Sleep is essential to optimal growth and functioning of the body. It is just as important as nutrition and physical activity. Below is a table of general recommendations on hours of sleep according to your child’s age:
Fifty to seventy million Americans suffer from sleep disorders. How do we help prevent our children from falling into this statistic? Good sleep hygiene! Sleep hygiene is made up of the practices and habits we engage in surrounding the time of going to sleep.
The foundation for our sleep habits are laid when we are infants so developing good habits early is important. The following are age related tips on sleep hygiene. (There are situations, like neurodevelopmental disorders such as autism, that can interfere with the brain’s regulation of sleep and these need to be considered separately.)
Safe sleep to decrease the risk of Sudden Infant Death Syndrome (SIDS) must be practiced above all else in this age group. Babies should always sleep in their own bed, on their backs and without soft or fluffy bedding. Rocking the baby to sleep is tempting but putting babies into bed when they are sleepy but not asleep will teach the baby how to fall asleep on his own. He may cry briefly but most babies will settle to sleep with in a few minutes. Many babies respond well to techniques like swaddling and playing white noise on a sound machine as well.
Having a consistent bedtime routine is essential. This helps the baby to know when sleep time is approaching. A good routine can consist of things like a bath, brushing teeth and reading a story. It is important to put the baby to bed when she is sleepy but not yet asleep so she can learn to fall asleep on her own. Also, continue placing baby in her own bed, on her back and without soft bedding to decrease the risk of SIDS and to avoid developing the habit of co-sleeping. Babies should not take bottles or cups to bed with them as this can damage their teeth as well as creating the habit of needing a bottle to fall asleep. A good naptime routine is also important. If the baby does not get enough sleep through the day it can result in being overly tired at bedtime which makes it harder for the baby to settle into sleep.
Consistent bedtime routines are very important in helping toddlers to know when playtime is over and it is time to settle down for bed. Calm activities and low lighting, as well as avoiding electronics (ie tv, iPad) 1-2 hours before bed, helps the brain to prepare for sleep. Ensuring that toddlers have had sufficient active play time throughout the day and minimal amounts of sedentary activities (like watching tv) helps them accept bedtime better. Most children still need a daily nap until around 3-5 years old. If the child fails to get a nap, or naps for too long, it can be more difficult for him to settle to sleep. It is best to avoid using the bed for punishment, like a “time-out” spot, so there are no negative associations with the bed. Also, remember to place the toddler in his own bed to sleep (and not in bed with parents) which will allow everyone to rest better and not wake each other with nighttime movements and brief awakenings.
A good bedtime routine is still very important in alerting the child to an upcoming expectation of sleep. The bedtime should be fairly consistent, even on weekends, to keep the body in a good rhythm. A calm bedtime atmosphere with quiet activities and low lighting is helpful. Also, avoiding stimulation with substances like caffeine (even up to 4 hours before bedtime) and glowing screens from electronics (which suppress the production of melatonin in the brain) will make it easier for children to settle into sleep.
Many of the same principles for the young child (consistent bedtime routine and no stimulating substances/activities near bedtime) apply to the older child as well. Consider also keeping the location of sleep consistent; not allowing children to sleep half the night on the couch and later moving to their bed. Remember to avoid naps for older children, heavy meals within 1-2 hours of bedtime, as well as electronics in the bedroom which have been shown to interfere with sleep even if turned off.
Here are some additional tips you may find helpful:
1. Stick to the same bedtime and wake time every day, even on weekends. Children sleep better when they have the same bedtime and wake time every day. Staying up late during the weekend and then trying to catch up on sleep by sleeping in can throw off a child’s sleep schedule for several days.
2. Beds are for sleeping. Try to use your bed only for sleeping. Lying on a bed and doing other activities (e.g., watching TV, using a tablet or computer) makes it hard for your brain to associate your bed with sleep.
3. A comfy, cozy room. A child’s bedroom environment should be cool, quiet, and comfortable.
4. Alarm clocks are for waking up. Children who tend to stare at the clock, waiting and hoping to fall asleep should have the clock turned away from them.
5. Bedtime routine. A predictable series of events should lead up to bedtime. This can include brushing teeth, putting on pajamas, and reading a story from a book.
6. Quiet, calm, and relaxing activities. Before bedtime is a great time to relax by listening to soft, calming music or reading a story. Avoid activities that are excessively stimulating right before bedtime. This includes screen time like watching television, using a tablet or computer, and playing video games, as well as physical exercise. Avoid these activities during a nighttime awakening as well. It is best to keep video games, televisions, or phones out of the bedroom and to limit their use at least 1 hour before bedtime.
7. How to relax. If a child needs help relaxing, they can use techniques such as taking deep and slow breaths or thinking of positive images like being on a beach.
8. Start the day off right with exercise. Exercising earlier in the day can help children feel more energetic and awake during the day, have an easier time focusing, and even help with falling asleep and staying asleep later on that evening.
9. Avoid caffeine. Avoid consuming anything with caffeine (soda, chocolate, tea, coffee) in the late afternoon and throughout the evening. It can still cause nighttime awakenings and shallow sleep even if it doesn’t prevent one from falling asleep.
10. If you can’t sleep, get out of bed. If a child is tossing and turning in bed, have them get out of bed and do something that isn’t too stimulating, such as read a boring book (e.g., textbook). They can return to bed once they are sleepy again. If they are still awake after 20-30 minutes, they can repeat the process and get out of bed for another 20 minutes before returning. Doing this prevents the bed from being associated with sleeplessness.
11. Put kids to sleep drowsy, but awake. The ideal time for a child to go to bed is when they are drowsy, but still awake. Allowing them to fall asleep in places other than their bed teaches them to associate sleep with other places than their bed.
12. Offer a stuffed animal or soft blanket. Giving a child a security object can be a good transition to help them feel safe when their parent(s) isn’t/aren’t there. Try to incorporate a doll, toy, or a blanket to comfort them when it’s time for bed.
13. Bedtime checkups should be short and sweet. When checking up on a child, the main purpose is to let them know you are there and that they are all right. The briefer and less stimulating, the better.
14. Maintain a sleep diary in order to track naps, bedtimes, wake times, and behaviors to find patterns and work on particular problems when things are not going well.
This is not an exhaustive list of tips for good sleep, but hopefully it can help your family to make some good habits that will result in restful nights. If your child is experiencing persistent sleep problems please make an appointment with one of our providers to discuss it further.