to your health
Good Establishing
Sleep Habits
with Children
Oluyemisi Fatunde, M.D., FAAP
S
leep is a fundamental necessity for humans. Adults spend about one-third of the 24-hour day sleeping while children need considerably more than this. On average, full-term newborn babies sleep for 16 hours a day. This decreases gradually with age to around 13 hours in two year olds, 11 hours by five years old, and 10 hours by nine years old. (Fourteen year olds require approximately nine hours of sleep a night while 17 year olds do well with a full eight.) Adequate sleep appears necessary for sustaining life and for optimal functioning of a child. Insufficient sleep can result in daytime sleepiness, mood disturbances (moodiness, irritability, emotional lability, depression, anger), daytime behavioral problems, fatigue, as well as various problems with memory, attention, concentration, decision making, over-activity and impulsivity. Sleep occurs in cycles of different stages interspersed with periods of wakefulness during which the child may become fully awake. Sleep problems are common in childhood, affecting 20 to 30 percent of infants, toddlers and adolescents and can be divided broadly into problems with falling asleep, staying asleep and episodic sleep-associated behavioral problems like night terrors or sleep walking. If not properly treated in early childhood, sleep problems may persist into adult life. Parents need to know that, just like they have to teach a young child good morals, grooming, and behavioral habits, the act of sleeping also needs to be taught. The child should be able to fall asleep by himself both at bedtime and following normal waking during the night. Teaching a baby to fall asleep by himself should start between the ages of two and six months. The baby should be put to bed while drowsy but not yet sleeping. If the baby falls asleep before being put to bed, wake her up and then allow her to fall asleep by herself. The importance of this is to teach the baby to settle herself down in her crib and fall asleep. Learning to self-soothe in this
manner will also help when the child wakes up in the natural rhythm of the night, as she will repeat the same process. It is important for parents to resist the temptation to let their baby get in the habit of only sleeping with a bottle, with rocking or other comforts which the baby will then want to continue to enjoy. Night feeding is not necessary after six months of age. If the baby will not settle, is crying and demanding parental attention, it is important to be firm. Ignoring the cries of the baby has shown to be very effective and is known as the extinction method. However, if parents find it difficult to put up with persistent crying of a child, a modification of the extinction method is to stay in the room but ignore the child until he falls asleep. Another alternative is the graduated extinction method. This involves the parents going into the room of the crying child for a specified time at regular intervals. They may or may not comfort the child for a few seconds. The interval between look-ins is gradually increased, from every five minutes to every 10 minutes, then 15 minutes until the child falls asleep. For a child who is fond of frequent night wakings, another effective method is scheduled awakenings. The parents deliberately wake up the child 15 to 30 minutes before he would usually wake up and then allow him to
Whatever method parents choose for their children, success is dependent on consistency.
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Amarillo Magazine • amarillomagonline.com • march 2010