5 Sleep Problems in Children, and How to Fix Them

Tired Teenager With Tablet“The city that never sleeps” should not be your home. But everyone did warn you. Last week’s blog–Why Does My Baby Not Sleep Longerwas about normal sleep; this week’s is about some of the problems that you may encounter trying to achieve that.

Not Getting Enough  Sleep?

If children are not getting enough sleep, they will not wake up by themselves in the morning, they will be sleepy during the day, and they may be moody and irritable. Kids who do not get enough sleep are not as able to control their emotions.

Chronically sleep deprived kids may have behavior problems that mimic attention problems. They can be emotionally labile. They injure themselves more often because they can be clumsy. Their grades fall because they are sleepy in class. They gain weight because their metabolism is confused.

If your child is showing symptoms of inadequate sleep, move their bedtime back until the symptoms go away. You cannot make them fall asleep, of course, but you can insist that they rest quietly in a darkened, cool room. No TV! Boredom will put them out in the end, and their systems will adjust to the new routine after a couple of weeks.

Infants

Trouble getting an infant to sleep? The bedtime routines described in last weeks blog will help, but also:

If a baby is waking up frequently at night, sometimes they sleep better if you can squeeze in one more feeding per day. Usually you can convince them to eat more often in the morning. Starting them on solid food early doesn’t help, no matter what Grandma said.

They will also sleep better if they are more awake during the day: play with them, keep them moving, and keep the light level up.

Media

Media does have an affect on sleep. Violent shows and games do keep kids up at night, and anything on a screen will affect their sleep within an hour or two of bedtime. If you like your rest, don’t let your kids engage with violent media or watch shows that scare them. Turn the screens off an hour or so before bed. Never put a TV in their bedroom. If you already have one in there, take it out. You need to be able to monitor what they watch anyway.

Get Physical

Diet matters, yet again. If you want your kids to sleep, don’t give them caffeine. It keeps people awake (you knew that, didn’t you?). Caffeine is in most sodas and tea, coffee, energy drinks, and chocolate.

Also avoid heavy, high fat or high sugar foods near bedtime.

Make sure your child gets at least twenty minutes of high heart rate and heavy breathing exercise every day. Run, play ball, jump rope – whatever they like. Keep it going for twenty minutes after they start breathing heavily. It will clean out the stress chemicals in their blood stream. Don’t get the exercise right before bed, however. It will wake them up (I know, you knew that too). If you want to exercise near bedtime make it yoga, or slow relaxing stretches.

Don’t expose your child to cigarette smoke if you want him to sleep. Nicotine is a stimulant. Keep the cigarettes out of the house and car even when he isn’t there. The poisons hang out in fabrics, on the walls and in the air.

There are some medical issues that can interfere with a child’s breathing during sleep, when their airway relaxes. Large adenoids, large tonsils and morbid obesity will block the flow of air into their lungs and they will wake up just enough to breathe over and over again through the night. They might snore, they will usually be tired during the day, or they might have behavioral issues. If your child shows signs of obstructed breathing, bring it up with your doctor.

Separation and Change

Separation anxiety can also keep a child awake. If your little guys suffer from this, leave the door cracked so they can hear you. Check on them every ten minutes or so until they fall asleep. Give them their comfort objects. It will pass.

Children will also have poor sleep when there are changes in their lives. If they have been ill and the routine changed while they were sick, it will take some effort to get it back. After a move, death, or divorce an established routine will save you. Stick to it and your child will feel more secure and safe, and may actually get some sleep.

Inheritable Stuff

Night terrors, sleepwalking, sleep talking and bedwetting are all genetic and inheritable. Most are more common in boys than girls. They generally occur when the child is sleeping deeply, more commonly early in the night. They grow out of these problems in the end, and nothing but time will cure them.

Night terrors are different than nightmares. When a child wakes from a nightmare he generally has been in a lighter sleep, usually later toward the morning. He wakes up and can remember the nightmare. He can be comforted.

A child in a night terror is still very deeply asleep. Their eyes may be open but they are not awake and they are not seeing what is actually there. Where you are standing they could be seeing the monster in their dream. Night terrors can last from ten to thirty minutes, and can occur for up to twelve years. They tend to occur when the child is overtired and sleeps very deeply. Contrary to popular belief, stress does not cause night terrors – unless it causes the child to be overtired.

You cannot comfort a child during a night terror because they are asleep. Speaking calmly seems to help, but don’t be surprised if they don’t want to be held. Watch them, keep them safe and wait it out. They will not remember it at all. There is no quick fix and there are no medicines that help, only the passage of time.

In The End

Children need to get enough sleep or they can have physical, behavioral or emotional problems. Avoid things – like high sugar foods, caffeine and violent television – that make sleep less likely, especially right before bed. Encourage exercise. Establish a relaxing routine that you can stick to every night, with quiet low light activity and comfort; keep a regular bedtime and enforce it. Having a bedtime routine will save you many arguments and will help your child feel more secure in times of upheaval. Sadly, you cannot make a child sleep, but you can insist that he or she rest in a darkened, boring, TV-less room. They will, in the end, get the sleep they need.

The Blogger's Pit Stop

Why Does My Baby Not Sleep Longer? (And 8 Things to do About It)

Adorable Sleeping BabyThe one warning all new parents receive is, “Enjoy your sleep now, you won’t get any after the baby arrives!” Babies sleep all the time – just never when we want them to.

The Science of Sleep

There are many geeky scientists who study sleep, and they have made some helpful and interesting discoveries. The most relevant of these for new parents is that people sleep in cycles, from light sleep to heavy and back again.

Infants cycle from light back to light sleep every hour. This cycle means that about once an hour they are sleeping lightly and may wake up. After about six months of age they can learn to put themselves back to sleep. They are not hungry and do not need to be fed, after that initial newborn period. They are not lonely and do not need to play. They need to learn to go back to sleep. When you check on them be boring, leave the room dark, pat them on the bottom and leave. Do not pick them up, do not play with them, and do not feed them if you ever want a full night’s sleep again.

Remember the part about how children will do what they are rewarded for doing? Picking them up, feeding them and playing with them is rewarding them for waking up.

Babies should come with warning labels.

So what’s normal?

Newborns sleep about sixteen hours a day, but only two to three hours at a time. Fortunately, they’re so cute that you don’t mind too much when they wake you up.

By about four months they will have one longer period of sleep (about four or five hours) per day. Heaven! Make sure it happens at night. You can’t keep babies from falling asleep, but you can certainly wake them up early if they try for that five-hour nap midday.

A six month old might sleep for ten or eleven hours straight to total, with naps, around fourteen hours.

The average toddler will sleep twelve or thirteen hours total. Most will take two naps until between eighteen and twenty-four months, then one nap until they are three to five years old. There is, of course, individual variation.

School aged children sleep between nine and twelve hours per night, taking about thirty minutes to fall asleep. No napping or they won’t sleep at night!

Bedtime Routine

A bedtime routine is the single most important tool you have in your arsenal to get your kids to sleep, and can be very reassuring when other things in their lives change. The details vary from family to family, but there are common elements that work:

  • Give them a light snack an hour or two before bedtime. Aim for low fat and low sugar. Fruit or a complex carbohydrate will work, like whole grain crackers or pop corn.
  • Notice if there is a time in the evening when your child slows down and gets sleepy: this is their natural bedtime. They will fall asleep more easily at this time. If they stay awake past it they will either get grouchy and irritable or, worse, find their second wind.
  • Slow things down an hour or so before bed. Turn the television and electronic games off. Lower the light level. Turn on some quiet music.Give them a nice warm bath (just like Grandma always said). Read a storybook.
  • Tell them how wonderful they are: going to sleep is easier when you’re happy.
  • Tuck them in with their comfort object, their night-light and their bottle of water (if they want them).
  • Make sure they are comfy – keeping it a little cool will help.
  • Leave while they are still awake, because you want them to be able to fall asleep without requiring your presence.
  • Once they are in bed, they need to stay there. If they get up, put them back. If you need to check on them, be boring. “You’re fine, it’s bedtime, go to sleep.” Don’t get angry, or you’ll upset them and they’ll stay up longer. Leave the lights off.

The routine should never vary much. Bedtime should be the same every day, unless dealing with a jet-lagged kid is your idea of fun. If you do the same things in the same order at the same time every night they will be so used to it that you will rarely, if ever, get an argument. The routine itself will trigger sleepiness.

If you get flexible, vary the routine a lot, or let them stay up late now and then you might have difficulty the next time they need to go to bed.

The absolute worst thing to do is to give in to whining. Planning ahead with “We’re staying up late tonight because it’s a holiday” will not set a precedent. Giving in to whining with “Fine, I’m tired of listening to you,” will. You will have taught them that if they whine enough they will get what they want. Then, since you have rewarded whining, you will see more of it.

If you are in a strange place or your family life is in upheaval, keeping the bedroom routine the same will not only help them fall asleep more easily but will also make them feel more safe and secure. Don’t forget to pack that Teddy bear and their favorite storybooks if you travel or when there is a family change or trauma!

Want answers on specific sleep problems like night terrors or airway obstruction? Come back next week, of course!

The Blogger's Pit Stop

Your Kid’s Brain on No Sleep

Tired Teenager With TabletEvery animal sleeps. Birds sleep attached to their branches, bats sleep upside down, whales sleep half their brains at a time–all of us need to catch some Z’s. Science doesn’t have a complete understanding of why we sleep, but we do have some ideas and we know people run into problems if they do not get enough.

Humans sleep in cycles from light sleep into heavy and then into dreams. Adults cycle about four times per night; infants cycle about every hour (that’s why they can wake up every hour). Each stage has a function: if you don’t get enough time in each stage you will not feel rested, even if you spent enough hours horizontal.

During the first stage, or “N1”, you are in drowsy sleep. You are not completely out, but neither are you completely aware of your environment. If someone sat beside you to read a book you would not notice; if that person said your name you would.

During N2 you loose all conscious awareness; N3 brings you into deep sleep.

Rapid eye movement (REM) sleep is the fourth stage. During REM sleep you dream, and your voluntary muscles become atonic, or mostly paralyzed, so you don’t whack yourself in the head.

Then you cycle through the phases again. Most deep sleep is early in the night; most REM sleep is later toward morning. (That’s why kids mostly wet the bed early in the night.)

If you get enough sleep you feel energetic during the day, your brain works and your emotions are under control.

The opposite happens if you, or your children, are sleep deprived. If your children do not get enough sleep they are tired, they cannot concentrate and they can be irritable.

Lack of sleep affects their working memory: the memory they employ constantly to reason and function. Without an effective working memory they will find it harder to make decisions. It will be difficult to focus and learn.

Sleep is necessary to organize, consolidate and solidify what your children have learned during the day, so it can be there the next day when they need it. There is even some evidence that REM sleep is necessary for your child’s brain to develop properly in the first place.

Many of these symptoms duplicate those of ADD, depression, and Oppositional Disorder. Sleep deprivation also affects the function of your immune system, your ability to heal, your growth hormone levels and your ability to lose weight–important stuff.

So how do you know if your children are getting enough sleep? Look at them during the day. If they are sleeping adequately they will wake up easily, perhaps without an alarm. They will be awake during the day, not sleepy, not dosing off when they are still. They will be less irritable. They will be able to concentrate, focus and learn.

If they are not getting enough sleep, getting more is a priority. Make sure there is enough time allotted in their busy schedules, and try to make bedtime the time of day that they are actually sleepy. Every person has a circadian rhythm that includes a time in the evening when they get drowsy. That time should be bedtime. It should be approximately the same every day, to avoid permanent jet lag.

During the day make sure they eat healthy whole foods. No caffeine please, no tobacco exposure (yes I mean you!) and watch that sugar intake. Also, they need at least twenty minutes of aerobic exercise every day to wash those stress chemicals out of their bodies.

Quiet things down about two hours before bedtime: no TV, no vigorous exercise. Turn on some quiet music, play a board game, or read a book. Lower the light level. Give your youngster a warm bath and read a bedtime story. Don’t even think of having a TV in the bedroom! Make their bedroom comfortable, quiet and a little cool.

Enough sleep is essential if you want a child who is not moody and has a functioning brain and energized body. If you are thinking your munchkin has a behavioral problem like ADD, Oppositional Defiant Disorder or depression, consider first whether he or she is getting enough sleep. If not, change what you need to to ensure that they do. Get that TV out of the bedroom, give them a healthy diet and enough exercise, and don’t expose him to cigarettes. Quiet things down two hours before bed. And get some sleep.

Domesticated Momster