Sleep Problems in Children: What parents need to Know?

Hello everybody! Based on the feedback I received, I have touched upon another very common problem parents face while raising kids . Sleep Problems in Children not only makes the children cranky but also many a times creats a havoc in their parents’ life as well.

I have tried collating much of the data already known in this field and have attempted to present it in a simplified manner for general understanding. Your comments will be highly appreciated.

 

Sleep problems in children are commonly faced by most parents. We often wonder how to get the child to sleep through the night, or else how to inculcate good sleep habits that will last a lifetime.  Some children may have chronic sleep difficulties, and many children (like most adults!) are actually going through their days sleep-deprived in today’s fast paced world.

Infants & Sleep cycles: When people sleep, they cycle between rapid eye movement (REM) sleep and non-rapid eye movement (NREM) sleep.  In REM, the eyes move around fast and you dream although your body doesn’t move much. REM is light sleep and the stage when the infant or child is most likely to wake up.  NREM sleep is deep sleep. In normal sleep, a child cycles between light sleep and deep sleep.  Each light sleep stage is a time when the child is more likely to wake up. 

Infants go through a complete sleep cycle about every 50-60 minutes, so they are in light sleep for many times in a night and can potentially wake up many times each night! 

Newborns just sleep any old time, on and off, all through the day and night.  By age four months, your baby will probably be sleeping a 6-8 hour chunk at night, and by age 6 months, about 10-12 hours.  But that’s not to say that they won’t wake up during that time!  Most babies still wake up at least once a night even at age nine months.  Some can get back to sleep by themselves, and some need your help to put them back asleep. 

School-age children and sleep
School-aged children still need somewhere between 9 and 12 hours of sleep at night. At this age, kids usually start a trend toward
becoming more and more sleep deprived. As the parents, you will need to help figure out how much sleep your child needs. Your child is getting the right amount of sleep if they:

  • Can fall asleep within 15 to 30 minutes.
  • Can wake up easily at the time they need to get up and don’t need you to keep bugging them to get up.
  • Are awake and alert all day, and don’t need a nap during the day.  You should check with your child’s teacher and make sure your child is able to stay awake and alert during school. In other words, if your child can go to bed, fall asleep easily, wake up easily, and not be tired

Good sleep habits- Do’s and Don’ts”:

DO:

  • Make bedtime a special time.  It should be a time for you to interact with your child in a way that is secure and loving, yet firm. At bedtime, spend some special time with your child. Be firm and go through a certain bedtime routine that your child is used to. At the end of that routine the lights go off and it is time to fall asleep.
  • Put some thought into finding your child’s ideal bedtime.  In the evening, look for the time when your child really is starting to slow down and getting physically tired. That’s the time that they should be going to sleep, so get their bedtime routine done and get them into bed before that time. If you wait beyond that time, then your child tends to get a second wind.  At that point they will become more difficult to handle, and will have a harder time falling asleep. 
  • Keep to a regular daily routine—the same waking time, meal times, nap time and play times will help your baby to feel secure and comfortable, and help with a smooth bedtime.  Babies and children like to know what to expect.
  • Use a simple, regular bedtime routine.  It should not last too long and should take place primarily in the room where the child will sleep.  It may include a few simple, quiet activities, such as a light snack, bath, cuddling, saying goodnight, and a story or lullaby. The kinds of activities in the routine will depend on the child’s age.
  • Make sure the sleep routines you use can be used anywhere, so you can help your baby get to sleep wherever you may be. 
  • Some babies are soothed by the sound of a vaporizer or fan running.  This “white noise” not only blocks out the distraction of other sounds, it also simulates the sounds babies hear in the womb.
  • Make sure your kids have interesting and varied activities during the day, including physical activity and fresh air.
  • Use light to your advantage.  Keep lights dim in the evening as bedtime approaches.  In the morning, get your child into bright light, and, if possible, take them outside.  Light helps signal the brain into the right sleep-wake cycle.

DON’T:

  • Never soothe your child to sleep by putting them to bed with a bottle of juice, milk or formula.  Water is okay.  Anything other than water in the bottle can cause baby bottle tooth decay. Feed or nurse your baby, and then put them down to sleep.
  • Don’t start giving solids before about 6 months of age.  Starting solid food sooner will not help your baby sleep though the night.  In fact, if you give your baby solids before their system can digest them, they may sleep worse because they have a tummy ache! Contrary to popular belief, a heavier baby or a baby with a stuffed-full tummy is not more likely to sleep through the night. 
  • Don’t fill up your child’s bed with toys.  It’s probably best to keep your child’s bed a place to sleep, rather than a place to play. One or two transitional objects–like a favorite doll or a special book are fine. Babies under 4-6 months should have an empty crib to prevent suffocation.
  • Never use sending your child to bed as a threat. Bedtime needs to be a secure, loving time, not a punishment.  Your goal is to teach your kids that bedtime is enjoyable, just as it is for us adults.  If the feeling around bedtime is a good feeling, your child will fall asleep easier.
  • Don’t give your child foods and drinks with caffeine in them, like hot chocolate, tea, cola, chocolate, etc.  Even caffeine earlier in the day could disrupt your child’s sleep cycle.
  • Don’t let your child watch more than one to two hours of TV during the day, and don’t let them watch TV at bedtime at all. TV viewing at bedtime has been linked to poor sleep.
  • If your child has a TV set in their bedroom, remove it. Research shows watching TV is linked to sleep problems, especially if the TV set is in the child’s bedroom. The presence of other media, such as a computer, video games or Internet in a kid’s bedroom is also associated with worse sleep.

How much sleep do kids need? 
The chart below will give you an idea of the ballpark you should be aiming for, depending on your child’s age.  Some kids will need more or less sleep, and differ in how they nap. 

Age

Nighttime Sleep

(hours)

Daytime Sleep

(hours)

Total Sleep

(hours)

1 month

8.5 (many naps)

7.5 (many naps)

16

3 months

6-10

5-9

15

6 months

10-12

3-4.5

14.5

9 months

11

3 (2 naps)

14

12 months

11

2.5 (2 naps)

13.5

18 months

11

2.5 (1-2 naps)

13.5

2 years

11

2 (1 nap)

13

3 years

10.5

1.5 (1 nap)

12

4 years

11.5

0

11.5

5 years

11

0

11

6 years

11

0

11

7 years

11

0

11

8 years

10-11

0

10-11

9 years

10-11

0

10-11

10 years

10

0

10

11 years

10

0

10

12-13 years

9.5-10

0

9.5-10

14 years

9.5

0

9.5

15 years

9.5

0

9.5

16 years

9.25

0

9.25

 

Different people need different amounts of sleep.  Remember that charts list the average amount of sleep for each age group.  These are not magic numbers.  The best way to tell if your child is getting enough sleep is to look at how they act while they are awake.  If your child’s poor sleep is causing daytime problems, then they are sleep deprived.

(Sources: University of Michigan, Pubmed, American Association of Pediatrics and other data published on the net)

Next write up will focus on some of the common sleep problems like nightmares, night terrors, night walking and other sleep disorders.

To be continued….

Dr. Sanjeev Ganguly is a pediatrician based in Delhi. He has several research publications in leading international journals and has served as the clinical expert in many international conferences.and the Founder director of Doorstep Doctor, a firm helping NRIs take care of their parents and family back in India. Doorstep Doctor addresses the crucial healthcare needs of parents and family still in India with a professionally managed healthcare program and emergency assistance right at their doorstep. Please click on the link here for more details.

 

Last 5 posts by Dr. Sanjeev Ganguly



8 Comments

  1. Anonymous

    Thanks for touching such an important issue. I think my problem is too long of a bedtime routine. It does take my son a long time to fall asleep at night after the routine! So I will have to work on some of the tips you have mentioned.

  2. Marjorie

    This is a great topic. I am looking forward to night waking and suggestions on transitioning to own room from cosleeping as part of it. Thank you very much

  3. Anonymous

    What are your thoughts on maybe putting on a video or TV which allows them to sleep? It is very effective.

  4. Indrani

    Thanks for sharing your thoughts on issues which bothers most of us. What age do you think is good to make the transition for sleeping in a separate room? Thanks a lot.

  5. Anonymous

    I think this is very helpful. I was wondering – what is the appropriate amount of sleep for adults?

  6. Sands

    Great info on such a sensitive topic. I just want to comment on what Anonymous no.1 said. I am sorry but I have to say I totally disagree on using the TV as lullaby- it can bring nightmares, one can not fall asleep at the same time every night, Tv doesn’t rest the mind, in fact it excites it and its difficult to sleep peacefully after that. Usually , the person isn’t well rested or fresh the next morning.

  7. It is not at all advisable to make use of TV or video for making children sleep. The flickering lights on the TV do not let the brain rest and it may be harmful for the children. I agree with Sands completely on this matter.

  8. Anonymous

    The list is good!!Thanks!!My 8 year old son sleeps late during vaccation but goes to bed early on school season

Leave a Reply