Posts Tagged ‘ kids’ sleep ’

Sleep And School Performance: Setting The Stage For A Good Year For Your Child

Tuesday, August 28th, 2012

Once kids are school-age, we don’t talk as much about sleep methods as we do for infants and toddlers. What we focus on is setting the proper schedule for a child, and making sure that good – and repetitive – routines are in place to help a child get the sleep they need. And as kids (and parents) start the school year, it’s worth revisiting some of the key points  - especially since there is a large (and growing) research literature documenting how a lack of proper sleep can negatively affect school performance (at any developmental stage).

You need to determine if your child is getting enough sleep. You can click here to read a prior blog post that went into this in some detail, but here are some very rough averages to keep in mind:

Ages 3 – 5: 11-12 hours

Ages 6 – 8: 10-11 hours

Ages 9-11: 10-11 hours

Ages 12-14: 9.5 – 10 hours

Ages 15-17: 9 hours

Since these are averages, your child may get a little more or less than what is listed above. That’s not necessarily bad – all kids are different. But you need to look for signs that the amount of sleep they get is right for them – or put another way, wrong for them. Signs of sleep deprivation are most telling at any age. Kids should not have difficulties waking up at the designated time during the school year. You shouldn’t have to work hard to wake them – and if they use an alarm, they shouldn’t have a tough time waking up to it. They shouldn’t be overly groggy when they get up. During the school day, they shouldn’t be yawning a lot or finding it tough to stay awake in class (a number of studies are documenting this phenomenon in school classrooms). For young kids, they should be tired when it’s nap time (not way before). For older kids, they just shouldn’t be overly tired during the day. Younger kids may be tired at the end of the school day (especially in the afternoon if they go all day), but they shouldn’t be exhausted and look like they are going to crash (it’s a sign that they are not getting enough sleep at night) – they need to crash at bedtime. Older kids shouldn’t be falling asleep in the afternoon.

These signs of sleep deprivation are critically important – plenty of studies show that sleep deprivation is associated with less learning and lower academic performance at every age.

What do you do if your child shows signs of sleep deprivation? You need to revisit their sleep cycle and figure out how much sleep they are getting. Work backwards from the time they have to get up, and figure out a new target sleep time using the averages listed above (note: not just bedtime – you need to know when they are actually going to sleep). You can introduce gradual changes  - modify the sleep time by 15 minute intervals every few nights and try to build toward the goal. What you want to do is find that sweet spot where a child’s own rhythm will get them ready for sleep at the right time – and you will know when that happens when they fall asleep in 15 – 20 minutes or so once they are in bed. You may need to examine the sleep ritual. What is your kid doing the 30 – 45 minutes before it’s bedtime? This is typically not the time for electronics, stimulating games, or television. It’s supposed to be a quiet time that gets the body and mind ready for sleep – so, think relaxed conversation, reading, anything low-key. And it’s not a time for social media either (and this statement applies to younger and younger kids every year). Structuring this time, and monitoring to make sure the rules are followed, are important – especially if there is a TV or computer in your kid’s room. Sorry, there are no big tricks up the parenting sleeve – it takes some pretty firm parenting to get this done, and done on a nightly basis.

That leads to another point that applies to all kids these days, even if sleep isn’t an issue – the problem of irregular sleep patterns. Lots of kids are busy these days, especially as they get older. There are long after-school activities and homework. The schedule isn’t the same every day. Some nights the work load is heavier than others. But the goal is to try to keep the sleep consistent during the school week – literally night after night. Irregular sleep patterns have been shown to mess up kids’ metabolic systems and can, over time, lead to gradual signs of sleep deprivation. Here’s where parents and kids have hard choices to make concerning how they spend their time and do all the things they want to do. The reality is that sleep patterns rarely factor into that mix, and they need to be considered. Many research studies – including a recent one published in the journal Child Development – show that staying up late (think cramming for an exam) has a negative effect on performance the next day. Sleep is critical for memory formation, and the lack of alertness that comes with shortened sleep often leads to non-optimal performance. So try to be extremely rigid about the sleep time – and put that on top of the list when figuring out schedules for the school year.

The issue of busy schedules leads to another point – the utility of catch-up sleep on the weekend. In moderation, this can be a very good thing for kids. An hour or two extra sleep on the weekend days during the school year can recharge the batteries (and in fact have metabolic advantages according to some studies). More than that can mess up the sleep cycle for the next week. And the corollary is that kids who have activities that get them up early on the weekends may be missing out on some sleep they need (again, another choice for parents and kids alike). If that’s the case, it’s a stronger argument for making sure your child is getting enough sleep during the week, on a nightly basis.

These are some pretty solid guidelines from research. The reality is that making sure your child gets the proper sleep to support their physical and cognitive development takes a lot of work, and it’s acknowledged that parents are also over-scheduled and in need of their own sleep (which makes the effort at the end of the day, well, feel like effort). The upside is that once good sleep habits are formed, and a solid and successful sleep schedule is in place and executed faithfully, the whole process becomes rather automatic. Of course, even with the best intentions and effort, sometimes sleep issues become difficult to solve. If that’s the case, I strongly recommend talking to your child’s pediatrician about visiting a sleep clinic. They are very skilled on figuring out real solutions to real problems (though parents will still have to do the work at home). If you haven’t read it before, here’s a link to my description of what happens at a pediatric sleep clinic.

Child soundly sleeping via Shutterstock.com 

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Type 2 Diabetes In Obese Youth Is Hard To Treat (Or Another Reason Why Prevention Is So Important)

Tuesday, May 1st, 2012

We all know that obesity rates in youth are way too high and increasing. We all know that obesity in youth is associated with the onset of type 2 diabetes. And now new research – you can click here to read the report – is showing that the initial course of treatment for type 2 diabetes in obese youth only helps about half of the kids – suggesting many will go on to need insulin therapy before they reach adulthood

What’s especially sobering is that this study was very well conducted. It used the most highly supported medication regimen for the early stages of type 2 diabetes along with psychological intervention designed to change lifestyles. The research protocol attempted to secure adherence to the interventions. The youth were carefully studied and monitored over time. Yet despite all this, in only half of the cases did the medication regimen achieve “glycemic control” – and that the psychological component did not produce additional benefit. Again – it bears repeating – the net result is that half of these kids will likely need insulin therapy in just a few years.

While it’s clear that researchers will continue to try to come up with more effective treatments for the early stages of type 2 diabetes in obese youth, this study provides yet another reason for parents to take prevention seriously in childhood. There are no magic bullets here – we all need to struggle with a number of environmental trends and pressures that promote the development of obesity in youth. So here are the logical places to start:

None of this is easy. It’s really not. Especially given the day to day challenges we all face as parents. But trying to be vigilant about your child’s nutrition, exercise, and sleep is the best pathway to trying to prevent obesity and the onset of type 2 diabetes.

Definition of insulin via Shutterstock.com

 

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Sleep Challenges, Part Two: Childhood And Middle Childhood

Saturday, December 31st, 2011

There are lots of transitions in kids sleep patterns and habits, including big ones that happen during the toddler years. That said, there are also critical changes that occur during childhood and middle childhood (I’m focusing here on 5 – 11 years of age). Most importantly, this is a developmental period where the consequences of sleep deprivation can be especially harmful. So the 2nd installment of my three-part series on sleep challenges focuses on childhood and middle childhood. 

What are the expectations? The biggest issue is that kids are in school for a good part of the year and as such are expected to have consistent sleep schedules that provide sufficient sleep to handle their cognitive, social, and emotional load. Kids between 5 and 11 years old should be getting between 10 and 11 hours of solid sleep every night, with consistent bedtimes and wake-up times. They also should not be tired during the day.

What are the challenges? Let’s start with the biggest challenge – understanding how much sleep your child actually needs and the negative consequences of not getting it. It’s troubling that study after study reports most kids get less sleep than they need – typically 1 hour less per night than is suggested. Add to this the observation from new studies that many kids get inconsistent sleep that can vary greatly from night to night. Such irregular sleep patterns have been shown to lead to substantial metabolic changes that promote risk for obesity and diabetes. And recent scientific reports – such as one that I flagged as one of the most influential studies of 2011 – have shown that sleep deprivation can have accumulating negative effects on cognitive development in childhood during key ages for learning (e.g., from 2nd grade through 4th grade). The culprits that undermine sleep can be many, including a lack of careful supervision of kids’ sleep habits, TV and electronics being available at bedtime (especially in the bedroom), increasing activities outside of school, and increasing time demands after school (such as homework).

How should you handle these challenges? We don’t typically think that sleep needs to be monitored in bigger kids like it does when we are dealing with babies or toddlers. But this isn’t true – in fact kids’ increasing independence screams out for parental monitoring given the sleep epidemic these days and the very real and serious consequences of sleep deprivation. A good start is to become familiar with the signs of sleep deprivation in children, which include the following

  • being very hard to wake-up on a consistent basis
  • sometimes falling asleep much earlier than usual
  • falling asleep frequently in the car
  • hearing from observers (such as teachers) that they seem tired, are yawning a lot, etc

If your child is showing some of these behaviors, it may be time to monitor their sleep habits more closely. Work backwards from when they need to get up and the amount of sleep they require to set a firm bedtime. Limit use of electronics before bedtime (maybe follow at a minimum a 30-minute rule – all technology gets shut down 30 minutes before bedtime). Promote reading as a good form of winding down. And try to be vigilant to make sure your child gets consistent sleep during the week – or put another way, try to avoid irregular sleep habits.

Image of sleeping child via Shutterstock.com

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Sleep Challenges, Part One: The Toddler Years

Saturday, December 31st, 2011

Making sure your child gets enough sleep is a challenge every parent faces. And the reality is that sleep needs to be managed differently as kids pass through different developmental stages – their sleep requirements change, their daily schedules evolve, and the cognitive and emotional platforms they bring to the sleep issue also can pose issues. With all this in mind, this is the first of a three-part series that takes a look at the sleep challenges that emerge during key developmental phases. First up – the toddler years. 

What are the expectations? During the toddler years – I’m focusing on ages 2-4 – the idea is that your child will settle into a consistent pattern of sleep. This should happen no matter what sleep method you choose. The two big transitions in sleep patterns that are expected to happen between ages 2 and 4 are:

  • decreasing the number of daytime naps (going from 2 naps a day to 1 and then to none)
  • decreasing the amount of total sleep during a 24-hour period (dropping from about 13 hours a night at age 2 to 11.5 hours a night at age four)

What are the  challenges? The biggest challenge is that you are, um, dealing with a toddler. As you have found out (or will find out), toddlers like to express their independence and their emotions and can be very strong willed. They might resist going to sleep or start waking up during the night. All of this is normative, reflecting both their expanding repertoire of behavior and also some physiological changes in sleep patterns. There can also be transitions in terms of moving from a crib to a bed and potentially from your room to their own room. New routines may be introduced. They may start daycare or preschool, which could change wake-up times, nap times, and amount of energy expended during the day.

How should you handle these challenges? Most importantly, be prepared to modify your child’s sleep routine (you may not have to modify it much, but it’s better to be prepared for a bigger transition in case you need one) – especially in light of the changes in sleep patterns noted above (e.g., stopping the daytime nap routine; getting less sleep at night). Some ideas to think about include:

  • Work backwards from the reality of your child’s daily routine (e.g., What time to they need to be at preschool? How much time do you all need to get ready?) AND the amount of sleep they should be getting for their age. Figure out the new bedtime and wake-up time and try to stick to it as much as possible.
  • Reevaluate sleep methods that have worked well and see if you can modify them to be more age appropriate. Whatever the method, this probably means more talk about when it’s going to be bedtime (to get your child to partner with you and to help them understand that you are setting a limit that is going to be upheld) and finding good pre-bedtime rituals to get them relaxed and ready for bed (this typically means more soothing talk from you – stories, songs, whatever – along with reading).
  • Turn off the electronics. TV is not considered a good winding down bedtime ritual. Neither is any other form of electronic stimulation.

There are lots of changes that happen throughout the toddler years. Knowing what the changes will be in terms of sleep patterns and altering your sleep methods to acknowledge the complexity of dealing with a toddler may help both you and your toddler handle these challenges well.

Image of toddler sleeping via Shutterstock.com

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