Childhood Sleep Problems

Sleep problems in children are exceedingly common, with studies indicating that between 25% to 40% of children aged 1-5 will encounter some form of sleep issue. These problems often persist, making it imperative to address them effectively. The most prevalent issues among children are difficulty falling asleep and frequent nocturnal awakenings. These problems not only impact the duration but also the quality of sleep.

These problems can arise due to improper sleep-related behaviors or inadequate management of sleep refusals and nocturnal awakenings. Over time, these issues can worsen, necessitating professional intervention. Nonetheless, many children respond well to treatments, which are typically of a short duration. Work, training, and explanations of sleep-promotion principles and proper sleep-related behaviors are key to helping, preventing, and treating these sleep problems.

Generally, during the first five years of childhood, the number of nocturnal awakenings tends to decrease while the quality of sleep improves. However, young children exhibit substantial variation in both sleep duration and the frequency of nighttime awakenings. Despite this, recommendations suggest that children aged 1-3 need between 12-14 hours of sleep, children aged 3-5 require 11-12 hours, and school-age children (6-12) should aim for 10-11 hours. It is vital to acknowledge that achieving the desired amount of sleep does not necessarily guarantee good quality sleep, as certain sleep disorders, such as multiple awakenings or sleep apnea, can impair the child’s sleep quality.

When parents perceive their child’s sleep as problematic, their complaints typically revolve around difficulty putting the child to sleep, frequent awakenings, prolonged awakenings, difficulty falling asleep after waking up, and early awakening. Parents often gauge the quality of their child’s sleep based on the frequency of nighttime awakenings.

Why Is Diagnosing and Treating Children’s Sleep Problems Important?

Several findings underscore the significance of addressing sleep problems in children. Sleep plays a crucial role in normal childhood development, and sleep issues can have adverse effects on physical, cognitive, behavioral, and emotional development. These problems have been associated with:

• A negative impact on daily functioning, often leading to behavioral problems in typically developing children.
• Links to mood disorders, depressive and anxiety symptoms, and difficulties in emotional regulation, particularly in children with short sleep duration.
• An association with attention deficit hyperactivity disorder (ADHD) in children, as those with shorter sleep duration are at a higher risk of developing hyperactivity-impulsivity symptoms.
• Effects on cognitive development and academic performance, as sleep disorders in childhood have been linked to lower neuropsychological functioning in adolescence.
• An increased risk of injury.
• Impairment of family relationships and functioning, with maternal depression and marital problems being common consequences.
• A higher risk of childhood obesity.

Principles of Sleep Hygiene

To promote better sleep habits and behaviors, it is essential to adopt principles of sleep hygiene. These principles should be consistently applied throughout the day and night to improve the overall sleep pattern. Key elements of sleep hygiene include:

• Establishing a regular bedtime routine at more or less fixed times, including enjoyable and relaxing activities, preferably shared with a parent.
• Maintaining a consistent wake-up time.
• Avoiding caffeine consumption at least four hours before bedtime, as caffeine is found in coffee, tea, chocolate, Coca-Cola, and similar products.
• Creating a comfortable sleeping environment with a dark, quiet room (a night light is acceptable, but avoid having a television in the room).
• Managing your child’s physical activity while steering clear of vigorous exercise close to bedtime.
• Setting clear boundaries for bedtime and lights-out.
• Ensuring your child sleeps in their bed without frequent changes in their sleeping location.
• Limiting daytime naps for school-aged children.
• Exposing your child to sunlight during the day, particularly in the morning and early afternoon.
• If your child experiences snoring, restlessness at night, daytime fatigue, frequent nighttime awakenings, sleep-related anxieties, or the need for an adult to help them sleep, it is advisable to seek professional guidance.

Please click here for preliminary childrens sleep assessment questionnaire