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Children and sleep issues
Do you get so concerned that your child’s sleep patterns are abnormal that you can’t sleep well, either? Or maybe you’re not concerned enough, thinking that your teen’s poor sleep habits are “just the way kids are.” To get a better handle on the clinical realities of children and sleep health, BeWell spoke with Rafael Pelayo, MD, clinical professor of psychiatry and behavioral sciences at the Stanford Center for Sleep Sciences and Medicine.
How much sleep does my newborn need, and how will that change when he’s a toddler?
It is important to remember that there is a natural maturation process to sleep. Newborns will sleep 16-18 hours a day. By three months old, the bulk of the sleep should be synchronized to the parents. For most families, this means that both parents and child will sleep at night. However, for shift workers, this might mean that both parents and child will sleep during the day.
Starting at six months, your baby will be taking two distinct naps a day: one in the morning and one in the afternoon. By age 1-1.5 years, your baby may drop the first nap, sleeping for a couple of hours in the afternoon. By 2.5-3 years old, your child may stop napping altogether.
How do I get my child to go to sleep?
Many parents will swear that their children do not want to sleep, but babies — like all humans — have a biological need to sleep. However, in order for them to sleep, they need to feel safe and comfortable. Therefore, the more anxious new parents feel about getting their babies to sleep, the harder time they will have doing so, as the baby will pick up on parental anxiety.
One way to help your baby and older child sleep is to establish a bedtime routine. Read the same books at bedtime or sing the same songs. Monotony signifies safety and thus will enable the child to sleep. If your child feels like she is “missing something” by sleeping, then it will be harder to get her to bed. Providing serenity and predictability at bedtime will go a long way to helping your child feel safe and loved and thus comfortable enough to sleep.
What is the most common reason why a child might have difficulty going to sleep?
Children need sleep, but they have to be taught a sleep routine. Children whose sleep situations are unpredictable — for example, not going to sleep at the same time every night, or switching off between sleeping with a parent on one night and sleeping in their own bed on other nights — can increase the likelihood that the child may have problems going to sleep.
If consistency is so important, what happens with children who are living in two different households because of divorced parents or other issues?
Of course, each household will have its own rhythm, but ideally the child will have the same bedtime and same wake-up time at each house. Above all, the child should have a sense of safety in each house. Sometimes, the parents may report that the child has sleep issues in one house and not at the other one. If this happens, you may need to troubleshoot the issue: perhaps in one home there are other (noisy) kids, pets that bring on allergies, or other factors.
My child snores. Should I be concerned about that?
The short answer is: yes. Snoring is never appropriate in a child. If your child snores, or if he sleeps with his mouth open, tell your pediatrician and insist that he/she be seen in a sleep disorders clinic. Snoring in children could be caused by any number of factors including sleep apnea, nasal obstruction, and allergies. Snoring and mouth breathing in sleeping children have been associated with increased irritability, learning difficulties, and stunted growth. Children who snore in preschool have quadruple the chance of developing ADD in elementary school.
What can you tell us about the sleep needs of teenagers?
Teenagers need nine hours of sleep per night. They should not be falling asleep in class and should be waking up feeling refreshed. If they need to “sleep in” more than two extra hours on the weekend, they are not meeting their sleep needs. Only 25% of teenagers are getting enough sleep. Sleep deprivation in teenagers is a serious issue, as it’s associated with suicidal behaviors. In addition, it should come as no surprise that teenagers who don’t get enough sleep are often grumpy and can’t effectively get their schoolwork done. Many parents feel that their child needs to skimp on sleep in order to get their all their schoolwork done and still participate in their extracurricular activities. I encourage parents to reconsider that notion; the cost of sleep deprivation is not worth it.
To help teenagers understand the value of sleep, sleep researchers at Stanford have developed the award-winning Sleep Ambassadors program, in which juniors and seniors from nearby Menlo-Atherton High School educate their classmates about the importance of sleep. Learn more here.
How do sleep needs vary between teenagers and college students?
While teenagers need close to nine hours of sleep a night, college students need about eight hours. College students can have sleep walking, insomnia, sleep apnea, or any other sleep issue that presents in adults. Physicians at Stanford’s Vaden Health Center regularly refer students with sleep issues to the Stanford Sleep Medicine Center. Anxiety can of course impact the quality of sleep of our college students. At Stanford, I (along with William Dement) teach the Sleep and Dreams class. As part of this class, students not only learn about the science of sleep, but also gain a deeper understanding of the importance of sleep in their daily lives. In addition, during that same class, we have an expert in Mindfulness-Based Stress Reduction (MBSR) teach the students how to meditate, as a way to reduce anxiety, before the midterm.
… any final thoughts?
People don’t sleep in isolation; sleep is really a family issue. If one person in the family doesn’t sleep, it will affect others. Restless legs syndrome (RLS), narcolepsy, insomnia, and sleep apnea are all sleep issues that run in families. There is definitely a genetic component to sleep. There is also an environmental component, in that the sleep issues of one family member can impact the sleep of another. For example, shift workers can throw off the sleep of their family members, as can sleepwalkers. I encourage anyone experiencing a sleep issue to come to a sleep clinic to be fully evaluated. The Stanford Sleep Medicine Center is the oldest and most comprehensive sleep center in the country.
Other sleep problems?
Treating sleep apnea
Help for restless legs syndrome
Sleep's impact on weight