How much sleep does your child need?

The importance of getting a good night’s rest

By Audra Kolesar
Winnipeg Regional Health Authority

Why is sleep important for children?

Children who get enough sleep are less likely to have behaviour problems and moodiness. They often develop better memory, concentration, and longer attention spans. With plenty of sleep, they may also recover from illness faster.

How much sleep does my child need?

How much sleep your child needs is based on age.

Toddlers: Toddlers and preschoolers sleep an average of 12 hours a day and take one nap. Naps may stop by the end of the third year. Sleep problems are common, especially when going to bed and falling asleep. They may have nightmares and night terrors. Bedtime rituals, such as a bath and story and favourite stuffed animal or blanket, are helpful to ease insecurity and relax a young child.

School-aged children: School-aged children require less sleep as they get older. Their need decreases to 10 hours a day. The child’s age, activity level, and health strongly influence the amount of sleep needed. Bedtime rituals and later bedtimes can help reduce any resistance to bedtime. Common fears at night are darkness, strange noises, intruders, or imagined ideas. They may have nightmares and night terrors.

Teenagers: Most teens and preteens need about 9 hours of sleep at night to be alert during the day. Teenagers get sleepy later than preteens and often have trouble falling asleep. They often complain of being tired after school, and like to sleep-in on the weekends. Puberty brings changes to their sleep-wake cycle. Many teens feel like staying up late and waking up late and then trying to catch up with sleep on the weekends. If they do this, they will be constantly sleep-deprived. Lack of sleep can cause moodiness as well as problems with attention and memory. It also puts them at risk for falling asleep while driving.

How can I help my child develop good sleeping habits?

Some children may seem anything but sleepy at bedtime. However, their “bouncing around the room” behaviour may actually be caused by lack of sleep. To help your child sleep:

Give your kids a 30-minute warning prior to bedtime so they can wind down and finish activities they are doing.
Start a bedtime ritual. For example, a bath followed by reading a book together. This will help your child’s body and mind get ready for sleep each night. Try not to make the rituals too long and complicated.
Make sure to start the bedtime routine early enough so that you can tuck in your child and talk to him or her. Children often like to have this “private” time to talk to their parents, and you need to plan for this time so it does not take time away from sleep time.
If your child has trouble getting to sleep, try playing calming music in their room or letting them read in bed or listen to recorded books.
Try to keep a standard time for bed. If your child goes to bed really late on weekends and sleeps late in the morning, it will be hard for him or her to switch back to going to bed early on weekdays for school.

Remember that every child is different and some require more sleep than others. If your child seems tired during the day, moody, or “hyper,” he or she may not be getting enough sleep.

What about sleep disorders in children?

Most child and teenage sleep problems can be corrected by adjusting the bedtime routine or your expectations of what is “normal” for your child. Some sleep problems, however, are true disorders that need special attention, and sometimes treatment by a health- care professional. The common sleep disorders with children and teenagers are:

Insomnia

Insomnia means children often have trouble falling or staying asleep or going back to sleep if they awaken. Most children go to sleep within 20 minutes of being in bed and quiet. Teens often take 30 minutes or longer. Generally, insomnia is much less of a problem for children and teens than for adults. Insomnia in children is not usually a serious problem. However, when getting to sleep takes more than half an hour, it can affect wake-up time and cause daytime sleepiness or irritability. Some children get up many times when they cannot get to sleep, which can be difficult for parents. Most of the time, insomnia will get better or go away if an improved sleep routine is strictly followed for two weeks. This includes a predictable quiet time of at least half an hour before bedtime such as a bath and reading time, and a regular bedtime. When an improved sleep routine does not help, try stopping all caffeine and giving warm milk 30 minutes before bedtime. Sleep medicines work differently in children and young teens, so they are rarely prescribed for these age groups. Ongoing insomnia may be a symptom of depression, an anxiety disorder, or hyperactivity. If your child has insomnia a lot, see your child’s health-care provider. It is important to review your child’s medicines and any other symptoms the child has.

Sleep-Rocking

Some children rock their bodies during part of the night. Most rock from side to side, but some rock forward from their knees to their elbows. It is most common up to the age of three or four. Usually sleep rocking is not serious and will stop on its own. However, in severe cases a child may bang his or her head or other body parts against the bed or wall. If this occurs, you may need to protect your child, for example, by padding the wall. If your child sleep-rocks, talk with your child’s health-care provider about it.

Sleep-Walking

Getting out of bed and walking around the room or house a few times each month is quite common with preschool and elementary school children. They may walk for two to 20 minutes and then either return to bed or lie down somewhere else. Their eyes are usually open, but are staring and not focused. They may do things like open doors or change clothing. Sometimes the child will talk, but will not usually wake up if you talk to them. Many times they will take calm guidance from you about returning to bed.

In the morning they rarely remember anything about sleep-walking. It is possible for children to walk into furniture or to fall. For this reason, make sure your child cannot walk down stairs or be where they might trip and fall.

Children usually begin sleep-walking between the ages of two and seven and stop on their own before the teen years. Most sleep-walking occurs a few hours after the child falls asleep. Sleep-walking tends to run in families, but the exact cause is not known. Talk with your child’s health-care provider about your child’s sleep-walking, especially if the walking occurs after sleeping more than half of the night.

Being very tired or stressed, or going to bed late can increase the chances that a child will sleep-walk that night. Some sleep-walkers are more anxious and shy than other children their age. However, most children who sleep-walk do not have emotional or behavioural problems.

There is no special treatment for sleep walking. If your child sleep-walks:

Try not to let your child get too tired or stressed, since this may increase the chances of sleep-walking.
Calmly lead them back to bed. Do not talk about the sleep-walking the next morning, since they will not remember walking around and you may make them feel bad by talking about it.
Some children will not sleep-walk if you purposely wake them (enough to sit up and respond) about an hour after they have gone to sleep.

Night Terrors

Children with night terrors usually seem to wake within the first few hours of going to sleep and scream or call out. The terror may last for several minutes. Usually the child’s eyes are wide open, but are staring and not focused. The child does not wake up, even if you talk to them or sit them up. Often they are not calmed by hugging or talking to them. The terror and not being able to comfort the child is usually scary for the parent. The children almost never remember what happened the next morning. Most night terrors are not caused by stress, diet, or parent behaviour. In some cases, a high fever can cause night terrors during the illness. The terrors usually fade away during the elementary school years. Talk with your child’s health-care provider if you are concerned about your child’s terrors.

There is no special treatment for night terrors. If your child has night terrors:

Try not to let your child get too tired or stressed, since this may increase the chances of having a night terror.
Comfort your child until they calm. This may take several minutes.
Do not talk about the night terror the next morning, since they will not remember the terror and you may scare them with stories about it.

Some children will not have a night terror if you purposely wake them (enough to sit up and respond) about an hour after they have been asleep.

Sleep Apnea

A child with sleep apnea usually snores and stops breathing for a few seconds at a time when sleeping. This signals the brain to wake them up. This process of stopping breathing followed by briefly waking up may happen many times during the night. While children seldom remember waking up, they may be tired or cranky during the daytime. In children, a common cause is enlarged tonsils or adenoids. Sleep apnea is much more common in adults than children.

If you think that your child has sleep apnea, talk with your child’s health-care provider.

Hypersomnia

Hypersomnia is a condition in which your child sleeps far more than is normal for his or her age. Your child is always tired, even after a good night’s sleep. A young child with hypersomnia may often be whiny and irritable and sleep too much. Other symptoms, besides the need for a lot of sleep, may be poor attention or poor memory. Hypersomnia is more common in teenagers than in younger children. Sometimes, especially with teens, it can be a symptom of depression.

If you think your child has hypersomnia:

Try setting a clear routine of bedtime and nap times for several days.
Watch children and teens for symptoms of depression, especially saying negative things about themselves or talking about thoughts of harming themselves or others.

If your child has symptoms of hypersomnia often, or has new medical symptoms, or if you think the child has depression, talk with your child’s health-care provider.

Bruxism

Bruxism is grinding or clenching the teeth during sleep. Children and teenagers who do this may also grind or clench their teeth when angry, upset, or anxious. This can be something that happens only once in a while or can be a nightly problem. Bruxism is more common in teenagers than in young children. Repeated grinding or clenching of the teeth can damage the teeth or the jaw. Special tooth guards may need to be used for nap and nighttime sleep.

If your child grinds or clenches his or her teeth during sleep, try reducing stress in your child’s life. Plan a quiet time of at least half an hour before bedtime, no matter how old the child is. If the bruxism happens often or is violent, talk with your child’s health-care provider and dentist.

Audra Kolesar is a registered nurse and manager with Health Links – Info Santé, the Winnipeg Health Region’s telephone health information service.