With school starting in the next few weeks, many families will have to shift their children from “summer time sleep mode” to “school year sleep mode.” Your children will have an easier time if their bedtimes are shifted gradually over the period of a week or two toward the desired time period. Remember, the average school aged child needs 10-11 hours of sleep at night and even teenagers function optimally with at least 9-10 hours of slumber per night.
Here are some straight forward rules to follow to help ensure good quality sleep for your child:
1) Keep sleep onset and wake up times as consistent as possible 7 days a week. If you allow your child to “sleep in” during the weekends, she will have difficulty falling asleep earlier on Sunday night, have difficulty waking up Monday morning, and start off her week over-tired, more cranky and less able to process new information—not good for learning.
2) Limit or eliminate caffeine intake. Often teens who feel too sleepy from failing to follow rule number 1 from above may drink tea, coffee, “energy drinks” or other caffeine laden beverage in attempt to self-medicate in order to concentrate better. What many people don’t realize is that caffeine stays in your body for 24 hours so it is entirely possible that the caffeine ingested in the morning can be the reason your child can’t fall asleep later that night. Caffeine also has side effects of jitteriness, heart palpitations, increased blood pressure, and gastro-esophageal reflux (heartburn).
3) Keep a good bedtime routine. Just as a soothing, predictable bedtime ritual can help babies and toddlers settle down for the night, so too can a bedtime routine help prepare the school aged child/teen for sleep.
4) Avoid TV/computer/ screen time just before bed. Although your child may claim the contrary, watching TV is known to delay sleep onset. We highly recommend no TV in a child’s bedroom, and suggest that parents confiscate all cell phones and electronic toys, which kids may otherwise hide and use without parent knowledge, by one hour prior to bedtime. Quiet activities such as reading for pleasure, listening to music, and taking a bath, are all known to promote falling asleep.
5) Encourage regular exercise. Kids who exercise daily have an easier time falling asleep at night than kids who don’t exercise. Gym class counts. So does playing outside, dancing, walking, and taking a bike ride. Of course, participating in a team sport with daily practices not only helps insure better sleep but also promotes social well being.
Getting enough sleep is important for your child’s academic success as well as for their mental health. I have had parents ask me about evaluating their child for ADD or ADHD because of his inability to pay attention and then come to find out that their youngster fights bedtime and averages 7-8 hours of sleep per night when he really need 1-2 hours more, or their teen is so over-involved in activities that she averages 6 hours of sleep per night. Increasing the amount of sleep these kids get can alleviate their attention problems and resolve their hyperactivity. Additionally, sleep deprivation can cause symptoms of depression. Just recall the first few weeks of having a newborn: maybe you didn’t think you were depressed but didn’t you cry from sheer exhaustion at least once?
Unfortunately for children, the older they get, their natural circadian rhythm shifts them toward the “night owl” mode of staying up later and sleeping later, and yet the higher up years in school start earlier so that teens in high school start school earliest at a time their bodies crave “sleeping in.” A few school districts in the country have experimented with starting high school later and Grade School earlier and have met with good success with less tired, more productive teens. Unless you live in one of these districts, however, your teens need to conform until they either go to college and can choose classes that start later in the day or choose a job that allows them to stay up later and sleep later in the day in order to be better in sync with their age specific body rhythms.
Some children seem to get plenty of sleep at night and are still tired during the day. Some medical conditions that interfere with sleep quality include but are not limited to:
- Asthma: kids cough themselves awake multiple times during the night
- Obstructive sleep apnea: children often are obese or have enlarged tonsils and adenoids or have anatomically “floppy” airways. These kids snore and pause their breathing, then rouse themselves in order to start breathing again, multiple times per night.
- Medication side effects
- Psychological conditions such as depression or anxiety
- Illicit drug use
If your child seems to be sleeping enough but still seems excessively tired during and after school, you should consult with your child’s health care professional to look for medical and psychological causes of fatigue. It is always ok to ask your child/teen directly if they feel depressed or anxious. Even if they deny this, they will appreciate your concern and may come back to you later with a more truthful answer. A night time ritual of “tell me about your day” can help kids decompress, help them fall asleep, and keep you connected with your child.
Julie Kardos, MD and Naline Lai, MC
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