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By Dr. Adam Aronson, father of 5 and still trying to efficiently put his kids to bed
Adam Aronson, MDAs is the case with so many other subjects, the challenges change as our children grow older and so we continue our overview of healthy sleep patterns and common problems.

School Age Children

From preschool through grade school – kids generally need 10-12 hours of sleep each night.  As children get older they bring home larger amounts of homework and have more after school activities – all of which make keeping an established bedtime more difficult.  Unlike younger children who can nap during the day when tired, these children are expected to maintain focus in school and so it is of paramount importance that they get a good night of sleep.

Teens

Adolescents typically need 8-9 hours a sleep, but few of them get that much on a regular basis.  They have pressure packed days of school, homework, extracurricular activities, and socialization – leaving them chronically sleep deprived.  Additionally – studies have shown that during adolescence the brain hormone melatonin is produced later at night compared to younger kids or adults.  This causes a shift in the internal clock ( the body’s circadian rhythm) resulting in teenagers falling asleep later at night and not feeling ready to wake up until later in the morning.
Studies have shown that sleep deprivation in teenagers can lead to decrease levels of attention, short term memory problems, poor school performance, delayed response time, and irritability.  While these issues are noted in younger children who are not getting enough sleep, they seem to be more notable in adolescents.  Teenagers should strive to have a set bedtime each night – and wake up at the same time each morning – just like in younger kids, their bodies respond well to consistency.

Nightmares and Night Terrors

Almost all children will have an occasional nightmare.  Parents should go to their child’s bed and comfort them until they are calm- then quickly have them go back to sleep on their own.  If a child has frequent nightmares or the fear of bad dreams keeps them up – it can help to talk about the dreams or to read peaceful books before falling asleep to trigger calming thoughts.  Families should also make sure that their children are not exposed to violent or scary TV programs, movies, or video games.
Night terrors may initially seem similar to nightmares, but they are more extreme.  During these episodes, the child will scream or shout in apparent fear.  They will often sit up in bed and may even thrash about in fear.  They may seem to be awake – however they are still in a sleep state and will not respond to the attempts of parents to comfort them.  After few minutes and the child will calm down and go back to sleep.  About 5%  of children  will experience a night terror, most often between the ages of  4 and 12.  Most of the time there is a family history of either night terrors or sleepwalking.  Night terrors most often  occur in children that are over tired or stressed – so ensuring children get enough sleep can reduce the frequency.

Tips for better Sleep

For younger children, some of the most common disruptions of sleep are fears of the dark and the “monsters that hide behind the shadows”.  Families can help ease these feelings by doing a walk through of the room before lights out to demonstrate that there is nothing to fear.  Another helpful strategy is to have the child place family pictures or other comforting objects throughout the room in prominent places.
Parents need to also be aware of their child’s stress level. Younger kids may worry about preschool or household chores – while adolescents feel stress and pressure related to schoolwork, exams, sports and extra curricular activities.  Parents can talk to their kids regularly to help ease stress and work to find balance.  Similar issues arise with social changes such as moving to a new house, parents separating or divorcing, or significant illness in family members.
Parents should also keep track of the sleep environment. Make sure the bed is ready for sleep and not overly cluttered with stuffed animals.  The bedroom is for sleeping and should be a tech free zone.  Pets should not be allowed to sleep in the child’s bed.  If the room is warm – dress the child in light clothes and turn on a fan.  If it is cool, give them a warm pair of socks and a heavier blanket.  Be sure the room is dark and quiet.
Careful scheduling of daytime activities is also critical. Children need physical activity and exercise – but not within a few hours of bedtime.  Make sure all extracurricular activities and sports are completed in enough time to allow the child’s body and mind to wind down and settle.
Healthy sleep is a critical part of keeping children healthy.  Their young bodies and precious minds need sleep to grow, rest and recuperate.  Studies have shown that lack of sleep can have detrimental affects on behavior and academics. While the suggestions that we have discussed are not going to solve every child’s sleep problems, they can be the foundation of establishing a good strategy and parents are encouraged to discuss these and other sleep issues with their pediatrician.