Children and Sleep: A Comprehensive Guide To Healthy Development
Dr. Jade Wu
Dr. Wu is a licensed clinical psychologist specializing in behavioral sleep medicine with degrees from Cornell University and Boston University. She also completed her medical psychology residency and clinical fellowship at Duke University School of Medicine.
We all need plenty of sleep to get through the day, but compared to adults, children and pre-teens have an even higher incidence of issues stemming from sleep deprivation. After all, kids need more sleep than the rest of us because their bodies and brains develop rapidly over a relatively short period of time. Without those pivotal snoozing hours at night, development can become seriously disrupted.
The earliest sleep studies for children were conducted in 1897—clearly, this question has been on our minds for a long time. If you notice signs of sleep problems in your child, it’s probably time for an intervention. Some of the most common symptoms you might notice include frequent napping during the day (unless your child is a baby, in which case they need plenty of naps), behavioral issues, lacking interest, and mood swings.
Addressing sleep deprivation in your kids early is the best course of action so as not to delay child development. What’s more, establishing good sleep habits at an early age can pave the way for a healthy relationship with sleep in adulthood.
How Much Should Children Sleep?
The American Academy of Sleep Medicine recommends children sleep the following amounts by age:
- 4-12 years old: 12-16 hours
- 1-2 years old: 11-14 hours
- 3-5 years: 10-13 hours
- 6-12 years: 9-12 hours
- 13-18 years: 8-10 hours
As children age, they need less sleep, but overall, from birth until adulthood, they need more sleep than the average adult. One reason for this could be the large impact sleep has on brain growth and development.
How Does Sleep Affect Healthy Development?
When you lie down to sleep each night, your body goes through a series of sleep cycles, and each of them is responsible for renewing and repairing your body in various ways. Besides the physical rest your body needs at the end of every day, your brain needs both REM (rapid eye movement) and NREM sleep (non-REM) to convert short-term memories to long-term, help you process the events and emotions of the day, and maintain a healthy metabolism.
Most of us have a four-stage sleep cycle and it works like this:
- Stage 1: Lightest stage of sleep; you become drowsy and your eyelids begin to close. Your heart rate and body temperature drop to prepare for sleep. You can easily be awakened from this stage.
- Stage 2: Brain waves called K-complexes and sleep spindles are released to protect you from waking up. The brain begins to process your memories and everything else you experienced during the day.
- Stage 3: This stage is the deepest stage of sleep. Your brain goes through delta or slow waves during this stage, and engages in many important tasks like boosting your immune system, clearing toxins from the brain, consolidating memories, and releasing growth hormones.
- REM: REM stands for “Rapid Eye Movement.” During this stage, you experience vivid dreams, and your brain goes through emotional processing.
Throughout the night, you cycle through these stages several times. Newborns ages 0-4 months sleep most of the day. Their sleep is somewhat different from older children and adults, consisting of “Quiet Sleep” (NREM sleep) and “Active Sleep” (REM sleep). As they get older, the distinctive brain waves of each sleep stage begin to emerge.
If your child seems to have trouble sleeping, it’s understandable to be concerned about their development. One comprehensive study sought to answer parents’ most common questions regarding sleep health in children. It concluded the following:
- Parents who rock their babies to sleep versus allowing the baby to self-soothe and “put themselves to sleep” had children with more sleep issues, specifically frequent night-waking.
- Nighttime sleep disruptions can lead to irritability, hyperactivity, increased environmental stress, and shorter attention spans.
- Establishing healthy sleep hygiene habits early on led to better sleep patterns as children got older.
Symptoms of Sleep Deprivation in Children
While most children don’t develop full-blown sleep disorders like obstructive sleep apnea or Restless Leg Syndrome, poor sleep patterns in their youth can set them up for developing these and other sleep disorders in adulthood.
If you notice these symptoms in your child or children, it’s time to start developing healthier sleep hygiene habits. If the problem persists or seems serious, go to a doctor.
|Age Range||Common Sleep Deprivation Symptoms|
|Infants and toddlers||Cranky, whiny, fussy|
Poor attention span
Disinterest or hyperactivity
Wakes up groggy, needs lots of naps
|Elementary school age||Hyperactive|
Struggles in school
Poor attention span
Trouble falling asleep
Night terrors, sleepwalking
|Preteens and older children||Problems waking up in the morning|
Poor academic performance
Sleeps too much
Helping Kids Get Enough Sleep
If your child refuses to sleep through the night, you’re not alone. A 2012 survey asked parents how concerned they were regarding the most common issues that plague parents’ minds, such as their children’s health and safety, verbal skills, and performance in school. 17 percent were somewhat concerned with their children’s sleep patterns, while 13 percent were very concerned.
Since children need varying amounts of sleep at different ages, we’ll examine how to help children go to sleep during each of these phases.
It would be hard for a newborn to not get enough sleep since they spend most of their time doing just that (up to 18 hours a day). While newborns can’t talk, they communicate their need for sleep in other ways: fussiness, yawning, or rubbing eyes are the most common. If your newborn is having issues sleeping, make sure they sleep in a dark, cool room without too much noise. Also make sure they don’t get over-tired, which can paradoxically make them seem wide-awake. Don’t keep a newborn awake for more than 60-90 minutes at a time.
Make sure to begin establishing a soothing bedtime routine that includes the same 3-4 activities each time (e.g., bath, feed, storytime, lullaby). Put your baby in their crib or bassinet when they are drowsy, not when they are already sleeping. This will help them learn how to put themselves to sleep.
When a newborn reaches three months of age, their circadian rhythms begin to emerge and they don’t need to wake up during the night to eat as often. Their daytime naps become less frequent. Continue to practice the bedtime routine and put them in bed when they are drowsy versus when they’re already asleep— this helps them “self-soothe” and rely less on their caretakers to put them to sleep.
You can help prepare your infant for sleep by giving them a warm bath, reading them a story in a dimly-lit room, or making sure their room doesn’t have any bright lights in it.
Preschoolers and Toddlers
Once children are between 1-5 years old, they need about 11-14 hours of sleep. At 18 months, their nap frequency decreases even more (usually to just one per day). At this stage, parents should avoid putting their children down for naps too close to bedtime, since this can disrupt their nighttime sleep-wake cycle.
A few sleep disorders may begin to creep up at this age, such as nightmares, night terrors, sleepwalking, or frequent nighttime waking. Parents may notice their children beginning to resist sleep at this age. During this time, parents should enforce a consistent bedtime routine every night and make sure the bedroom environment is conducive to sleep. They can help to reduce “curtain calls” at bedtime by being gentle but firm–once they’ve put their child to bed, there should be no more long interactions or lots of attention.
Make sure the bedroom temperature is set to a comfortably cool level. If the temperature is too hot or cold, settling in for a good night’s sleep will be more difficult. Above all, do not allow electronics in your child’s bedroom at night; the blue light emitting from the screens can significantly delay the sleep cycle.
School-aged Children and Pre-Teens
As children enter elementary school, they still need about 9-11 hours of sleep each night. At this stage, getting enough sleep becomes even harder because children’s schedules fill up with studying, after school activities, and social gatherings. Parents should continue to limit their kids’ exposure to blue light in the evenings, such as TVs, smartphones, e-readers, and tablets.
Avoid feeding children any foods before bedtime that could irritate their sleep cycles, such as caffeine, heavy or spicy foods, or sugary treats.
Potential Consequences of Sleep Deprivation in Children
A 2017 study measured the role of infant sleep on physical and cognitive growth and it uncovered some interesting patterns! Before the early 1950s, most assumed brain activity was practically nonexistent during sleep. Now we know more about the different stages of sleep and how healthy sleep impacts our short and long-term wellness. Bottom line: not getting enough sleep has both short and long-term consequences that shouldn’t be ignored.
Recent studies have pointed to poor sleep being a risk factor for Alzheimer’s and other brain diseases later in life. Now that same evidence is appearing at earlier ages; children who don’t get enough sleep show poorer memory retention. For instance, one study tested 15-month-olds’ memory retention with and without a 30-minute nap during the day; kids who had taken a nap had better retention and were able to learn more abstract concepts.
Developing vocabulary is one of the most rapid phases of child development— children learn up to 13 new words a day. Without proper sleep, learning language can be delayed, leading to other possible literacy issues down the road.
Figuring out your child’s sleep needs can be a tricky balance, especially if they are resistant to set sleep routines. But if they don’t get the recommended hours of shut-eye, their physical growth can be stunted along with their cognitive development.
Dozens of studies have examined the relationship between weight gain and poor sleep in adults, and more and more studies are looking at this relationship in children, too. One study found that infants who slept less than 12 hours per day during the first two years of life had a higher BMI (body mass index), skinfold thickness, and increased risk of being overweight.
We know how much hormones affect our sleep patterns—melatonin, cortisol, and ghrelin all play a part in restful sleep. Other lesser-known but still important hormones released during healthy sleep are the growth hormones that stimulate, well, growth! The rate of growth hormone secretion is influenced by sleep, physical activity, and nutrition. Less sleep can inhibit the release of these growth hormones.
Best and Worst Sleep Habits for Children
Instilling healthy sleep hygiene habits in your children when they are young is the surest way to prevent sleep issues as they get older. While recommended sleep time varies with age group, most of these principles overlap and remain relevant throughout the most formative years of child development.
Young children pick up habits rapidly; that’s why you’ve probably heard their brains compared to “sponges.” What you teach them at this age can come back to haunt you (or help you) later on.
Create a Routine
One of the most effective treatments for children is to create and then stick to a bedtime routine. When the sun goes down, our bodies naturally begin to prepare for sleep; any bright lights or stimulation can delay this process. Dim the lights in your child’s room, read a story, and then turn the lights out (this is just one example of a bedtime routine).
You’ve probably noticed when your child starts showing signs of sleepiness; set their daily bedtime around this time while giving them enough time to get the total sleep hours they need.
“Remember that children tend to be early birds–they need to go to bed much earlier than adults,” explains Dr. Jade Wu, Ph.D., a clinical psychologist specializing in sleep research. “Teens, on the other hand, tend to be biologically hardwired night owls. Try to let your child or teen sleep during the time window that is most appropriate for their age, as long as it’s consistent from day to day.”
Stick to the Routine
Yes, even when traveling! Children need routines for best overall health. A 2018 study learned that children with consistent bedtime routines had better cognitive flexibility, high executive function (specifically their memory and attention spans), greater academic performance, and even better dental health.
Promote Physical Wellness and Healthy Nutrition
We already know that exercise leads to healthy sleep habits in adults, and the same is true for children. Physical activity can lead to faster sleep-onset and healthier, deeper sleep overall. Children shouldn’t eat heavy or processed snacks close to bedtime since this often disrupts digestion and can lead to an upset stomach.
Feed Baby a Bottle to Help Them Sleep
Feed or nurse the baby and then start the bedtime routine to put them to sleep. Feeding your baby a bottle to make them fall asleep can result in their becoming dependent on feeding to sleep. In other words, they won’t learn how to self-soothe and you might struggle with a child who can’t sleep on their own (leading to some sleep deprivation of your own).
Keep a TV in Their Room
The circadian rhythm in all of us relies on the light and dark patterns of the daytime; as the sun goes down, our bodies prepare us for sleep whether we notice or not. Exposing ourselves to bright light, specifically blue light (instead of warm, orange light) throws off the circadian rhythm and can lead to sleep disorders like insomnia.
If there’s a TV in your child’s room, take it out. Help them avoid developing habits such as looking at a screen before bed.
Focusing on Sleep for Optimal Child Development
Sleep is important for all of us, but during the formative childhood years, missing out on sleep can lead to issues like obesity, sleep disorders like nightmares and night terrors, sleep dependence, delayed physical growth, and poor cognitive development. Establishing consistent bedtime routines while your children are young can prevent any potential issues from arising in the future— your children will get the sleep they need, and so will you!
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This article is for informational purposes and should not replace advice from your doctor or other medical professional.