Children and Sleep Problems

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For some children, the problems start soon after they are born. During their first 8 weeks or so, many infants fall asleep while they are nursing or bottle-feeding. Usually their parents carefully and lovingly put them to bed without awakening them. In some cases however this apparent kindness is a disservice, for those babies learn to associate the presence of a parent with the act of falling asleep.
When they’re infants, it’s middle-of-the-night feedings. When they’re toddlers and school-age, it’s awakening to give medicine or soothe them after a nightmare. It’s no surprise that according to the latest poll from the National Sleep Foundation (NSF), more people without kids in the house rated their sleep as “excellent” or “very good,” compared to those with children.
According to the American Academy of Child and Adolescent Psychiatry, many childhood sleep problems are related to irregular sleep habits or anxiety about bedtime. Young children view bedtime as a time of separation which is why they pull out a number of stalling tactics such as repeated requests for water and trips to the bathroom. Other childhood sleep problems include talking during sleep and bedwetting.
If you think your child may have a sleep problem, ask yourself these five questions (remember them by the acronym “BEARS”):
1.    Bedtime: Does my child have problems going to bed or falling asleep?
2.    Excessive daytime sleepiness: Does my child seem sleepy or overtired during the day? Is he or she difficult to get up in the morning?
3.    Awakenings: Does my child awaken frequently during the night or have trouble getting back to sleep?
4.    Regularity and duration of sleep: What time does my child go to bed and get up on weekdays? Weekends? How much sleep does he or she get? Need?
5.    Snoring: Does my child snore loudly? Does he or she seem to have breathing problems at night?
 
Many children have sleep problems. Examples include:
·      Frequent awakening during the night
·      Talking during sleep
·      Difficulty falling asleep
·      Waking up crying
·      Feeling sleepy during the day
·      Having nightmares
·      Bedwetting
·      Teeth grinding and clenching
·      Waking early
Many childhood sleep problems are related to poor sleep habits or to anxiety about going to bed and falling asleep. Persistent sleep problems may also be symptoms of emotional difficulties. “Separation anxiety” is a developmental landmark for young children as for all young children bedtime is a time of separation. Some children will do all they can to prevent separation at bedtime.
Nightmares are relatively common during childhood, the child often remembers nightmares which usually involve major threats to the child’s well-being. Nightmares which begin at a variety of ages affect girls more often than boys and for some children nightmares are serious, frequent, and interfere with restful sleep.
Sleep terrors (night terrors), sleepwalking, and sleep talking constitute a relatively rare group of sleep disorders called “parasomnias”. Sleep terrors are different from nightmares, the child with sleep terrors will scream uncontrollably and appear to be awake, but is confused and can’t communicate. Sleep terrors usually begin between ages 4 and 12. Children who sleepwalk may appear to be awake as they move around, but are actually asleep and in danger of hurting themselves and it usually begins between ages 6 and 12. Both sleep terrors and sleepwalking run in families and affect boys more often than girls. Most often, children with these sleep disorders have single or occasional episodes of the disorder. Fortunately, as they mature, children usually get over common sleep problems as well as the more serious sleep disorders (parasomnias). However, when episodes occur several times a night or nightly for weeks at a time, or interfere with the child’s daytime behavior, treatment by a child and adolescent psychiatrist may be necessary.
 
Although it appears so deceptively simple that we take it for granted, learning to go to sleep is often as much of a challenge to children as learning to walk. Bedtime is a cue for frustration for many parents and children: Babies cry when they wake up in the middle of the night. Toddlers refuse to leave their families evening activities to go to sleep. Preschoolers ask their parents for yet another story, drink of water or trip to the bathroom. Older children become frightened of ghosts or monsters that climb into their rooms when the sun goes down.
The key issue here is not sleep, although that is how parents will usually refer to it when describing the problem. The baby is sleeping just fine. The problem lies in mastering the transition from the waking state to the sleeping state.
Among babies, one simple solution is to look for times during the day when the child is awake but drowsy. Put her to bed, quietly leave the room, and let her fall asleep by herself. If that task is too much for her, you can make use of babies’ natural tendency to become sleepy after eating. Watch her eyes closely toward the end of a meal. You’ll probably notice that her eyelids become “heavy” as she blinks a few times before falling asleep in your arms.
Among infants, sleep problems are more common during times of stress. Infants sometimes develop problems sleeping when they have colds, stuffy noses may make them uncomfortable at night causing them to wake up crying a few hours after midnight. Parents, who are acutely aware that their children are suffering go to their rooms to comfort them and help them to back to sleep.
Toddlers often need help shifting gears from the animated activities of the day to the more passive pursuits of bedtime. Parents frequently assume that children can mentally prepare themselves for bed as quickly as adults do. However, young children need a cool-down period. If Daddy’s just played horsey with them, it’s a too abrupt transition to go to bed.
Rituals form an important part of this cool-down period for toddlers and preschoolers. Quiet activities, such as being read a story or listening to soothing music, can help the child learn to fall asleep without problems. Television however is not good for this since it is filled with rapid-fire images that are too stimulating. The bedtime story or glass of milk becomes the child’s transitional object for falling asleep. That’s one of the reasons why preschoolers will often ask to have the same story read to them for weeks or even months at a time. It provides reassurance that all is well and that they will be safe when their parents leave them alone for the night.
Quick Tips for Sleep Problems
1.    Remember that you can’t control your children’s sleep. You can control only their bedtime. If a child says he can’t sleep, tell him that he has to be in bed. If he’s old enough he can read or listen to calming music quietly.
2.    Not all children require the same amount of sleep at a particular age. While some children are dazed if they don’t get as much as 10 or more hours of sleep per night, others are happy with as little as six hours.
3.    Pay attention to when your child falls asleep. If a child goes to bed at 7 p.m. but always falls asleep at 8:30, you might be better off putting him to bed at 8:30. There will be less of a struggle at bedtime, and the child will get the same amount of sleep.
4.    One of the most common reasons toddlers have difficulty sleeping through the night is that they nap too much during the day.
5.    If you want to teach your toddler or preschooler new skills having to do with falling asleep, such as learning to go to sleep in a strange bed, introduce those skills during daytime naps rather than at night.
6.    Encourage calming rituals around bedtime. Remember that children often need at least 10 minutes to calm down from the excitement of the day. A warm bath is often quite effective.
 
Does this sound familiar to all parents….
·         “But I don’t want to go to bed”
·         Why does Jimmy get to stay up later? It’s not fair.
·         Just let me watch this show. It’s my favorite! It’s a special! I always have to miss it and everyone else watches it!
·         Nobody else in the fourth grade has to be in bed by 8:00.
·         Can I have a drink? A cookie? A hug? One more story? Pleeease.
·         Where’s my stuffed rabbit. You know I can’t sleep without my stuffed rabbit. I WANT MY RABBIT!”
 
 
Establishing and maintaining a bedtime routine is worth the struggle. There is so much good learning that can go on during the hour before lights out that it really shouldn’t be missed. Bedtime is a daily opportunity to build and nurture your relationship with your child. There’s something about a quiet darkened room that invites conversation. This is the time to snuggle, to talk about some of the important things that your child is thinking about. When children know that bedtime is a time when you give a few minutes of undivided attention, they often save up their most sensitive questions for sharing.
Repetition and structure help children feel safe. Bedtime declares that the day is over. When you are loving and firm about when it is time for bed, you are building your children’s confidence in their world. Repetition for young children is comforting, the repetition of the getting ready for bed routine (getting into pajamas, brushing teeth, a drink of water, a story, a hug, goodnight) lets your child know what to expect and helps him or her feel secure.
Bedtime routines help children learn to transition from the busy activity of the day to settling down for sleep. Bedtime is a time to teach children how to soothe themselves and how to relax. Help them learn a few relaxation tricks like tensing and releasing muscles or thinking about a favorite place. This is a gift they’ll use forever.
Bedtime connected to story time puts a love of language deep inside a person. Try to read aloud to your child every evening, or at least two out of three. Don’t quit when kids can read on their own and keep reading aloud as part of the bedtime routine right up to the teen years. It will help you stay connected in a positive way during what can be a prickly time.
Like everything else about family life, bedtime is often anything but the relaxed calm ending to the day we’d like it to be, it is important for both parents and children to have a sense of what is supposed to happen. When you do, you add a significant measure of emotional strength to your children and your family.
The goal isn’t to be perfect around bedtime routines, You won’t be!! But to pull it off more often than not!!!
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