Sleep is Critical to a Child’s Development, Health and Quality of Life.
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Childhood is an Opportune Time for Parents to Help Their Children Establish Good Sleep Habits
This is important for: Prevention of common sleep
problems Developing a positive attitude
about sleep Developing a healthy
“sleepstyle”
Sleep Architecture Changes Over Time
Hours in Sleep
Slee
p St
ages
Children’s SleepAwake
REM
1
2
3
4
1 2 3 4 5 6 7
Sleep Needs, Characteristics, Patterns and Issues Vary Throughout Childhood
Amount of Sleep Needed Characteristics of Sleep
Sleep Developmental Tasks (Milestones)/Issues
Newborns (0–2
months)10.5–18 hrs.
Irregular sleep patterns until about 6–8 weeks that interact with hunger; multiple sleep periods in day and night; Sleep is active: smiling, sucking, body movements
Sleep on back to prevent SIDS: Facilitate nighttime sleep; Create a positive and safe sleeping environment; Identify signs of sleepiness
Infants (2–12 months)
Total Average: 14.5 hrs.
[Naps: 2.5–5 hrs]
Increasing nighttime sleep; sleep pattern emerges; 3–4 naps to 1–2 by end of first year
Create a regular bedtime schedule and routine; Nighttime awakenings; Learning to self-soothe
Toddlers (1–3
years)
Total Average: 12–14 hrs. [Naps: 1.5–
3.5 hrs.]
Morning naps cease around 18 months; most sleep through the night on regular sleep schedule
Follow a bedtime routine; Set limits; Encourage falling asleep independently; Transition from crib to bed
Preschoolers (3–5 years)
Total Average: 11–13 hrs.
Naps usually end by 5 years; nighttime fears may emerge
Consistent sleep/wake time and bedtime routine
School-Age(5–12 years)
Total Average: 10–11 hrs.
Increasing demands on children’s time can lead to sleep deprivation; Impact of TV, computers, caffeine and medical conditions on sleep
Establish lifetime sleep and health habits; Be alert for persistent sleep problems and daytime sleepiness
Tips for Newborns
Observe the baby’s sleep patterns and identify signs of sleepiness
Put baby in the crib when drowsy, not asleep Place baby to sleep on his/her back with face and head
clear of blankets and other soft items The crib should be safety approved A quiet and dark room at a comfortable temperature is best
for sleep Encourage nighttime sleep
Increasing nighttime sleep; Regular sleep pattern emerges; 3–4 naps to 1–2 by end of first year
Infants
Amount of Sleep Needed Characteristics of Sleep
Sleep Developmental Tasks (Milestones)/Issues
Newborns (0–2 months)
10.5–18 hrs. Irregular sleep patterns until about 6–8 weeks that interact with hunger; Multiple sleep periods in day and night; Sleep is active: smiling, sucking, body movements
Sleep on back to prevent SIDS; Facilitate nighttime sleep; Create a positive and safe sleeping environment; Identify signs of sleepiness
Infants (2–12
months)
Total Average: 14.5 hrs.
[Naps: 2.5–5 hrs]
Create a regular bedtime schedule and routine; Nighttime awakenings; Learn to self-soothe
Toddlers (1–3
years)
Total Average: 12–14 hrs.
[Naps: 1.5–3.5 hrs.]
Morning naps cease around 18 months; most sleep through the night on regular sleep schedule
Follow a bedtime routine; Set limits; Encourage falling asleep independently; Transition from crib to bed
Preschoolers (3–5 years)
Total Average: 11–13 hrs.
Naps usually end by 5 years; Nighttime fears may emerge
Consistent sleep/ wake time and bedtime routine
School-Age(5–12 years)
Total Average: 10–11 hrs.
Increasing demands on children’s time can lead to sleep deprivation; Impact of TV, computers, caffeine and medical conditions on sleep
Establish lifetime sleep and health habits; Be alert for persistent sleep problems and daytime sleepiness
Tips for Helping Infants Sleep Well
Develop a regular daily and bedtime schedule
Create a consistent and enjoyable bedtime routine Establish a regular “sleep friendly” environment Encourage your baby to fall asleep independently
and to become a “self-soother”
Toddlers
(1–3 years)
Total Average: 12–14
hrs. [Naps: 1.5–3.5
hrs.]
Morning naps cease around 18 months; most sleep through the night on regular sleep schedule
Follow a bedtime routine; Set limits; Encourage falling asleep independently; Transition from crib to bed
Amount of Sleep Needed
Characteristics of Sleep Sleep Developmental Tasks (Milestones)/Issues
Newborns (0–2 months)
10.5–18 hrs. Irregular sleep patterns until about 6–8 weeks that interact with hunger; Multiple sleep periods in day and night; Sleep is active: smiling, sucking, body movements
Sleep on back to prevent SIDS; Facilitate nighttime sleep; Create a positive and safe sleeping environment; Identify signs of sleepiness
Infants (2–12 months)
Total Average: 14.5 hrs.
[Naps: 2.5–5 hrs]
Increasing nighttime sleep; Regular sleep pattern emerges; 3–4 naps to 1–2 by end of first year
Create a regular bedtime schedule and routine; Nighttime awakenings; Learn to self-soothe
Preschoolers (3–5 years)
Total Average: 11–13 hrs.
Naps usually end by 5 years; Nighttime fears may emerge
Consistent sleep/ wake time and bedtime routine
School-Age(5–12 years)
Total Average: 10–11 hrs.
Increasing demands on children’s time can lead to sleep deprivation; Impact of TV, computers, caffeine and medical conditions on sleep
Establish lifetime sleep and health habits; Be alert for persistent sleep problems and daytime sleepiness
Toddlers
Tips for Helping Toddlers Sleep Well
Maintain a daily sleep schedule and consistent bedtime routine
The bedroom environment should be the same every night and throughout the night
Set limits Encourage use of a security object
Preschool-Age Children
Amount of Sleep Needed
Characteristics of Sleep Sleep Developmental Tasks (Milestones)/Issues
Newborns (0–2 months)
10.5–18 hrs. Irregular sleep patterns until about 6–8 weeks that interact with hunger; Multiple sleep periods in day and night; Sleep is active: smiling, sucking, body movements
Sleep on back to prevent SIDS; Facilitate nighttime sleep; Create a positive and safe sleeping environment; Identify signs of sleepiness
Infants
(2–12 months)
Total Average: 14.5 hrs.
[Naps: 2.5–5 hrs]
Increasing nighttime sleep; Regular sleep pattern emerges; 3–4 naps to 1–2 by end of first year
Create a regular bedtime schedule and routine; Nighttime awakenings; Learn to self-soothe
Toddlers (1–3
years)
Total Average:12–14 hrs. [Naps: 1.5–
3.5 hrs.]
Morning naps cease around 18 months; Most sleep through the night on regular sleep schedule
Follow a bedtime routine; Set limits; Encourage falling asleep inde-pendently; Transition from crib to bed
Preschoolers
(3–5 years)
Total Average: 11–13 hrs.
Naps usually end by 5 years; Nighttime fears may emerge
Consistent sleep/ wake time and bedtime routine
School-Age(5–12 years)
Total Average: 10–11 hrs.
Increasing demands on children’s time can lead to sleep deprivation; Impact of TV, computers, caffeine and medical conditions on sleep
Establish lifetime sleep and health habits; Be alert for persistent sleep problems and daytime sleepiness
Tips for Helping Preschoolers Sleep Well
Maintain a regular and consistent sleep schedule Follow-through with a bedtime routine every night The child should sleep in the same sleeping
environment every night. It should be cool, quiet, dark and without a TV
Watch for difficulty breathing, unusual nighttime awakenings, chronic sleep problems, and behavioral problems during the day
Amount of Sleep Needed
Characteristics of Sleep Sleep Developmental Tasks (Milestones)/Issues
School-Age Children
Newborns (0–2 months)
Total Average:10.5–18 hrs.
Irregular sleep patterns until about 6–8 weeks that interact with hunger; multiple sleep periods in day and night; Sleep is active: smiling, sucking, body movements
Sleep on back to prevent SIDS; Facilitate nighttime sleep; Create a positive and safe sleeping environment; Identify signs of sleepiness
Infants
(2–12 months)
Total Average: 14.5 hrs.
[Naps: 2.5–5 hrs]
Increasing nighttime sleep; Regular sleep pattern emerges; 3–4 naps to 1–2 by end of first year
Create a regular bedtime schedule and routine; Nighttime awakenings; Learn to self-soothe
Toddlers (1–3
years)
Total Average:12–14 hrs. [Naps: 1.5–
3.5 hrs.]
Morning naps cease around 18 months; Most sleep through the night on regular sleep schedule
Follow a bedtime routine; Set limits; Encourage falling asleep inde-pendently; Transition from crib to bed
Preschoolers
(3–5 years)
Total Average:11–13 hrs.
Naps usually end by 5 years; Nighttime fears may emerge
Consistent sleep/ wake time and bedtime routine and sleeping environment
School-Age(5–12 years)
Total Average: 10–11 hrs.
Increasing demands on children’s time can lead to sleep deprivation; Impact of TV, computers, caffeine and medical conditions on sleep
Establish lifetime sleep and health habits; Be alert for persistent sleep problems and daytime sleepiness
Tips for Helping School-Age Children Sleep Well
Introduce healthy sleep habits, disease prevention and health promotion
Continue to emphasize the need for a regular and consistent sleep schedule and bedtime routine
The child’s bedroom should be conducive to sleep: dark, cool and quiet. TV’s and computers should be off and out of the bedroom
Set limits Avoid caffeine Watch for signs of chronic difficulty sleeping, loud snoring, difficulty
breathing, unusual nighttime awakenings and frequent daytime sleepiness
Common Sleep Problems Lead to Serious Consequences
Not enough sleepNot enough sleep
Disruption of sleep(poor sleep)
Disruption of sleep(poor sleep)
Inappropriate timing of sleep
Inappropriate timing of sleep
Daytime sleepiness
Daytime sleepiness
Sleep Disorders in Children are Treatable
Difficulty initiating or maintaining sleepInsomnia
Partial or complete obstruction in the airway leading to pauses in breathing. The brain is alerted and the child resumes breathing.
Sleep Apnea
Airway passage is partially blocked and air from the nose or throat passes around the blockage causing throat structures to vibrate against each other making the snoring noise
Snoring
SymptomsSleep Problem/Disorder
Symptoms
Sleep Disorders in Children are Treatable (cont.)
• Excessive daytime sleepiness • Involuntary sleep attacks during the day• Can include: cataplexy or sudden loss of muscle tone in response to emotion; sleep paralysis; hypnagogic hallucinations; disturbed nighttime sleep
Narcolepsy
Unpleasant, tingling, or creepy-crawly feelings in the legs with an irresistible urge to move
Restless Legs Syndrome
Sleep Problem/Disorder
Talk to Your Child’s Doctor if Any of the Following Symptoms are Observed:
A newborn or infant is extremely and consistently fussy A child is having problems breathing or breathing is noisy A child snores, especially if the snoring is loud Unusual nighttime awakenings Difficulty falling asleep and maintaining sleep, especially if
you see daytime sleepiness and/or behavioral problems
General Tips for All Children
Establish a regular sleep/wake schedule Recognize signs of sleepiness in your child Understand that sleep needs and patterns change
Follow a 20-30 minute relaxing bedtime routine Bedroom should be quiet, dark and cool Have a light snack (no caffeine) before bed Quiet activities (not television) are more conducive to falling
asleep Exercise daily Get good nutrition Children should nap according to age and sleep needs
References American Academy of Pediatrics. Guide to Your Child’s Sleep: Birth Through
Adolescence. George J. Cohen, ed. New York: Villard, 1999. American Academy of Sleep Medicine. “My Child Snores” brochure, 2000. Chervin RD, Clarke DF, Huffman JL, et al. “School Performance, Race, and Other
Correlates of Sleep-Disordered Breathing in Children.” Sleep Medicine, 2003;4:21-27. Ferber R, Kryger MH, eds. Principles and Practice of Sleep Medicine in Child.
Philadelphia: WB Saunders , 1995 Goodwin JL, Babar SI, Kaemingk KL, et al. “Symptoms Related to Sleep-Disorder
Breathing in White and Hispanic Children: The Tucson Children’s Sleep Assessment.” Chest, 2003;124(1):196-203.
Gottlieb DJ, Vezina RM, Chase C, et al. “Symptoms of Sleep-Disordered Breathing in 5-Year-Old Children Are Associated with Sleepiness and Problem Behaviors.” Pediatrics, 2003;112(4):870-877.
Mindell JA. Sleeping Through the Night: How Infants, Toddlers and their Parents Can Get a Good Night’s Sleep. New York: HarperCollins, 1997.
Mindell JA, Owens JA. A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Philadelphia: Lippincott Williams & Wilkins, 2003.
National Sleep Foundation. “Children and Sleep” sleep sheet. National Sleep Foundation. Sleep in America Poll, 2004. Children and Sleep. National Sleep Foundation and Johnson and Johnson. “Babies and Sleep”
package for parents and pediatricians, 2002. Owens JA, Maxim R, McGuinn M, et al. “Television-Viewing Habits and Sleep
Disturbance in School Children.” Pediatrics, 1999;104(3). Owens JA, Spirito A, McGuinn M, et al. Sleep Habits and Disturbance in
Elementary School-Age Children. Developmental and Behavioral Pediatrics 2000;21(1):27-34.
Rosen G. “EDS [Excessive Daytime Sleepiness] in Children.” Sleep Medicine Alert 1999;4(3):5-6, National Sleep Foundation.
References
American Academy of Sleep Medicine (AASM) T: (708) 492-09301 Westbrook Corporate Center, Suite 920 www.aasmnet.orgWestchester, IL 60514
Sleep Research Society T: (708) 492-09301 Westbrook Corporate Center, Suite 920 www.sleepresearchsociety.orgWestchester, IL 60514
National Center of Sleep Disorders Research (NCSDR) P: (301) 435-01992 Rockledge Center, Suite 7024 www.nhlbi.nih.gov/about/6701 Rockledge Drive, MSC 7920 nscdr/index.htmBethesda, MD 20892-7920
Narcolepsy Network Inc. P: (513) 891-352210921 Reed Hartman Highway www.narcolepsynetwork.orgCincinnati, OH 45242 e-mail: narnet@aol.com
American Sleep Apnea Association P: (202) 293-3650A.W.A.K.E Network www.sleepapnea.org1424 K Street, NW, Suite 302 e-mail: asaa@sleepapnea.orgWashington, D.C. 20005
Restless Legs Syndrome Foundation819 Second Street S.W. www.rls.orgRochester, MN 55902-2985
References
National Sleep Foundation
The National Sleep Foundation is an independent nonprofit organization dedicated to improving public health and safety by achieving public understanding of sleep and sleep disorders, and by supporting public education, sleep-related research and advocacy.
1522 K Street, NW Suite 500Washington, DC 20005
202-347-3471Website: www.SleepFoundation.org
©2003
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