Sleep is Critical to a Child’s Development, Health and Quality of Life.

Sleep is Critical to a Child’s Development, Health and Quality of Life

Childhood is an Opportune Time for Parents to Help Their Children Establish Good Sleep Habits

This is important for: Prevention of common sleep

problems Developing a positive attitude

about sleep Developing a healthy

“sleepstyle”

The Drive to Sleep is Regulated by Biology

Biological Time Clock and Circadian Rhythms

Sleep Architecture Changes Over Time

Hours in Sleep

Slee

p St

ages

Children’s SleepAwake

REM

1

2

3

4

1 2 3 4 5 6 7

Sleep Needs, Characteristics, Patterns and Issues Vary Throughout Childhood

Amount of Sleep Needed Characteristics of Sleep

Sleep Developmental Tasks (Milestones)/Issues

Newborns (0–2

months)10.5–18 hrs.

Irregular sleep patterns until about 6–8 weeks that interact with hunger; multiple sleep periods in day and night; Sleep is active: smiling, sucking, body movements

Sleep on back to prevent SIDS: Facilitate nighttime sleep; Create a positive and safe sleeping environment; Identify signs of sleepiness

Infants (2–12 months)

Total Average: 14.5 hrs.

[Naps: 2.5–5 hrs]

Increasing nighttime sleep; sleep pattern emerges; 3–4 naps to 1–2 by end of first year

Create a regular bedtime schedule and routine; Nighttime awakenings; Learning to self-soothe

Toddlers (1–3

years)

Total Average: 12–14 hrs. [Naps: 1.5–

3.5 hrs.]

Morning naps cease around 18 months; most sleep through the night on regular sleep schedule

Follow a bedtime routine; Set limits; Encourage falling asleep independently; Transition from crib to bed

Preschoolers (3–5 years)

Total Average: 11–13 hrs.

Naps usually end by 5 years; nighttime fears may emerge

Consistent sleep/wake time and bedtime routine

School-Age(5–12 years)


Increasing demands on children’s time can lead to sleep deprivation; Impact of TV, computers, caffeine and medical conditions on sleep

Establish lifetime sleep and health habits; Be alert for persistent sleep problems and daytime sleepiness

Tips for Newborns

Observe the 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 The crib should be safety approved A quiet and dark room at a comfortable temperature is best

for sleep Encourage nighttime sleep

Increasing nighttime sleep; Regular sleep pattern emerges; 3–4 naps to 1–2 by end of first year

Infants

Amount of Sleep Needed Characteristics of Sleep

Sleep Developmental Tasks (Milestones)/Issues

Newborns (0–2 months)

10.5–18 hrs. Irregular sleep patterns until about 6–8 weeks that interact with hunger; Multiple sleep periods in day and night; Sleep is active: smiling, sucking, body movements

Sleep on back to prevent SIDS; Facilitate nighttime sleep; Create a positive and safe sleeping environment; Identify signs of sleepiness

Infants (2–12

months)


[Naps: 2.5–5 hrs]

Create a regular bedtime schedule and routine; Nighttime awakenings; Learn to self-soothe

Toddlers (1–3

years)


[Naps: 1.5–3.5 hrs.]





Naps usually end by 5 years; Nighttime fears may emerge

Consistent sleep/ wake time and bedtime routine





Tips for Helping Infants Sleep Well

Develop a regular daily and bedtime schedule

Create a consistent and enjoyable bedtime routine Establish a regular “sleep friendly” environment Encourage your baby to fall asleep independently

and to become a “self-soother”

Toddlers

(1–3 years)

Total Average: 12–14

hrs. [Naps: 1.5–3.5

hrs.]



Amount of Sleep Needed

Characteristics of Sleep Sleep Developmental Tasks (Milestones)/Issues




Infants (2–12 months)


[Naps: 2.5–5 hrs]











Toddlers

Tips for Helping Toddlers Sleep Well

Maintain a daily sleep schedule and consistent bedtime routine

The bedroom environment should be the same every night and throughout the night

Set limits Encourage use of a security object

Preschool-Age Children






Infants

(2–12 months)


[Naps: 2.5–5 hrs]



Toddlers (1–3

years)

Total Average:12–14 hrs. [Naps: 1.5–

3.5 hrs.]

Morning naps cease around 18 months; Most sleep through the night on regular sleep schedule

Follow a bedtime routine; Set limits; Encourage falling asleep inde-pendently; Transition from crib to bed

Preschoolers

(3–5 years)








Tips for Helping Preschoolers Sleep Well

Maintain a regular and consistent sleep schedule Follow-through with a bedtime routine every night The child should sleep in the same sleeping

environment every night. It should be cool, quiet, dark and without a TV

Watch for difficulty breathing, unusual nighttime awakenings, chronic sleep problems, and behavioral problems during the day



School-Age Children


Total Average:10.5–18 hrs.

Irregular sleep patterns until about 6–8 weeks that interact with hunger; multiple sleep periods in day and night; Sleep is active: smiling, sucking, body movements


Infants

(2–12 months)


[Naps: 2.5–5 hrs]



Toddlers (1–3

years)

Total Average:12–14 hrs. [Naps: 1.5–

3.5 hrs.]

Morning naps cease around 18 months; Most sleep through the night on regular sleep schedule

Follow a bedtime routine; Set limits; Encourage falling asleep inde-pendently; Transition from crib to bed

Preschoolers

(3–5 years)

Total Average:11–13 hrs.


Consistent sleep/ wake time and bedtime routine and sleeping environment





Tips for Helping School-Age Children Sleep Well

Introduce healthy sleep habits, disease prevention and health promotion

Continue to emphasize the need for a regular and consistent sleep schedule and bedtime routine

The child’s bedroom should be conducive to sleep: dark, cool and quiet. TV’s and computers should be off and out of the bedroom

Set limits Avoid caffeine Watch for signs of chronic difficulty sleeping, loud snoring, difficulty

breathing, unusual nighttime awakenings and frequent daytime sleepiness

Common Sleep Problems Lead to Serious Consequences

Not enough sleepNot enough sleep

Disruption of sleep(poor sleep)

Disruption of sleep(poor sleep)

Inappropriate timing of sleep

Inappropriate timing of sleep

Daytime sleepiness

Daytime sleepiness

Managing Common Sleep Problems

Bedtime Struggles—Limit Setting Disorder

Nighttime Awakenings

Managing Common Sleep Problems (cont.)

Nightmares Sleep Terrors Sleepwalking Sleeptalking

Sleep Disorders in Children are Treatable

Difficulty initiating or maintaining sleepInsomnia

Partial or complete obstruction in the airway leading to pauses in breathing. The brain is alerted and the child resumes breathing.

Sleep Apnea

Airway passage is partially blocked and air from the nose or throat passes around the blockage causing throat structures to vibrate against each other making the snoring noise

Snoring

SymptomsSleep Problem/Disorder

Symptoms

Sleep Disorders in Children are Treatable (cont.)

• Excessive daytime sleepiness • Involuntary sleep attacks during the day• Can include: cataplexy or sudden loss of muscle tone in response to emotion; sleep paralysis; hypnagogic hallucinations; disturbed nighttime sleep

Narcolepsy

Unpleasant, tingling, or creepy-crawly feelings in the legs with an irresistible urge to move

Restless Legs Syndrome

Sleep Problem/Disorder

Talk to Your Child’s Doctor if Any of the Following Symptoms are Observed:

A newborn or infant is extremely and consistently fussy A child is having problems breathing or breathing is noisy A child snores, especially if the snoring is loud Unusual nighttime awakenings Difficulty falling asleep and maintaining sleep, especially if

you see daytime sleepiness and/or behavioral problems

Keep a Sleep Diary of the Child’s Sleep Habits and Patterns

Parents Can be Effective Models of Good Sleep for Their Children

General Tips for All Children

Establish a regular sleep/wake schedule Recognize signs of sleepiness in your child Understand that sleep needs and patterns change

Follow a 20-30 minute relaxing bedtime routine Bedroom should be quiet, dark and cool Have a light snack (no caffeine) before bed Quiet activities (not television) are more conducive to falling

asleep Exercise daily Get good nutrition Children should nap according to age and sleep needs

References American Academy of Pediatrics. Guide to Your Child’s Sleep: Birth Through

Adolescence. George J. Cohen, ed. New York: Villard, 1999. American Academy of Sleep Medicine. “My Child Snores” brochure, 2000. Chervin RD, Clarke DF, Huffman JL, et al. “School Performance, Race, and Other

Correlates of Sleep-Disordered Breathing in Children.” Sleep Medicine, 2003;4:21-27. Ferber R, Kryger MH, eds. Principles and Practice of Sleep Medicine in Child.

Philadelphia: WB Saunders , 1995 Goodwin JL, Babar SI, Kaemingk KL, et al. “Symptoms Related to Sleep-Disorder

Breathing in White and Hispanic Children: The Tucson Children’s Sleep Assessment.” Chest, 2003;124(1):196-203.

Gottlieb DJ, Vezina RM, Chase C, et al. “Symptoms of Sleep-Disordered Breathing in 5-Year-Old Children Are Associated with Sleepiness and Problem Behaviors.” Pediatrics, 2003;112(4):870-877.

Mindell JA. Sleeping Through the Night: How Infants, Toddlers and their Parents Can Get a Good Night’s Sleep. New York: HarperCollins, 1997.

Mindell JA, Owens JA. A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Philadelphia: Lippincott Williams & Wilkins, 2003.

National Sleep Foundation. “Children and Sleep” sleep sheet. National Sleep Foundation. Sleep in America Poll, 2004. Children and Sleep. National Sleep Foundation and Johnson and Johnson. “Babies and Sleep”

package for parents and pediatricians, 2002. Owens JA, Maxim R, McGuinn M, et al. “Television-Viewing Habits and Sleep

Disturbance in School Children.” Pediatrics, 1999;104(3). Owens JA, Spirito A, McGuinn M, et al. Sleep Habits and Disturbance in

Elementary School-Age Children. Developmental and Behavioral Pediatrics 2000;21(1):27-34.

Rosen G. “EDS [Excessive Daytime Sleepiness] in Children.” Sleep Medicine Alert 1999;4(3):5-6, National Sleep Foundation.

References

American Academy of Sleep Medicine (AASM) T: (708) 492-09301 Westbrook Corporate Center, Suite 920 www.aasmnet.orgWestchester, IL 60514

Sleep Research Society T: (708) 492-09301 Westbrook Corporate Center, Suite 920 www.sleepresearchsociety.orgWestchester, IL 60514

National Center of Sleep Disorders Research (NCSDR) P: (301) 435-01992 Rockledge Center, Suite 7024 www.nhlbi.nih.gov/about/6701 Rockledge Drive, MSC 7920 nscdr/index.htmBethesda, MD 20892-7920

Narcolepsy Network Inc. P: (513) 891-352210921 Reed Hartman Highway www.narcolepsynetwork.orgCincinnati, OH 45242 e-mail: [email protected]

American Sleep Apnea Association P: (202) 293-3650A.W.A.K.E Network www.sleepapnea.org1424 K Street, NW, Suite 302 e-mail: [email protected], D.C. 20005

Restless Legs Syndrome Foundation819 Second Street S.W. www.rls.orgRochester, MN 55902-2985

References

National Sleep Foundation

The National Sleep Foundation is an independent nonprofit organization dedicated to improving public health and safety by achieving public understanding of sleep and sleep disorders, and by supporting public education, sleep-related research and advocacy.

1522 K Street, NW Suite 500Washington, DC 20005

202-347-3471Website: www.SleepFoundation.org

©2003

Sleep is Critical to a Child’s Development, Health and Quality of Life.

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