kids and headaches (complaining)

[ny2125]

our 5 yr. old daughter will complain of either a headache or stomachache one minute, then the next minute she is fine and running around!  she will usually say a headache more than a stomachache.  we notice that these complaints will arise when she is either tired (sleeps around 9 hours a night), hasnt eaten well (she is a picky eater who loves starches and sweets), or USUALLY when she has to do something she doesnt like.  particulary long car rides.  she will say she is carsick.  then get out of the car and be fine like nothing is wrong.  she is very active and is a very smart little girl.  my wife does get carsick too.  
these "complaints" have never led her to have to stop doing any activities, made her vomit, or led us to see any other neurological sign.  the only time she was given meds was if she was sick w/fever or flu.  her peditrician feels she is healthy and told us to just watch for red flags that might suggest an issue w/her health.  
i do notice w/her and my other daughter, that they will sometimes get a twitch while they are sleeping.  no big jerky movements, more like a finger/hand or lower leg twitch.  i know this can happen during sleep stages and i was told it is ok as long as they are sleeping fine and breathing fine.  
to summarize my wife and i do not want to have to bring her in to a doctor for every complaint.  what should we look for?  if someone could give us some insight if this is familiar w/kids and even about night twitches we would appreciate it!!!  thanks!!!

[ny2125]

thanks for replying to my answers and input!

[Kevin Kennedy, Ph.D.]

It doesn't sound like the muscle twitches are anything to worry about. Her pattern is very normal.

[ny2125]

i actually notice some of the twitches right before she wakes up in the morning.  does this happen when people fall asleep and when they are starting to wake up???  when she is in deep sleep, i do notice her breathing is slower and she is very relaxed and i do not recall any twitches or much movement at all during this time of sleep.  
as for the headaches, so far (thank God) she seems fine between complaints.  no missed school or activities.  and a lot of the time we can predict when she will complain.  and then the next minute she is fine.
thanks again!

[Kevin Kennedy, Ph.D.]

Normally the twitching occurs during REM sleep, not during non-REM ('deep') sleep. If you witness the involuntary muscle movements during the day it would warrant an evaluation. As you observe your daughter, it is not always possible to discern what stage of sleep a child is in. But during non-REM sleep, or deep sleep, cardiovascular functioning slows down and breathing is likely to be slower. Relative to the headaches, your doctor's guidance seems prudent. That is, if she otherwise appears to be well, you needn't take any special action. Complaints by children of such things as headache or GI symptoms can be hard to evaluate, because the parent can't really 'see' them - you're relying on the child's report and often it's a judgement call re: what to do about them. But if a child is truly ill, you will usually see this refelcetd in their routines (eating, sleeping), their level of activity, their demeanor, their participation in school, etc.

[ny2125]

so people can twitch through the night and during other stages of sleep too?  what would be a "red flag"/warning sign that maybe we should take her to see a doctor (in regards to headaches or twitches)?  thanks again.

[Kevin Kennedy, Ph.D.]

The sort of muscle movement you describe is a normal event during Rapid Eye Movement (REM) sleep and poses no cause for worry. Likewise, the sort of quick jerking of a muscle (often a leg muscle), called myoclonus, that occurs sometimes as people are falling asleep is normal and not a sign of underlying neurological disorder. Headaches and GI complaints are common somatic complaints among children, and you will probably be safe at this point treating them in an off-hand fashion with your daughter. By off-hand I do not mean making light of them, but rather not making much of an issue about them either. You have noticed the correlation of the symptoms with certain states or events, and this indicates that you are safe to not worry about them. Relative to the car rides, brief stops for some fresh air can be useful. Car sickness, even without actually vomiting, can sure make car rides an unpleasant experience.