Sleeping Problems in Children

Chronic sleep problems put kids at increased risk for behavioral problems, attentional difficulties and even obesity.  The amount of sleep a child needs is variable and generally depends on the child’s age.  The National Sleep Foundation reports that, on average, children need to following amount of sleep.

Below 12 months of age:  more than 14 hours per day

1-3 years:  12-14 hours per day

3-5 years:  11-13 hours per day

5-12 year:  10-11 hours per day

Adolescents: 8-10 hours per day

Many children have trouble getting or staying asleep and more and more parents are turning to medications and over-the-counter pills such as melatonin.  While some studies show that they are generally safe and effective in the short term, their long term safety has not been established and many parents report that they lose their efficacy over time, resulting in higher doses or switches to more powerful agents. 

Before considering this path, it is worthwhile to check in with families about sleep hygiene.  Of particular significance to children are the following items that can markedly improve sleep without resorting to pills. 

  • Exercise.  Kids weren’t designed to sit around on the couch all day, and parents shouldn’t be surprised when more sedentary children don’t feel tired at night.  Encourage families to start early in enforcing regular exercise and limits on television and video games.
  • Caffeine.  Most parents know about coffee and cola, but caffeine can be found in many other food products from chocolate to other types of soda.  These items can make it very difficult to fall asleep.
  • Bedtime routines.  While a slightly later bedtime at night on weekends and vacations is probably okay, most kids get to sleep better when their bedtime is consistent and part of a nightly routine.
  • Sleeping environment.  Keep TVs and computers out of child bedrooms, and have good shades on the windows.  Temperature, noise, and the mattress can all play a role in making an optimal environment for sleep.

 In the primary care office, a couple other situations are also worth mentioning.

  • In working with a family trying to wean off a sleeping pill, it can be very useful to instruct them to begin tapering on days that the child might be extra tired (like after a big soccer game).  Also, it can be very important to help parents anticipate that sleep might first get worse before it gets better when stopping or reducing a sleep agent.  This anticipation can help them not give up too quickly.
  • In working up ADHD or depression, take time to investigate sleep.  For some children, the sleep problems are a result of the underlying condition, but for others it may be more of a cause of the symptoms.

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