, anterior rhinitis, nasal foreign bodies, and nasal angiofibromas. Systemic causes include upper respiratory tract infections, aplastic anemia, thrombocytopenic purpura, cirrhosis, vitamin C deficiency, hemophilia, leukemia, and other conditions.
When a child has a nosebleed, parents should not panic. The child should be placed in a seated or semi-seated position with the head slightly tilted forward. Avoid lying flat or tilting the head backward to prevent blood from entering the respiratory tract. If blood flows into the throat, coughing may further aggravate the bleeding. At this time, a cold towel can be applied to the head, and fingers can be gently pressed against the sides of the nose for 3–5 minutes. Alternatively, sterilized cotton can be dipped in a 0.1% epinephrine solution or Yunnan Baiyao, packed into the nostril for 10 minutes, and then gently removed.
To prevent indoor dryness, water can be sprinkled on the floor, or an air humidifier can be used to maintain a certain level of humidity. Encourage the child to drink more water, eat more vegetables and fruits, and consume nutrient-rich, light, and easily digestible foods to prevent vitamin C