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Sleep Disorders

Sleep disorders include a range of problems -- from insomnia to narcolepsy -- and affect millions of Americans. Dr. Michael Breus shares information and advice on sleep disorder and insomnia treatments and causes.

Monday, April 06, 2009

Why Little Kids Need Big Sleep
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Photo Credit: Gareth Saunders
If sleep weren't such a necessity during those tender years, then you wouldn't see babies snoozing most of the day, and you wouldn't have your toddler take afternoon naps so there's a semblance of sanity in the home. We all need sleep as much as we need water and food, but how much is enough? What's the difference between the needs of a baby and that of a toddler or nine-year-old? What are the rules of disengagement from the world when it comes to children under 10?

Shifts in Rhythms, Changes in Bedtimes
One of the most profound changes that occurs in a developing human is the shift in biological rhythms. Everyone's body clock or circadian "pacemaker" ticks at a different rate, but as you age your pacemaker will speed up or slow down, thus altering how your body responds to that 24-hour cycle. Babies don't get a rhythm going until about 6 months of age, at which point they establish a rhythm that matches closely with the 24-hour day. This is explains why newborns maintain irregular sleep schedules. But even once they establish a rhythm and have a regular sleep-wake cycle, sleep remains the dominant theme here as they develop and grow. Sleeping a total of 10.5 to 18 hours around the clock with periods of one to three hours of wakefulness, a newborn's cycle is primarily based on the need to be fed, changed, and nurtured. A lot is going on developmentally and at the cellular level, for which sleep is the ideal environment.

By six months of age, many infants don't need to be fed during the night; 70 to 80 percent will sleep through the night by nine months of age. Infants typically sleep 9 to 12 hours a night and take 30 minute to two-hour naps, one to four times daily. Naps become fewer as they reach their first birthday.

By the age of two, most children have spent more time asleep than awake. A child will spend about 40 percent of his or her childhood asleep. Why? Because it's critical for their development both mentally and physically.

Trouble Beings During Toddler and Preschool Years
Virtually everyone has witnessed the tantrums of toddlerhood. It is during this stage in life when trouble can set in to the achievement of high-quality sleep, which is why napping should be carefully planned so it doesn't occur too close to bedtime. In general, toddlers need about 12 to 14 hours of sleep in a 24-hour period. By the time they are 18 months old, toddlers nap only once a day for about one to three hours.

As many parents can attest, toddlers' rapidly growing sense of independence coupled with their expanding motor, cognitive, and social skills can make for difficult bedtimes. They may not want to go to bed when they are supposed to, and can also show signs of separation anxiety from mom and dad. Nightmares can also become a common experience, intruding on a toddler's sleep. It helps to remember that a child's imagination is also springing into action at this age, which can further complicate restful sleep. Toddlers who are unusually sleepy and cranky during the day may not be getting enough sleep.

Photo Credit: katrinket
Those between the ages of 3 and 5 typically sleep 11 to 13 hours nightly, and most don't nap after five years of age. As with toddlers, difficulty falling asleep and waking up during the night are common. With further development of their imagination, preschoolers commonly experience nightmares and a general fear of the night. Sleepwalking and sleep terrors peak during these years.

There's nothing more frustrating for a parent than a sleep-deprived child-at any age. Bedtimes are important, and not just for kids. As parents, we need to set examples and be open with our kids about the value of sleep. To that end, here are a few pointers:
  • Make sufficient sleep a family priority. It's important for the health of all family members.

  • As parents, you need to determine the amount of sleep each family member needs, especially if you have a household with mixed ages, and take steps to ensure individual needs are met.

  • Establish regular bedtime routines, creating a quiet and comfortable bedroom. Help your toddlers prepare for bed by making sure they disengage from stimulating activities at least 30 minutes prior to bedtime. Reading, for example, is much more relaxing and sleep-inducing than watching TV.

  • Learn to recognize sleep problems. The most common sleep problems in children include difficulty falling asleep, nighttime awakenings, snoring, stalling and resisting going to bed, having trouble breathing, and loud or heavy breathing while sleeping. These sleep problems can be evident in daytime behavior such as being overtired, sleepy or cranky.

  • Talk to your child's doctor about sleep - even if your doctor doesn't breach the topic.

Remember: little kids need big sleep. It's during these critical years that they are rapidly developing physically, socially, and psychologically. Sleep plays a huge role in this development and will continue to do so as they get older and learn new things. If they can enter their preteen and teenager years "well-rested," they will be all the more prepared and ready for whatever life brings. Which is sure to get more challenging.

Sweet Dreams,

Michael Breus, PhD
The Sleep Doctor

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Posted by: Dr. Breus at 6:00 AM

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