Sleep Issues of Kids & Teens

From the day the baby is brought home from the hospital to the day the teenager becomes an adult and moves out, parents are face with the question, are they getting enough sleep? Recent research shows that children of all ages are not getting enough sleep. The studies also show that failure to get enough sleep can result in poor school achievement and behavior problems. Through the ages children and teenagers have fought with their parents about bed time and the need for sleep. On the page you will find information on how sleep effects child and adolescent develop. You will also learn how to help your child or teen get the right amount of sleep.

Newborns & Infants

Newborn infants have irregular sleep cycles, which take about 6 months to mature. While newborns sleep an average of 16 to 17 hours per day, they may only sleep 1 or 2 hours at a time. As children get older, the total number of hours they need for sleep decreases. However, different children have different needs. It is normal for even a 6 month old to wake up briefly during the night, but these awakenings should only last a few minutes and children should be able to go back to sleep easily on their own.

Sleep and Newborns (1-2 months)

For newborns, sleep during the early months occurs around the clock and the sleep-wake cycle interacts with the need to be fed, changed and nurtured. Newborns sleep a total of 10.5 to 18 hours a day on an irregular schedule with periods of one to three hours spent awake. The sleep period may last a few minutes to several hours. During sleep, they are often active, twitching their arms and legs, smiling, sucking and generally appearing restless.

Newborns express their need to sleep in different ways. Some fuss, cry, rub their eyes or indicate this need with individual gestures. It is best to put babies to bed when they are sleepy, but not asleep. They are more likely to fall asleep quickly and eventually learn how to get themselves to sleep. Newborns can be encouraged to sleep less during the day by exposing them to light and noise, and by playing more with them in the daytime. As evening approaches, the environment can be quieter and dimmer with less activity.

Sleep Tips for Newborns:

• Observe baby’s sleep patterns and identify signs of sleepiness.
• Put baby in the crib when drowsy, not asleep.
• Place baby to sleep on his/her back with face and head clear of blankets and other soft items.
• Encourage nighttime sleep.

Sleep and Infants (3-11 months)

By six months of age, nighttime feedings are usually not necessary and many infants sleep through the night; 70-80 percent will do so by nine months of age. Infants typically sleep 9-12 hours during the night and take 30 minute to two-hour naps, one to four times a day – fewer as they reach age one.

When infants are put to bed drowsy but not asleep, they are more likely to become “self- soothers” which enables them to fall asleep independently at bedtime and put themselves back to sleep during the night. Those who have become accustomed to parental assistance at bedtime often become “signalers” and cry for their parents to help them return to sleep during the night.

Social and developmental issues can also affect sleep. Secure infants who are attached to their caregiver may have less sleep problems, but some may also be reluctant to give up this engagement for sleep. During the second half of the year, infants may also experience separation anxiety. Illness and increased motor development may also disrupt sleep.

Sleep Tips for Infants:

• Develop regular daytime and bedtime schedules.
• Create a consistent and enjoyable bedtime routine.
• Establish a regular “sleep friendly” environment.
• Encourage baby to fall asleep independently and to become a “self-soother.”

Toddlers & Preschoolers

Fewer minutes and hours of sleep add up to more problems in the daytime behavior of children aged two to five, according to new research. Two- and three-year-old children sleeping less than 10 hours in a 24-hour period were consistently at greatest risk for behavior problems such as oppositional or noncompliant behavior, “acting out” behaviors, and aggression, reported the team of Northwestern University scientists conducting the study. Preschoolers who sleep less at night have almost 25 percent greater chance of psychiatric diagnosis, according to the study, published in the June issue of Developmental and Behavioral Pediatrics.

Here are some basic suggestions from the American Academy of Pediatrics:

1. Make sure there is a quiet period before your child goes to bed. Establishing a pleasant routine that may include reading, singing, or a warm bath. A regular routine will help your child understand that it will soon be time to go to sleep. If parents work late hours, it may be tempting to play with their child before bedtime. However, active play just before bedtime may leave the child excited and unable to sleep. Limit television viewing and video game play before bed.
2. Try to set a consistent schedule for your child and make bedtime the same time every night. His sleep patterns will adjust accordingly.
3. Allow your child to take a favorite teddy bear, toy, or special blanket to bed each night. Such comforting objects often help children fall asleep–especially if they awaken during the middle of the night. Make sure the object is safe. A teddy bear may have a ribbon, button, or other part that may pose a choking hazard for your child. Look for sturdy construction at the seams. Stuffing or pellets inside the stuffed animal may also pose a danger of choking.
4. Make sure your child is comfortable. Check the temperature in your child’s room. Clothes should not restrict movement. He may like to have a drink of water, have a night-light left on, or the door left slightly open. Try to handle your child’s needs before bedtime so that he doesn’t use them to avoid going to bed.
5. Try to avoid letting your child sleep with you. This will only make it harder for him to learn to settle himself and fall asleep when he is alone.
6. Try not to return to your child’s room every time he complains or calls out. A child will quickly learn if you always give in to his requests at bedtime. When your child calls out, try the following:

• Wait several seconds before answering. Your response time can be longer each time to give your child the message that it is time for sleep. It also gives him the opportunity to fall asleep on his own.
• Reassure your child that you are there. If you need to go into his room, do not stimulate the child or stay too long.
• Move farther from your child’s bed every time you reassure him, until you can do this verbally without entering his room.

Sleep Tips For Toddlers:

• Maintain a daily sleep schedule and consistent bedtime routine.
• Make the bedroom environment the same every night and throughout the night.
• Set limits that are consistent, communicated and enforced. Encourage use of a security object such as a blanket or stuffed animal.

Sleep Tips for Preschoolers:

• Maintain a regular and consistent sleep schedule.
• Have a relaxing bedtime routine that ends in the room where the child sleeps.
• Child should sleep in the same sleeping environment every night, in a room that is cool, quiet and dark – and without a TV.

School Age Children

A recent study reported in Developmental and Behavioral Pediatrics that 37% of the children in this age group experience significant sleep problems. Problems may include a reluctance to go to sleep, waking up in the middle of the night, nightmares, and sleepwalking. In older children, bed-wetting can also become a challenge.

Children in the sixth-grade may suffer adverse cognitive, behavioral and emotional consequences due to an increased risk of being chronically sleep deprived, according to a new study in the May issue of Developmental Psychology, a journal published by the American Psychological Association (APA).r />
Children vary in the amount of sleep they need and the amount of time it takes to fall asleep. How easily they wake up and how quickly they can resettle are also different for each child. It is important, however, that as a parent you help your child develop good sleep habits at an early age. The good news is that most sleep problems can be solved and your pediatrician can help. A good place to start looking for help is in Sleep Problems in Children by the American Academy of Pediatrics.

Children’s nightmares can be so recurrent and so real that the Walt Disney Co. recently devoted a whole movie to them. In the recently released “Monsters, Inc.,” there is a parallel universe of beasts that make a living by creeping out of the closet and into the scary dreams of little ones.

OKOK, so in reality monsters don’t live inside the closet. They still, however, are found in the dreams. But give a child an empowering image, and he just might be able to chase that monster away, says Alan B. Siegel, a California psychologist and author of “Dreamcatching: Every Parent’s Guide to Exploring and Understanding Children’s Dreams and Nightmares.” – The Washington Times
Dreamcatching: Every Parent’s Guide to Exploring and Understanding Children’s Dreams and Nightmares

Sleep Tips for School-aged Children:

• Teach school-aged children about healthy sleep habits.
• Continue to emphasize need for regular and consistent sleep schedule and bedtime routine.
• Make child’s bedroom conducive to sleep – dark, cool and quiet.
• Keep TV and computers out of the bedroom.
• Avoid caffeine.

Teenagers

In the 1970’s researchers at Stanford University discovered that teenagers require more sleep, by 1 to 2 hours, than do their younger 9 and 10 year old siblings, yet most teenagers get 1 to 2 hours less. Teenagers are the sleepiest members of society and this sleepiness is associated with poor school performance, increased drug and alcohol use, and increased automobile accidents. This level of sleepiness may also play a role in the high rate of teenage suicides. However, in addition to requiring more sleep than do 9 and 10 year old children, or adults, teenagers typically have altered biologic rhythms which vary the time of night teenagers sleep best and the times of day teenagers are most alert. The timing of sleep and wake is very dependent on the sun. Humans typically sleep at night and are awake in the daytime. By following the simple practices of awakening at about the same time (give or take 1 to 2 hours) daily and getting bright light and by remembering that the need for sleep increases during the teenage years, teenagers can sleep well. If teenagers sleep well at night, they are very likely to function well in the daytime. Please see News from the AAP: New Study Shows Some Sleep Problems Carry Into Adolescence. The Sleep Center at St Mary’s Hospital in Walla Walla, Washington has an excellent discussion on this subject.