Sleep is Critical to a Child s Development, Health and Quality of Life

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2 Sleep is Critical to a Child s Development, Health and Quality of Life

3 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

4 The Drive to Sleep is Regulated by Biology Biological Time Clock and Circadian Rhythms

5 Sleep Architecture Changes Over Time Children s Sleep Sle eep Stages Awake REM Hours in Sleep

6 Sleep Needs, Characteristics, Patterns and Issues Vary Throughout Childhood Amount of Sleep Developmental Tasks Sleep Needed Characteristics of Sleep (Milestones)/Issues Newborns (0 2 months) 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) Toddlers (1 3 years) 14.5 hrs. [Naps: 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 Morning naps cease around 18 months; Follow a bedtime routine; Set limits; hrs. most sleep through the night on regular Encourage falling asleep independently; [Naps: hrs.] sleep schedule Transition from crib to bed Preschoolers (3 5 years) hrs. Naps usually end by 5 years; nighttime fears may emerge Consistent sleep/wake time and bedtime routine School-Age (5 12 years) 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 b sleep

Put baby in the crib when drowsy, not asleep

face and head clear of blankets and other

7 Tips for Newborns Observe the baby s b 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

8 Infants Amount of Sleep Developmental Tasks Sleep Needed Characteristics of Sleep (Milestones)/Issues Newborns (0 2 months) 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) 14.5 hrs. [Naps: 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) hrs. [Naps: 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) hrs. Naps usually end by 5 years; Nighttime fears may emerge Consistent sleep/ wake time and bedtime routine School-Age (5 12 years) 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

9 Tips for Helping Infants Sleep Well Develop a regular daily and bedtime schedule Create a consistent t and enjoyable bedtime routine Establish a regular sleep friendly environment Encourage your baby to fall asleep independently and to become a self-soother

10 Toddlers Amount of Sleep Needed Characteristics of Sleep Sleep Developmental Tasks (Milestones)/Issues Newborns (0 2 months) Infants (2 12 months) 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 14.5 hrs. [Naps: hrs] Increasing nighttime sleep; Regular sleep pattern emerges; 3 4 naps to 1 2 by end of first year Sleep on back to prevent SIDS; Facilitate nighttime sleep; Create a positive and safe sleeping environment; Identify signs of sleepiness Create a regular bedtime schedule and routine; Nighttime awakenings; Learn to self-soothe Toddlers ( hrs. years) [Naps: 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) hrs. Naps usually end by 5 years; Nighttime fears may emerge Consistent sleep/ wake time and bedtime routine School-Age (5 12 years) 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

11 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

12 Preschool-Age Children Amount of Sleep Needed Characteristics of Sleep Sleep Developmental Tasks (Milestones)/Issues Newborns (0 2 months) 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) 14.5 hrs. [Naps: 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) hrs. [Naps: 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) hrs. Naps usually end by 5 years; Nighttime fears may emerge Consistent sleep/ wake time and bedtime routine School-Age Increasing demands d on children s time can Establish lifetime sleep and health (5 12 years) hrs. lead to sleep deprivation; Impact of TV, computers, caffeine and medical conditions on sleep habits; Be alert for persistent sleep problems and daytime sleepiness

13 Tips for Helping Preschoolers Sleep Well Maintain i 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

14 School-Age Children Amount of Sleep Needed Characteristics of Sleep Sleep Developmental Tasks (Milestones)/Issues Newborns (0 2 months) 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) 14.5 hrs. [Naps: 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) hrs. [Naps: 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) 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) hrs. Increasing demands d 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

15 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 it t sleep schedule hdl and bdti 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

16 Common Sleep Problems Lead to Serious Consequences Not enough sleep Disruption of sleep (poor sleep) Inappropriate timing of sleep Daytime sleepiness

17 Managing Common Sleep Problems Bedtime Struggles Limit Setting Disorder Nighttime Awakenings

18 Managing Common Sleep Problems (cont.) Nightmares Sleep Terrors Sleepwalking Sleeptalking

19 Sleep Disorders in Children are Treatable Sleep Problem/Disorder Snoring Sleep Apnea Insomnia Symptoms 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 Partial or complete obstruction in the airway leading to pauses in breathing. The brain is alerted and the child resumes breathing. Difficulty initiating or maintaining sleep

20 Sleep Disorders in Children are Treatable (cont.) Sleep Problem/Disorder Symptoms Restless Legs Syndrome Narcolepsy Unpleasant, tingling, or creepycrawly feelings in the legs with an irresistible urge to move Excessive daytime sleepiness Involuntary sleep attacks during the day Can include: cataplexy or sudden loss of muscle tone in response to emotion; sleep pparalysis; hypnagogic hallucinations; disturbed nighttime sleep

21 Talk to Your Child s Doctor if Any of the Following Symptoms are Observed: A newborn or if 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 Difficulty falling asleep and maintaining sleep, especially if you see daytime sleepiness and/or behavioral problems

22 Keep a Sleep Diary of the Child s Sleep Habits and Patterns

23 Parents Can be Effective Models of Good Sleep for Their Children

24 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 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

25 References American Academy of Pediatrics. Guide to Your Child s Sleep: Birth Through Adolescence. George J. Cohen, ed. New York: Villard, American Academy of Sleep Medicine. My Child Snores brochure, Chervin RD, Clarke DF, Huffman JL, et al. School Performance, Race, and Other Correlates of Sleep-Disordered Breathing in Children. Sleep Medicine, 2003;4: 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): 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): Mindell JA. Sleeping Through the Night: How Infants, Toddlers and their Parents Can Get a Good Night s Sleep. New York: HarperCollins, 1997.

26 References Mindell JA, Owens JA. A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Philadelphia: Lippincott Williams & Wilkins, National Sleep Foundation. Children and Sleep sleep sheet. National Sleep Foundation. Sleep in America Poll, Children and Sleep. National Sleep Foundation and Johnson and Johnson. Babies and Sleep package for parents and pediatricians, 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): Rosen G. EDS [Excessive Daytime Sleepiness] in Children. Sleep Medicine Alert 1999;4(3):5-6, National Sleep Foundation.

27 References American Academy of Sleep Medicine (AASM) T: (708) Westbrook Corporate Center, Suite Westchester, IL Sleep Research Society T: (708) Westbrook Corporate Center, Suite Westchester, IL National Center of Sleep Disorders Research (NCSDR) P: (301) Rockledge Center, Suite Rockledge Drive, MSC 7920 nscdr/index.htm Bethesda, MD Narcolepsy Network Inc. P: (513) Reed Hartman Highway Cincinnati, OH narnet@aol.com American Sleep Apnea Association P: (202) A.W.A.K.E Network K Street, NW, Suite asaa@sleepapnea.org Washington, D.C Restless Legs Syndrome Foundation 819 Second Street S.W. Rochester, MN

28 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 K Street, t NW Suite 500 Washington, DC Website:

Better Bedtime Routines. Michelle Mogenson, D.O. Children s Physicians Spring Valley

Better Bedtime Routines. Michelle Mogenson, D.O. Children s Physicians Spring Valley Better Bedtime Routines Michelle Mogenson, D.O. Children s Physicians Spring Valley Outline Sleep expectations Guidance on how to improve sleep Infant sleep methods What you want: Why are you here? Why