Sleep Disturbances in Children

Children spend about 40% of their childhood asleep. Those restorative hours of slumber are as important to a child’s health as nutrition and exercise, allowing the body and brain to flush out toxins, consolidate memories, release growth hormone, lower stress hormones like cortisol, as well as repair and replenish cells. Poor sleep can lead to excess weight gain, diabetes, learning and memory problems, daytime tiredness, moodiness, clumsiness and accidents, and trouble paying attention. Unfortunately, studies suggest that over the last century, the amount of sleep that children get has been declining.

Parents who are concerned about their child’s sleep patterns will be reassured to know that in general, up to 40% of children experience sleep disturbances, and usually the problem is temporary or can be remedied. Later this week, we’ll share some mindfulness techniques that can help children fall asleep and stay asleep. First, however, it is important to know which sleep pattern is typical for each developmental stage.

Newborns sleep between 10-18 hours a day and experience short sleep cycles with frequent awakenings for feeding.
Infants age 3-6 months need 2-3 daytime sleeps of up to two hours each and may still wake at least once at night. They may sleep up to 15 hours a day.
Between 6 and 12 months, most babies stay asleep for six or more hours. They can wake between one and four times a night, and will still need daytime naps. They sleep up to 15 hours a day.
Toddlers (age 12-36 months) sleep between 12-14 hours a day, often including naps
Children aged 3-5 years need around 11-13 hours of sleep a night. From 6-9 years children need 10-11 hours of sleep a night. Tweens entering puberty need 8-10 hours of sleep a night.
Adolescents need around 8-9.5 hours of sleep a night.

It is normal for most young children to wake briefly at the end of a sleep cycle. Some will call out and want help settling back to sleep again, while others will put themselves back to sleep.

When sleep issues arise, they tend to fall into common categories: nightmares and night terrors, sleeping too little or too much, and trouble falling or staying asleep.

Common Causes of Sleep Problems in Children

Toddlerhood: This developmental stage, with its rapid gains in motor, cognitive and social skills, can lead to bedtime resistance and sleep problems. Toddlers may want to stay up with their parents and older siblings, feel anxious about being separated, wake after falling asleep, and call out or wander into their parents’ bedroom. All this is part of a developmental stage that commonly presents as resistance to an early bedtime and is most common until about age five.

Anxiety and Depression: At all ages, anxiety can lead to sleeping problems. Children with anxiety may have difficulty falling or staying asleep, or may refuse to sleep alone. Anxiety may also show up as a fear of the dark or monsters, or an increase in nightmares. Depression can also lead to more frequent nighttime awakenings, or excessive sleep. A traumatic stressful event can cause anxious or sad feelings and sleep disturbances that are usually self-limited. National surveys find that 70% of children experience at least one such traumatic, stressful life event, whether at school, home or in the community

Health issues: Many health issues, such as asthma or autism spectrum disorder, can impact sleep quality, with increased night-time waking or early morning rise times. Attention Deficit Hyperactivity Disorder (ADHD) is also linked with shorter sleep time and more fragmented sleep, which can in turn intensify ADHD symptoms.

Caffeine: Caffeine leads directly to sleep deprivation. A 2010 study in the Journal of Pediatrics looked at 200 children aged five to twelve, and found that three-quarters consumed caffeine on a daily basis. The more caffeine they consumed, the less they slept. As many as three-quarters of adolescents also report that they rely on caffeine and energy drinks to keep them awake. The recommended intake of caffeine for children twelve and up is under 100 milligrams a day—the amount in half a can of soda.

Nighttime “Screen” Exposure: Nighttime exposure to artificial light is associated with poor sleep. Screen time on computers, plasma and LCD televisions, smart phones and tablets, can lead to trouble falling asleep, especially if used within two hours of bedtime. The bright light of a screen, with its blue hue, suppresses the sleep-hormone, melatonin, and disrupts natural dark-light rhythms. This leads to delays in falling asleep.

Changes at Home: Changes at home can upset the regular, reassuring routine of a set bedtime routine. Divorce is one such change. Each year, the parents of more than a million U.S. children divorce. When children divide their time between two homes, bedtime routines may vary widely. Insomnia, oversleeping, bedtime refusals and nighttime waking, are common among children who move frequently between homes and routines. Irregular bedtime routines can also be caused by a new baby or even a new puppy joining the family, by moving to a different city or state, or even going away and returning from summer camp. Parents who work in the evenings or at night may also find it challenging to reinforce bedtime routines.

Hormonal Changes: The natural turbulence of adolescence, with its rapid physical, emotional and sexual changes, can lead to sleep issues. One study of over 4000 teens found that around 14% of teens had experienced insomnia. Another study of over 1,000 teens found that one-third had experienced sleep problems at some point during their lives, including difficulty sleeping at least twice a week for a month or longer during the previous year. In addition, puberty brings a shift in circadian rhythms and melatonin secretion. As a result, teens go to sleep about two hours later than they did when younger, and yet are still required to wake early for school.

The Emotional and Mental Fallout of Poor Sleep

Poor or insufficient sleep can hamper healthy child development. Sleep difficulties can lead to problems with attention, memory, learning and behavior. Children experiencing poor quality sleep can be irritable, moody, fussy, anxious and depressed. Younger children who are overtired may be more impulsive, hyperactive, aggressive or prone to tantrums.

When sleep quality is poor or insufficient, children of all ages can have trouble concentrating and school performance can suffer. One study examined over 86 studies of 35,000 children ages 5 to 12, and found that too little sleep led to behavioral problems and poor school performance. ADHD can be intensified by poor sleep, and some children’s ADHD symptoms have been shown to be largely alleviated by improving sleep habits and routines..

Poor sleep quality in infants is associated with poorer language skills several years later. Lack of sleep can also contribute to an increased risk of obesity and diabetes, conditions which increase a child’s emotional stress and may lead to feelings of shame.

Quality sleep, in sufficient amounts, is the foundation of healthy physical, cognitive, emotional and language development. Later this week, we’ll share some tips on how mindfulness techniques can help your child get more sleep.