In my pediatric visits one of the most important areas of health that I ask parents about is sleep. Parents often do not realize the degree of impact that inadequate sleep can have on the behavior and development of their children. Toddlers need between 11 and 13 hours of sleep per day while school aged children (6-13 years old) require about 9-11 hours of sleep per night. Interestingly, sometimes parents will report to me that their children are getting enough sleep, but when I ask the child they may report that they do not actually fall asleep when their parents think they do, or they report waking in the middle of the night and lying awake for hours. If you are suspicious that your child might not be getting enough sleep check for these common signs of inadequate sleep:
- Falls asleep during the day such as in the car or at the dinner table
- Difficult to wake in the morning and/or wakes very crabby
- Has a very short attention span with difficulty focusing
- Frustrated and difficult to please-may hit, bite, or scratch
- Is overly clingy and sensitive
It is important to note that the symptoms of sleep deprivation in children may be misleading. A cumulative effect of insufficient sleep can result in hyperactivity. Research in chronic partial sleep deprivation shows that kids who get inadequate sleep will demonstrate impulsivity, irritability, difficulty focusing, and impulse control issues which in some instances may be mislabeled as ADHD. In addition to focus/attention some of the other health conditions associated with lack of sleep in kids are slow metabolism, lowered immune function, mood changes, and learning disorders.
To improve your child’s sleep, I suggest trying the below suggested tips first:
#1 Make the room totally dark (if possible)
Numerous studies show the negative effect even small amounts of light can have on our normal circadian rhythm. Make sure to use black out curtains (especially important in our Northern latitude) to block out natural and artificial street light, and remove all digital clocks, digital tablets, cell phones, and night lights.
#2 Relax into Bedtime
Set a reasonable bedtime. At approximately 30 minutes to an hour before the appointed time, start a series of relaxation activities such as a warm bath, reading a book under soft lighting, or giving your child a relaxing massage. One hour before bedtime avoid eating, wrestling or active play, computer games, television, or any stressful activities which can lead to an increase in alertness. Some herbal formulas aimed at relaxation may also be helpful before bedtime such as Calm Restore by Gaia Kids.
#3 Be Consistent
Going to bed and waking up at the same time each day sets the body’s "internal clock" to expect sleep at a certain time night after night. Try to continue your child’s routine on weekends to avoid a Monday morning sleep hangover.
#4 Get Help
If you have tried the above measures and you do not see improvement in the quality or quantity of your child’s sleep then I recommend consulting with a physician. Bedwetting, teeth grinding, night terrors, and sleep walking in children are signs that warrant a thorough medical exam. If your child has a sleep disturbance your doctor may run tests to rule underlying physical cause such as heartburn, constipation, breathing difficulties, skin disorders, and thyroid disease.