Child Sleep: Understanding Your Child's Sleep Patterns

Sleep is an essential building block for your child's mental and physical health. However, sleep problems are some of the most common issues faced by parents. Children need enough sleep to be able to play, learn and concentrate during the day. Not getting enough sleep can have a big impact on your child's behaviour, mental state and emotions.

There are many reasons why your child may not be sleeping. They may be overtired, scared, worried, or uncomfortable. They may be experiencing separation anxiety, or they may not have a bedtime routine.

No bedtime routine

Children thrive on routine. A consistent bedtime routine is the only way to honour a child's internal clock and ensure they get enough sleep. A bedtime routine is a predictable, repetitive set of activities that are carried out before bed every night. They help prepare your child for sleep by helping them relax and wind down. A predictable routine also gives your child a sense of security and teaches them how to fall asleep on their own.

Research shows that children who follow bedtime routines are more likely to go to sleep earlier, take less time falling asleep, sleep longer, and wake up less during the night. These benefits to sleep quality are still seen years later in children who followed bedtime routines when they were younger.

How to create a bedtime routine

A bedtime routine for kids usually consists of three or four activities, for example, having a snack, brushing teeth, putting on pyjamas, and reading a book. These should always be done in the same order. To make the routine even more effective, start winding down the household by dimming the lights and turning off screens in the lead-up to bed.

Typical bedtime activities that have been shown to have beneficial effects on sleep include:

• A nutritious snack or bottle/breastfeeding
• A bath or diaper change
• Brushing teeth and going to the bathroom
• A lullaby or singing a song together
• Massage, cuddling, and rocking
• Talking about their day

The bedtime routine should culminate in a goodnight kiss and lights out. You should leave the room while your child is sleepy but not asleep yet. This way, they learn to fall asleep on their own, and they won’t panic if they wake up in the middle of the night and find you gone.

Benefits of a bedtime routine

In addition to improving sleep, bedtime routines teach your child self-care and lay the ground for working memory, attention, and other cognitive skills. They also foster parent-child bonding and may help improve mood, stress levels, and behaviour.

In the long term, these benefits translate to better readiness for school, as well as better academic performance and social skills. By contrast, those who don’t follow a bedtime routine in childhood are more likely to have sleep problems and be overweight during adolescence.

Tips for creating a bedtime routine

• Keep it short and sweet: For most children, a bedtime routine should last around half an hour, or a little longer if there’s a bath included. Prolonging the routine can delay bedtime and makes it harder to implement on days when you’re short on time.
• Keep it up during the day: Following a routine during the day, including setting clear limits, leads to increased sleep duration for young children. Getting lots of exercise, sunlight, and outdoor time during the day can also help them sleep better at night.
• Listen to your child: Although you’re ultimately in charge, it’s not a bad thing to leave your child some liberty. If a part of the bedtime routine isn’t working for your child, listen to their concerns and adapt the routine if necessary.
• Follow sleep hygiene rules: Keep the bedroom dark, cool, and quiet to promote sleep. If your child is scared of the dark, you can use a dim nightlight. Even after bedtime, noise levels in the rest of the house can keep young children awake, so try to transition to quieter activities once you’ve tucked the kids in.

Separation anxiety

Understanding Separation Anxiety:

• Separation anxiety is a typical developmental phase that all children go through. It is the brain's instinct to protect oneself from potential danger.
• Young children, especially babies, do not understand the concept of time. When a parent walks out of the room, they may think the separation is permanent.
• As children grow and become more aware of their surroundings, they sense when their caregivers are not present and may feel unsafe.
• Separation anxiety can be triggered by various factors, such as starting school or daycare, the arrival of a sibling, moving to a new home, or changes in caregivers.
• It usually peaks between 10 and 18 months and typically ends by the time a child is 3 years old. However, it may vary for each child.

Signs and Symptoms of Separation Anxiety:

• Inability or refusal to fall asleep without a parent nearby.
• Crying and clinging behaviour, especially in new situations or around strangers.
• Frequent night wakings and inconsistent sleeping patterns.
• Increased anxiety when leaving home or being left alone.
• Screaming and tantrums when separated from caregivers.
• Longer naps during the day due to lack of sleep at night.

Strategies to Manage Separation Anxiety:

• Maintain a consistent and positive bedtime routine. A predictable schedule can help minimise a child's anxiety.
• Offer comfort items such as blankies, stuffed animals, or night lights to provide a sense of security.
• Practice planned separations by playing games like peek-a-boo or hide-and-seek to help children understand that you will come back.
• Create a brief goodbye ritual, such as a hug, kiss, and reassuring words. Avoid prolonging goodbyes, as it can increase anxiety.
• Stay calm and reassure your child that you are there for them. Your confidence and calm presence can help soothe their anxiety.
• Avoid sneaking out of the room after they fall asleep. Instead, let them know you are leaving and that you will be there for them if needed.
• Practice separation during the day by encouraging independent play and spending time with other trusted caregivers, such as grandparents.
• Acknowledge your child's feelings and emotions and teach them coping skills, such as deep breathing and visualisation techniques.
• Maintain your own emotional well-being by taking breaks and seeking support when needed.

Screen time before bed

Research has shown that screen time before bed is associated with delayed bedtimes and shorter total sleep time in children. One study found that 3-year-olds who watched a 10-minute episode of a TV show before bed took longer to fall asleep. Another study found that for every minute of daytime touchscreen use by 13-month-olds, there was one minute of lost nighttime sleep.

The American Academy of Pediatrics (AAP) recommends that screen time be limited to one hour a day for children aged 2 to 5. However, a Common Sense Media study showed that 2- to 4-year-olds logged an average of two-and-a-half hours of daily screen time. To reduce the negative effects of screen time on sleep, it is recommended that digital technology use be avoided in the hour before bedtime. This includes mobile phones, tablets, computer screens, and TV. Instead, children should be encouraged to engage in quiet activities such as reading or listening to music.

It is also important to monitor and limit violent or stressful content at any time of day, as this can affect sleep regardless of the time and length of use. Encouraging children to connect with friends earlier in the day and to engage in outdoor physical activity can also improve sleep at night. Implementing family rules, such as leaving mobile phones and other devices in a family room overnight, can help establish healthy sleep habits.

Lack of exercise

Sleep is vital for a child's health, development, and well-being. It helps them stay healthy, grow, learn, and do well in school. However, one common reason why children may not be getting enough sleep is a lack of exercise.

Children who don't get enough exercise are more likely to have trouble falling and staying asleep. Sleep deprivation can build up over time, resulting in the equivalent of a whole night of missed sleep by the end of the week. This can lead to attention problems, inconsistent performance, short-term memory loss, and delayed response times. Regular exercise helps children maintain healthy sleep patterns and makes it easier for them to fall asleep and stay asleep.

There are several reasons why children may not be getting enough exercise. One significant factor is the increasing use of modern technology, such as video games and television, which replaces traditional playtime and keeps children indoors without burning many calories. Additionally, children may lack safe places to play outdoors or adequate supervision. In some cases, exercise may not be a family priority, and if parents don't exercise, children are less likely to follow suit.

To encourage children to get enough exercise, it's important to lead by example. Parents can participate in physical activities with their children, making it a family affair. It's also crucial to respect children's choices and involve them in activities they enjoy, whether it's a group sport or nature walks. By making exercise fun and avoiding overdoing it, children will be more inclined to develop healthy habits that benefit their sleep and overall well-being.

• Be a role model: Children learn more by observing than by being instructed. Try to be active as a family and include a variety of fun activities that they will look forward to.
• Limit screen time: Set limits on electronic devices and avoid unsupervised screen time, especially for younger children.
• Make it fun: Add variety to their routine with nature walks, outdoor games, swimming, or group activities.
• Keep a realistic schedule: Establish a consistent schedule that includes time for exercise, sleep, and other activities.
• Encourage and praise: All children have different abilities, so encourage and praise their efforts, boosting their confidence and motivation.
• Safety first: Supervise your child when needed, ensure they wear safety gear, and take necessary precautions to prevent injuries.

Sleep disorders

Sleep is an essential building block for a child's mental and physical health. However, the American Academy of Pediatrics estimates that sleep problems affect 25 to 50 percent of children.

Dysomnias

• Excessive daytime sleepiness
• Problems getting to sleep
• Obstructive sleep apnea
• Insomnia

Parasomnias

• Night terrors
• Sleepwalking
• Sleep talking
• Snoring
• Restless leg syndrome

Causes of Sleep Disorders in Children

Certain sleep disorders have similar causes in both adults and children. Obesity is a leading risk factor for developing obstructive sleep apnea, a sleep-related breathing disorder. Sleep disorders that may have a genetic predisposition, such as restless legs syndrome, affect children as well as adults. In addition, certain medical issues and anxiety disorders can increase the risk for sleep issues at any age.

Behavioral patterns unique to children can also lead to sleep disorders. Up to about age 5, insomnia is usually the result of inconsistent bedtimes and bedtime-resistant behaviors. Insomnia affects 20% to 30% of children and is characterized by trouble falling asleep, staying asleep, or both.

Treatment

Behavioral changes such as establishing a consistent bedtime routine are typically the first line of treatment for sleep disorders in children and can lead to improvements in well-being for both the child and their caregivers.

Frequently asked questions