Children’s Health: Sleep

Sleep is as important for children as it is for adults. We all need the right amount of sleep – not too little nor too much – to be healthy. And while adults need a good night’s sleep to perform effectively at work, children need it to do well at school.

Children also need sleep as it helps with the release of growth hormone and because it’s important for their brain and emotional development. A good night’s sleep can help a child process the things they experience during the day, whether the lessons they learn at school or in life in general.

Sleep difficulties, however, are a common problem in children. Indeed, according to researchers, at some stage around half of all children have a sleep problem considered significant by a parent (i), with 30 per cent thought to be affected by sleeplessness during their first two years (ii).

Those with a health condition – asthma, for instance – a psychiatric disorder (such as ADHD) or a learning disability are thought to be particularly susceptible to sleep difficulties (iii). The latest NHS statistics also suggest sleeplessness in children is on the rise, with the number of children and young people being admitted to hospital for sleep disorders having increased sharply over the last six years (iv).

What is sleeplessness?

Sleeplessness – or insomnia – can be defined as difficulty falling asleep, difficulty staying asleep and waking very early. So children who are affected may not be able to fall asleep on their own, they may wake up frequently during the night and not be able to get back to sleep on their own, or they may wake very early and not go back to sleep.

There are many factors involved in sleeplessness in children. According to the Royal College of Psychiatrists (v), some of the reasons are as follows:

• Fear of being left alone at night (separation anxiety), which is normal at a young age.

• Fear of the dark.

• Napping too much during the day.

• Overtiredness (when a child becomes very tired they get irritable, aggressive and can also become overactive).

Teenagers are also susceptible to sleeplessness, thanks again to a variety of factors such as worry over school performance and exams, drinking too much caffeine (from energy/fizzy drinks) generally getting into the habit of staying up late.

Sleeplessness, however, doesn’t just make children tired during the daytime. It can have a negative effect on their behaviour, mental development and mood. Sleep problems can lead to irritability, aggression, poor memory and concentration, as well as emotional issues such as stress and depression. And when a child doesn’t sleep well the whole family can be affected.

How much sleep do children need?

On average, adults need around seven to nine hours of sleep a night (vi). However children need different amounts of sleep at different ages. The following is a guide to the approximate hours of sleep needed by children of different ages, as recommended by experts at the Millpond Children’s Sleep Clinic (vii):

• 1 week: 8 hours during the day, 8 hours 30 minutes at night

• 4 weeks: 6 - 8 hours during the day, 8 - 9 hours at night

• 3 months: 4 - 5 hours during the day, 10 - 11 hours at night

• 6 months: 3 hours during the day, 11 hours at night

• 9 months: 2 hours 30 minutes during the day, 11 hours at night

• 12 months: 2 hours 30 minutes during the day, 11 hours at night

• 2 years: 1 hour 30 minutes during the day, 11 hours 30 minutes at night

• 3 years: 0 - 45 minutes during the day, 11 hours 30 minutes - 12 hours at night

• 4 years: 11 hours 30 minutes at night

• 5 years: 11 hours at night

• 6 years: 10 hours 45 minutes at night

• 7 years: 10 hours 30 minutes at night

• 8 years: 10 hours 15 minutes at night

• 9 years: 10 hours at night

• 10 years: 9 hours 45 minutes at night

• 11 years: 9 hours 30 minutes at night

• 12 years: 9 hours 15 minutes at night

• 13 years: 9 hours 15 minutes at night

• 14 years: 9 hours at night

• 15 years: 9 hours at night

• 16 years: 9 hours at night

 

Common childhood sleep disorders

Besides sleeplessness, some children are affected by sleep disorders called parasomnias that can disrupt their sleep or make sleeping otherwise problematic.

The most common parasomnias include the following:

Sleepwalking

While this can be alarming for parents because they may worry a sleepwalking child could injuring themselves, it’s usually just a phase that most children grow out of without harm. Sleepwalking can run in families, but it may also be triggered by eating foods high in sugar or not getting enough sleep. Around 17 per cent of children, mostly between the ages of eight and 12 years, are thought to be affected by sleepwalking, compared with around four per cent of adults (i).

According to experts from the Millpond Sleep Clinic it’s best not to wake a child who is sleepwalking, but to gently guide them back to bed and stay with them until they settle (viii). You can also help keep a sleepwalking child safe by fixing a stair gate at the top of the stairs and making sure all your windows are locked and secured.

Night terrors

This can also be alarming for parents. If a child has night terrors, they may seem to wake up suddenly and become very agitated, thrashing around, screaming and crying, plus their heart rate may be very fast and their pupils dilated. And while they may look awake, in reality they aren’t fully awake and they don’t usually have any memory of the episode the next day.

Night terrors are common in children between the ages of three and eight years (ix), particularly those who have a family history of night terrors or sleepwalking. They can happen when a child is tired or when they have a fever, or if something wakes them from deep sleep, such as a loud sudden noise or if they have a full bladder.

Again, it’s best not to wake a child who’s having an episode of night terrors, just to wait with them until they settle down again. According to the NHS, night terrors aren’t harmful, and most children grow out of them.

Nightmares

These are very common, and Millpond Sleep Clinic experts reckon about a quarter of three-to-six-year olds have at least one nightmare a week (x). If your child has a nightmare, they are most likely to have one in the second half of the night, as nightmares happen when your child is in a phase of sleep called REM (which is when dreaming takes place).

Most children grow out of nightmares, but they can cause strong feelings of fear, terror and distress. If your child has one, try to reassure them and, if necessary, stay with them until they’ve calmed down.

Obstructive sleep apnoea

While this isn’t classed as a parasomnia, it’s thought to affect up to five per cent of children (i). OSA is a breathing problem that happens during sleep, causing snoring and irregular breathing. And because it can disrupt a child’s sleep, OSA can make them irritable, moody, inattentive and drowsy the next day. If your child snores and you notice there are pauses in their breathing or they make snorting and choking sounds while asleep, your GP can advise you about treatment options that could improve their sleep significantly.

Sleep well tips for parents

If your child is having problems with sleeplessness, one of the most effective things you can do is to make sure they have a calming bedtime routine that’s the same every night, at the same time.

According to the Millpond Sleep Clinic, this means carrying out the same series of steps every night 30 to 40 minutes before your child goes to bed (xi). This can help your child’s body to start preparing for sleep.

For instance, your child’s bedtime ritual could start with a 10-minute warm bath, followed by a drink of water or milk, brushing their teeth then listening to some relaxing music or reading a favourite book for a few minutes before the lights go out.

If your child is hungry before they go to bed, avoid giving them anything sugary to eat – try a bowl of low-sugar cereal with milk, for instance, or some peanut butter on wholegrain bread.

Meanwhile try to make sure they don’t use a TV, computer, laptop, tablet or smartphone close to bedtime, as the bright light these devices emit has been shown to interfere with children’s ability to fall asleep (xii).

Other things you may find helpful include the following:

• Make their bedroom a comfortable, calm and relaxing environment that’s free from noise and clutter. Try to make sure their room isn’t too hot or too cold, and make it as dark as possible (if they’re afraid of the dark, use a small night light or leave the landing light on with the bedroom door slightly ajar).

• Physical activity during the daytime may help your child sleep better at night – though try to avoid any stimulating activity during the two hours leading up to bedtime.

• Keep lights as dim as possible after starting your child’s bedtime routine, as being exposed to any kind of bright light at night may keep children awake.

• Avoid allowing your child back into the living room after they’ve started their bedtime routine, as any stimulating environment can make them active again when they should be winding down.

• Try not to talk to your child about things that may be worrying them close to bedtime, as it could make them more likely to have a nightmare.

• If they’re old enough to not need sleep during the day, try not to let them take ay naps, even if they’re tired, as it could stop them from getting to sleep the following night. Similarly, try not to let them sleep in if they’ve had a restless night – ideally they should get up at the same time every day as well as going to bed at the same time every night.

 

Natural help for sleeplessness

If after establishing a regular relaxing bedtime routine your child is still having difficulties sleeping well, there are several things you could try to support them naturally:

Lavender oil

Lavender essential oil has a long tradition of helping people to sleep, and it may help children relax at bedtime too. Try adding a drop of lavender essential oil to your child’s evening bath, or heat some lavender oil in a diffuser while you’re reading their bedtime story or playing them some soothing music.

However, lavender oil may not be suitable for all children. A study published in the Journal of Pediatric Endocrinology and Metabolism suggests it may disrupt hormone levels in young boys who haven’t reached puberty (xiii). Parents of children who have asthma should also take care when diffusing lavender or any other aromatherapy oil.

Live bacteria

While the research may be in its infancy, experts are becoming increasingly interested in the fact that there may be a link between digestive health and sleep (xiv). And one way to boost your digestive health is to make sure your gut has a good balance of bacteria by topping up your levels of live bacteria.

Studies have yet to prove the benefits of live bacteria supplements use in children. In the meantime you can add more live bacteria to your child’s diet by giving them natural live yoghurt and a fermented milk drink called kefir.

Magnesium

There is evidence that taking a magnesium supplement may improve insomnia in older adults (xv), and some natural health practitioners use it for sleeplessness in children too.

Recommended doses of magnesium for children are lower than those for adults, so if you want to consider a supplement for your child ask a nutritionist for advice, or try a multivitamin and mineral supplement formulated for children that contains the correct level of magnesium for your child’s age.

You can also make sure your child has a magnesium-rich diet by giving them plenty of fruit, green leafy vegetables, peas, broccoli, green beans and whole grains such as brown rice and oats.

B vitamins

All of the B vitamins are important for health, but some may also help you sleep better because they’re involved in the body’s production of melatonin, a hormone that helps regulate sleep. Children need lower levels of B vitamins than adults, so if you’re considering a supplement one convenient way to make sure they’re getting the right level of nutrients is to give them a good-quality multivitamin and mineral supplement formulated for children that contains appropriate amounts of the various B vitamins.

There are also lots of food sources of B vitamins, including whole grains, fortified foods (such as breakfast cereals), eggs, milk, green leafy vegetables and fruit.

Thankfully, most children’s sleep problems can be resolved with time and patience. But if your child continues to suffer from sleeplessness, your GP or health visitor can refer you to a sleep clinic for further help and support. Find out if there’s a sleep clinic near where you live.
 

References:

1. Carter. K.A., Hathaway. N.E., Lettieri. C.F. Common sleep disorders in children. Am Fam Physician. 2014 Mar. 189(5):368-77. Available online: https://www.aafp.org/afp/2014/0301/p368.html

2. Nunes. M.L., Bruni. O. Insomnia in childhood and adolescence: clinical aspects, diagnosis, and therapeutic approach. J Pediatr (Rio J). 2015 Nov-Dec. 91(6 Suppl 1):S26-35. Available online: https://www.sciencedirect.com/science/article/pii/S0021755715001308?via%3Dihub

3. Available online: https://patient.info/doctor/sleep-problems-in-children

4. Available online: https://www.theguardian.com/lifeandstyle/2018/sep/30/childrens-lack-of-sleep-is-hidden-health-crisis-experts-say

5. Available online: https://www.rcpsych.ac.uk/mental-health/parents-and-young-people/information-for-parents-and-carers/sleep-problems-in-childhood-and-adolescence-for-parents-and-carers

6. Available online: https://www.nhs.uk/conditions/insomnia

7. Available online: https://www.nhs.uk/live-well/sleep-and-tiredness/how-much-sleep-do-kids-need

8. Available online: https://millpondsleepclinic.com/category/sleep-walking

9. Available online: https://www.nhs.uk/conditions/night-terrors

10. Available online: https://millpondsleepclinic.com/category/nightmares

11. Available online: https://millpondsleepclinic.com/category/all/how-to-sleep-well

12. Akacem. L.D., et al. Sensitivity of the circadian system to evening bright light in preschool-age children. Physiol Rep. 2018 Mar. 6(5): e13617. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC58354976

13. Diaz. A., et al. Prepubertal gynecomastia and chronic lavender exposure: report of three cases. J Pediatr Endocrinol Metab. 2016 Jan. 29(1):103-7. Available online: https://www.ncbi.nlm.nih.gov/pubmed/26353172

14. Available online: https://www.theguardian.com/lifeandstyle/2018/mar/19/is-your-gut-keeping-you-awake-at-night

15. Abbasi. B., et al. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci. 2012 Dec. 17(12):1161-9. Available online: https://www.ncbi.nlm.nih.gov/pubmed/23853635

 

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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.

 

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