Friday, 01 August 2014 00:00

Is Your Child Getting Enough Sleep?

Article as it appeared in Dischem Benefits magazine - Mother and Child. By Vanessa Papas

There is nothing more precious than watching your child sleep, and nothing more frustrating than battling all night to get them to sleep. Without sleep, even the most happy, calm and loving child can become a tyrant, and the same applies to parents! Is there a secret behind creating a good sleeper? We explore the ABCs of ZZZZZs with our ultimate sleep guide.

Scientists believe every living creature on earth sleeps. It's the body's natural way of repairing and healing itself. While it's important that adults get enough sleep, sleep is critical for children as it directly impacts on their mental and physical development. Babies need between 16 and 18 hours of sleep a day, pre-schoolers between 11 and 12 hours while school-aged children need at least 10 hours.

As a teacher, I can always tell if a learner has slept very little the previous night; they tend to yawn a lot in class, struggle to complete tasks in the allocated time, are not as creative as the other children, don't come up with ideas, have impaired memory, can't concentrate, are moody and fight with their friends, and will continuously ask when is it home time," says Madelein Luttig, Grade 2 teacher at Riverside College. "If a child misses a lot of sleep for many days in a row, their studies suffer and often they develop an attitude of negativity towards school. There's an increasing body of evidence substantiating the damaging effect on children who get less sleep than they need - from weight gain to depression, from poor performance and concentration to reduced creative ability and lower immunity to diseases. Parents need to be aware of the potential long-term harm of not getting enough sleep and not developing knowledge of a good sleep habit."

Let Sleeping Babes Lie

Babies need twice as much sleep as adults due to the fact that brain development takes place while they sleep. "Quality periods of sleep are just as important to your baby as the nourishment he gets," says Sister ! Lilian, Pampers Institute and renowned parenting expert. "Research has highlighted the importance of sleep in the development of a baby's central nervous system and general baby development. There's also an indication that a healthy immune system is in part dependent on a baby having a sufficient amount of sleep. While your baby is awake, every sound and motion is a new experience which requires physical and mental energy to process, as baby hasn't yet learnt how to block out sounds and movements that he doesn't want to have to deal with.

The only way for your baby to completely 'switch off', recharge and undergo proper baby development, is to sleep. This state offers him sanctuary from his physical and social environment. Every baby is different, so parents need to be clear that the only good way to build an acceptable sleep routine is to take a baby's individual nature into account. Rather than following a prescribed routine, build one around your child's patterns. Observe your baby carefully in the initial days and weeks of life as this will give you a good idea about sleep needs and other patterns."
Small babies need to be comforted and held close for optimal emotional security and development - if this need is responded to, baby (and mom) will sleep better and more. Co-sleeping safely is an excellent sleep strategy.

Conditions That Can Affect Sleep

Bedwetting, Restless Leg Syndrome and teeth grinding can negatively impact your child's sleep patterns. Fortunately, most of the time these conditions are not a sign of any deeper medical or emotional issues, but can still be very stressful for families.

Bedwetting is one of the most common issues families face and is extremely common among young children. "Children usually achieve control over their bedwetting habits by the age of five years, however some do take longer (even up to eight years old)," says paediatrician Dr Hetan Hari. "While not often the case, bedwetting is sometimes related to certain diseases such as diabetes, urinary infections or occasionally structural problems of the renal system, or it may be related to a psychological problem. To stop bedwetting, try to restrict fluid intake two to three hours before bedtime, take your child to the toilet before sleeping, wake the child up once or twice at night to go to toilet, reward the child for dry nights and avoid punishment or humiliation as this often worsens the problem.
"Restless Leg Syndrome (RLS) is a neurologic disorder characterised by abnormal sensations (crawling and creeping) in lower limbs during periods of rest and inactivity, usually at the onset of sleep. Often it's referred to as 'growing pains' in young children. Eighty percent of children with RLS have repetitive rhythmic, kicking movements of legs and find it difficult to sleep or stay asleep. There are various treatments available that your doctor can advise you on, but a good starting point is adopting appropriate bedtime habits like a warm bath before bedtime and reading a bedtime story.
"Teeth grinding is also a common problem in children and can begin in the first five years of life. It is commonly associated with daytime anxiety and can lead to dental problems. Helping relieve anxiety in your child will help reduce grinding. Often it settles with time, without medication."

Things That Go Bump In The Night

Between 20 and 30 percent of children between the ages of five to 12 years old have frequent nightmares. "Nightmares are vivid dreams that happen in the REM state of sleep and occur more often during times of stress," says Occupational Therapist Kate Bailey. "In order to deal with nightmares, parents need to become aware of the triggers that may be causing stress and anxiety. Prepare children well for changes that may be occurring and talk to them about their fears and concerns. During the nightmare, parents should stay calm and comfort their child until they are ready to fall back to sleep.

"Children with Sensory Sensitive Processing Styles are prone to overstimulation and accumulation of stress in the day, and are thus more prone to having nightmares." Bailey says parents need to distinguish the difference between nightmares and night terrors. "Night Terrors happen shortly after a person falls asleep, in the Non Rapid Eye Movement (NREM) stage of sleep and are characterised by extreme terror and panic where a child may scream, shout or jump out of bed. Although not fully awake, their eyes are open. They do not respond to soothing from others and it is best not to wake them up. Most often, there is no recollection of the event in the morning. During episodes of night terrors, parents should stay calm, be comforting and reassuring. Do not shout, slap or shake your child. During night terrors, some children may get out of bed and try to get outside in panic. Make sure they are safe by eliminating sharp objects and closing off areas to stairs and high windows. Relaxing bedtime routines, ensuring your child has the proper amount of sleep, as well as helping them deal with their daytime stresses, will help reduce terrors. Sleep walking, and sleep talking, are also common in children and are usually outgrown."

Sleep And ADHD

Procrastination, forgetfulness, a propensity to lose things and, of course, the inability to pay attention consistently are all consequences of lack of sleep. They are also the key signs of ADHD. Could there be a link? Psychologist Claire Newton believes so. "For some children sleep deprivation does not necessarily cause lethargy, but can cause hyperactivity and unfocused behaviour. The 'over-tired' child is often difficult, whiny and can't sleep!" says Newton. "A number of studies have shown that a huge proportion of children with a diagnosis of ADHD also have one or more sleep disorders, which disrupt their sleep. Researchers are increasingly seeing connections between poor sleep and what looks like ADHD. Many patients do not have ADHD at all; they are just not getting enough deep sleep. It might just be a coincidence, but the explosion in ADHD diagnoses began in the 1990s - the same decade that our modern sleep-restricting lifestyle began getting more extreme, with its non-stop 14-hour schedules and melatonin-inhibiting electronic devices like laptops, smart phones, tablets and reading devices."

Set The Stage For Sleep 

Newton says one of the best ways to help your child sleep is to develop good 'sleep hygiene'. "Sleep hygiene refers to the principles of behaviour and the techniques that a child needs to develop to ensure he or she gets a good night's sleep and wakes up feeling great. This includes regular and consistent sleep schedules and bedtime routine, as well as a suitable sleep space. Create a habit of your child going to bed and waking up at the same time each day as this helps anchor their body clock to these times.
"Watch what children eat at dinner as a large, heavy meal too close to bedtime will interfere with their sleep. Avoid foods containing tyramine (bacon, cheese, ham, aubergines, pepperoni, raspberries, avocado, nuts, soy sauce) as tyramine causes the release of norepinephrine, a brain stimulant. Good dinner options for children are foods that trigger the hormone serotonin, which makes you sleepy (bread, cereal or fruit).
"Make sure your child's bedroom is conducive to sleep - dark and quiet (invest in curtains or blinds which block out the light, especially if you live in an area where the sun rises early or sets late). If your child has technology in his room, ban it from being used at a certain time of night. It is very important that your child has a comfortable bed with a good quality mattress (cotton bedding is best as it helps keep body at a constant temperature and reduces perspiration.

Good To Know

  • By the age of two, most children have spent more time asleep than awake and overall, a child will spend 40 percent of his or her childhood asleep.
  • Even though it will take more than a nappy to ensure that your baby sleeps well, the use of a high absorbency nappy that offers superior skin protection is a good start, as your baby is less likely to wake up during the night as a result of skin irritation.
  • Just like adults, children can also suffer from insomnia. Fortunately there are treatment options available, ranging from behavioural and cognitive-behavioural therapy, alternative and complementary medicine, to the use of prescription medications. It is vital that parents seek professional help from a doctor if they suspect their child may have a sleep disorder.
  • Electronic devices emit a certain kind of light (light in the blue-and- white range), which has an effect on your child's sleep so cover any baby monitors, radios and heaters that emit a light.
  • Milk contains a sleep promoting substance called Tryptophan so drinking a cup of hot milk laced with honey before bed aids sleep. (The milk must not be boiled though, as it loses its sleep-inducing properties.)
  • Don't allow your child caffeine at night (chocolates, tea, hot chocolate, cola drinks, milo, energy drinks).
  • Don't play activity games with your child within four hours of their bedtime as exercise produces stimulants that stop the brain from relaxing quickly.
  • Do not strive for absolute silence when babies (no matter the age) sleep. Normal background sounds (white noise) can be very relaxing and reassuring.

The Natural Sleep Cycle

Sleep occurs in a five-stage cycle that takes between 90 and 110 minutes to complete. A full night's sleep involves four or five of these cycles.

Stage 1: The 'dropping off' stage involves the transition between wakefulness and light sleep. It is short-lived and accounts for less than five percent of your sleep. It's the stage where you 'drop off'.

Stage 2: The light sleep' stage accounts for around 50 percent of your sleep.

Stages 3 and 4: The 'deep sleep' stages are progressively deeper stages of sleep. These are the stages in which physical and mental recovery happens. The amount of deep steep increases with the amount of fatigue experienced before sleep. The deeper the sleep stage, the more difficult it is to wake you and the longer it takes for you to become fully alert. At the same time, disturbances to sleep, such as a loud noise, take you back to a lighter sleep stage, interrupting the essential recuperative effect of the deep sleep stage.

Stage 5: REM sleep also known as Rapid Eye Movement (REM) sleep, is the stage that you dream. It is probably for this reason that muscle and spinal reflexes are now maximally suppressed to prevent you acting out your dreams. REM sleep is critical for mental stability, memory and learning. Lack of REM sleep is responsible for irritability, poor judgment and hallucinations. If you are sleep deprived, you usually recover your deep sleep debt on the first night and your REM sleep debt on the second night.