Concerned about your child’s irritability, sadness, difficulty managing emotions, trouble concentrating, seeming forgetful, poor school performance, physical complaints such as headaches or stomach upset, or trouble waking in the morning? Each of these concerns may be a sign of inadequate sleep. Sleep serves as a foundation that supports children’s mental health, emotion regulation, behavior, attention, learning and physical health. For this reason, taking a good look at your child’s sleep can be a helpful first step in addressing a wide range of concerns.
Children need a lot of sleep! The American Academy of Pediatrics recommends:
· 10-13 hours of sleep for 3- to 5-years-olds (this includes naps)
· 9-12 hours of sleep for 6- to 12-year-olds
· 8-10 hours of sleep for 13- to 18-year-olds
How can we set up children for good, quality sleep?
Aim for consistent bedtime and wake up times that allow the recommended amount of sleep for their age. Try to not to alter bedtime and waking time by more than 1 hour on weekends or while on vacation.
Create a bedtime routine that begins at the same time each night and includes the same activities such as putting on pajamas, brushing teeth, washing face, and then reading.
Screen activities (phone, tablet, television, computer, etc) are a significant factor affecting many children’s sleep. Avoid screen activities for at least 30 minutes before bedtime. Collecting all electronics at bedtime is a helpful strategy. It’s also helpful to avoid having a television or computer permanently located in children’s bedrooms.
Be sure that your child’s bedroom is quiet, cool and dark. Some children prefer to have a nightlight. If this is the case for your child, keep the amount of light as low as they will tolerate.
We want children’s brains to associate their bedroom, particularly their bed, with sleep. For this reason, try to make sure your child’s bed is only used for sleeping and not for other activities, such as eating, playing on the phone or tablet, watching television, etc. Try to reinforce the idea that the bed is only for sleeping.
Avoid daytime naps for children who no longer nap since random naps may disrupt their typical sleep schedule. For children who regularly nap, aim for a consistent nap duration since an extra lengthy nap can make bedtime difficult later.
Avoid caffeine, sugar and large meals before bedtime. Exercise can promote good sleep but try to avoid high levels of physical activity within 2 hours of bedtime.
Consider practicing relaxation techniques, such as progressive muscle relaxation, to help reduce physical and emotional arousal before going to sleep. Instructional videos can be found online.
Try to identify any differences between nights when your child is able to settle to sleep quickly and those nights that are difficult. Older children may be able to help with this by keeping a sleep diary to record how much time they slept the night before and how they feel the next day. Over time, it may be possible to identify behavior patterns, underlying difficulties and potential influences on the quality and quantity of sleep.
If you’ve tried the strategies outlined above and sleep continues to be a concern, consider consulting with your child’s pediatrician. Working with a mental health provider may also be helpful, particularly if anxiety or behavioral concerns seem to be impacting sleep. Occupational therapists can also support routines surrounding bedtime and modifications to the physical environment to improve sleep hygiene.
Books for children about sleep:
What to Do When You Dread Your Bed by Huebner and Matthews guides children and their parents through the cognitive-behavioral techniques used to treat problems with sleep.
Emily Grace and the What-Ifs: A Story for Children About Nighttime Fears. By Lisa B. Gehring includes information and strategies for coping with bedtime struggles.
Helpful websites: