Kick Off the New School Year with Healthy Sleep Habits

Bedtime troubles are very common at some point in most children’s lives. This often disrupts the household, and it prevents a child from getting the amount of sleep they need. This can also affect a child’s performance at school.

20130426_0079newJust in time for back to school, check out the following guidelines to help establish good sleep habits for your children.

Your child should be getting the recommended amount of sleep depending on their age.

Please note these recommendations are only guidelines and not every child will follow them.

Age 1 to 2: 10 to 12 hours at night /  one to four hours during the day

Age 3 to 5: 10 hours at night  /  up to one hour during the day; child may outgrow a nap at this age

Age 6 to 11: 10 hours at night  /  No daytime nap

Tips for establishing good sleep habits

• Older babies and children should have a nap time and bedtime schedule.
• Limit screen time to no more than two hours per day, including time spent in front of smart phones, tablets, computers and TVs. Screens should be turned off at least two hours prior to bedtime.
• Start a quiet time, such as listening to quiet music or reading a book, 20 to 30 minutes before bedtime. TV or other digital screens should not be a part of the quiet time.
• After quiet time, follow a bedtime routine, such as a diaper change, going to the bathroom and brushing teeth.
• Set a time limit for quiet time and the routine so it does not drag on and your child knows what to expect before bedtime.
• Say goodnight, turn off the light and leave the room.
• Security objects, such as a special blanket or stuffed animal, can be part of the bedtime routine.
• It is important for children to be put to bed awake so they learn to fall asleep themselves.

What if my child won’t go to sleep?

Young children can easily fall into bedtime habits that are not always healthy. These suggestions can help when a child does not want to go to bed or is having trouble staying in bed:

• If your child cries, speak calmly and reassure him or her, “You are fine. It is time to go to sleep.” Then leave the room.
• Do not give a bottle or pick up your child.
• Stretch out the time between trips to the room if your child continues. Do not do anything but talk calmly and leave.
• Your child will calm down and go to sleep if you stick to this routine. It may take several nights for your child to get used to the new plan.
• If your child is used to getting a large amount of milk right at bedtime, start to cut down the amount of milk in the bottle by 1/2 to 1 ounce each night until the bottle is empty and then take it away completely.
• Sometimes children get out of their routine of night sleeping because of an illness or travel. Quickly return to good sleep habits when things are back to normal.

Older children sometimes go through a stage when they revert back to bad sleep habits or develop new problems. Here are some tips to help parents with older children who have problems going to bed.

• If your child gets out of bed, take him or her back to bed with a warning that the door will be shut (not locked) for one  or two minutes if he or she gets out of bed.
• If your child stays in bed, the door stays open. If your child gets out of bed, the door is closed for two minutes. Your child can understand that he or she has control of keeping the door open by staying in bed.
• If your child gets out again, shut the door for three to five minutes (no more than five minutes).
• Be consistent. Put your child back in bed each time he or she gets out of bed.
• When your child stays in bed, open the door and give your child praise (for example, “You are doing a great job of staying in bed. Goodnight.”).
• Your child can be rewarded by earning a star on a calendar for staying in bed all night. You can give a special prize for a certain number of stars earned.

If you think your child might have a sleep disorder, talk to their pediatrician about having a CHOC Children’s sleep study. For more on kids and sleep, please click here.

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Tips for Avoiding Pediatric Sleep Disorders and Coping with Daylight Saving Time

By Dr. Anjalee W. Galion,  CHOC Children’s neurologist

Losing an hour of sleep as we “spring forward” to daylight saving time can wreak havoc on sleep schedules this week, especially children who already struggle with sleeping problems. Due to their developing brains, children can be particularly sensitive to sleep deprivation.

According to the National Pediatric Sleep Foundation, about 71 percent of infants wake at least once, and 21 percent of infants wake up three or more times per night.  Thirty percent of parents report their children have difficulty with sleeping – – across all ages.

Signs and symptoms of pediatric sleep disorders

Dr. Anjalee Galion, CHOC Children's Neurologist
Dr. Anjalee Galion, CHOC Children’s Pediatric Neurologist

Sleep -deprived children exhibit symptoms differently than adults.  Adults usually experience general daytime sleepiness, whereas children tend to display sleepiness in a variety of ways, such as showing traits of inattention and hyperactivity that are sometimes mistaken for ADHD.  Additionally, sleep deprivation in children causes physical stress, which can contribute to difficulty initiating and maintaining sleep.  Many parents might recognize this trend when trying to keep their children awake until late at night, which can actually lead to children having trouble staying asleep and waking up earlier than normal.

Turn off the TV

The blue light emitted by all screens (TV, computer, smart phones, tablet devices, etc.) can interfere with the way the brain identifies day and night. The brain uses the eyes to give cues to lightness and darkness to set the body’s internal clock, also known as the circadian rhythm. Having “screen time” throughout the day, and especially at night makes it difficult for the body to identify day and night and can cause significant difficulty falling asleep or staying asleep.

The National Sleep Foundation found that children with TVs in their rooms are most likely to be among the worst sleepers. The presence of the screen, even if it is turned off, activates the brain and makes it more difficult to go to sleep and stay asleep. Children who get more sleep are more likely to read books as part of their bedtime routines, instead of time in front of a screen. It’s best to encourage children to enjoy reading in the few hours before bedtime.

Daylight saving time tips

Adhering to a consistent sleep schedule – as close as possible to a child’s normal routine – is particularly important during this time.  As easy as it may be to permit kids, who don’t feel sleepy or can’t sleep as a result of the longer days, to stay up later, such a habit will disrupt sleep patterns. The use of blackout shades and a timed night light can serve as consistent cues for little ones, letting them know when it’s time to sleep and time to wake up.

Dr. Anjalee W. Galion is a CHOC Children’s pediatric neurologist who is also fellowship trained in sleep medicine. She is actively involved in pediatric sleep medicine research having completed National Institutes of Health – National institute for Neurologic Disorder and Stroke clinical trials fellowship. She has also developed protocols to improve sleep in children with autism.  Dr. Galion is also trained in cognitive behavioral therapy for sleep disorders and has authored a book chapter on the evolution of insomnia from children to adults.  She is actively involved with reading sleep studies and in the comprehensive diagnostic evaluation of children with all types of sleep disorders. 

More articles about healthy sleep and kids:

  • 7 Tips to Help your Child Sleep Better
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  • Meet Dr. Anjalee Warrier Galion
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Kids and Sleep

boy and bear - sleep

Sleep is an essential part of your growing child’s health. When it comes to making sure your children are getting the proper amount of Z’s, there are some guidelines you can follow. Infants, on average, sleep 10 to 12 hours per night. Newborns and adolescents typically sleep eight to 10 hours. The recommended amount is about nine hours a night for teenagers, says Dr. Triebwasser.

DON’T SKIMP ON SLEEP

When kids don’t get enough sleep, they will experience a lag, both physically and mentally, and often appear cranky. Their school performance and immune systems also may suffer. “People get sick when they don’t sleep as much,” says Dr. Triebwasser. “It’s hard to learn when your brain is not well-rested.” Like washing your hands to avoid germs, children need to develop proper sleep “hygiene.”

Parents should also be aware of sleep disorders like restless leg syndrome, when people move their legs excessively or sleep apnea, which happens when you have one or more pauses in breathing while you sleep, lasting from a few seconds to minutes. If your child experiences any abnormal sleeping patterns, discuss it with our physician.

POWERING DOWN

For teenagers, the biggest interference with turning in “on time” is a lot of homework, video games, texting and social media, says Dr. Triebwasser. Since common sleep issues such as difficulty falling asleep or staying a sleep can result from poor sleep hygiene, teens should take several precautions:

  • Go to sleep at a reasonable time
  • Avoid late-night television
  • and snacks
  • Try not to over stimulate their brains right before bedtime

How can parents with younger children enforce healthy sleep habits?

  • Say good night, turn off the light, and leave the room
  • Put children to bed awake
  • Make naptime part of a routine

FAST FACTS

  • Hours of sleep per day that preschoolers need: 12
  • Hous of shut-eye teens need per night: 9
  • Minutes of quiet time suggested before bed: 30

 

Dr. Harvey S. Triebwasser
Dr. Harvey S. Triebwasser
CHOC Adolescent and Pediatric Specialist

PHYSICIAN FOCUS: DR. HARVEY S. TRIEBWASSER

Dr. Triebwasser is a longstanding member of the Society for Adolescent Medicine. He specializes in adolescents and pediatrics. He served his internship and residency at Cornell New York Hospital.

Dr. Triebwasser’s philosophy of care: “The most important thing to raising teenagers is love and limits.”

EDUCATION:
State University of New York – Downstate

BOARD CERTIFICATIONS:
Pediatrics and Adolescent Medicine

More about Dr. Triebwasser

This article was featured in the Orange County Register on September 4, 2013 and was written by Shaleek Wilson.

View the full feature on Kids and Sleep

Set the Stage for a Peaceful Night’s Rest

It’s not clear at what age kids begin to dream, but even toddlers may speak about having dreams — pleasant ones and scary ones. While almost every child has an occasional frightening or upsetting dream, nightmares seem to peak during the preschool years when fear of the dark is common. But older kids (and adults) have occasional nightmares, too.

Nightmares aren’t completely preventable, but parents can set the stage for a peaceful night’s rest. Helping kids conquer this common childhood fear also equips them to overcome other scary things that might arise down the road.

Check out our Kids Health patient education resource on choc.org  for some great tips on this common topic.

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Establish a Consistent, Soothing Bedtime Routine for Your Kids

Getting plenty of sleep should be part of every child’s routine, especially now that school is back in! Sleep is especially important for growing children as it directly impacts mental and physical development.

Check out these quick tips to help your littles ones sleep tight:

  • Keep a consistent bedtime and soothing routine for getting to bed.
  • Make sure your child has everything he or she needs to get a good night’s sleep, including: a place to sleep with comfortable temperature, ventilation, and a nightlight if age appropriate.
  • Turn off the TV, video games and computer at least 30 minutes before bedtime.
  • To help your child unwind, a bath, warm drink or story time can help.
  • Praise your child for staying in bed.
  • Don’t return to your child’s room every time he or she complains or calls out. Instead, wait several seconds before answering and make your response time longer each time he/she calls. Reassure your child that you are there, and that it’s time to go to sleep.
  • Helping your child develop good sleep habits can take time. Be patient and understanding.

Check out additional tips on creating consistent and soothing bedtime routines.

Related articles:

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