In our high-pressure, fit-it-all-in, digitally-oriented society, sleep is often way down on our priority list, for our children and teens as well as ourselves. According to the national Sleep Foundation, 60% of middle schoolers and 70% of high school students report inadequate sleep on school nights.
What is considered adequate sleep: the U.S. Centers for Disease Control and Prevention recommends 8 to ten hours of sleep in a day for teens ages 13 to18 and 9 to twelve hours for children ages 6 to 12.
Bad sleep, bad outcomes
Without good sleep, kids don’t function well, and detrimental changes start to occur in the brain. In a 2022 study published in the journal Lancet Child & Adolescent Health, researchers found that the brain regions responsible for memory, intelligence, and well-being elementary in school-age children were different for those who got less than nine hours of sleep compared to those who got the recommended nine to 12 hours of sleep per night.
“We found that children who had insufficient sleep at the beginning of the study had less grey matter or smaller volume in certain areas of the brain responsible for attention, memory, and inhibition control, compared to those with healthy sleep habits,” said study corresponding author Ze Wang, PhD, Professor of Diagnostic Radiology and Nuclear Medicine at University of Maryland School of Medicine. “These differences persisted after two years, a concerning finding that suggests long-term harm for those who do not get enough sleep.”
The brain changes correlated with greater mental health problems, like depression, anxiety, and impulsive behaviors
The root of many troubling behaviors
Sleep deprivation is the root of many behavior problems in kids, notes Mary Sheedy Kurcinka, who authored the 2015 classic “Raising Your Spirited Child: A Guide for Parents Whose Child Is More Intense, Sensitive, Perceptive, Persistent, and Energetic” (now in its third edition). Kurcinka also wrote “Sleepless in America: Is Your Child Misbehaving or Missing Sleep?” and “Kids, Parents and Power Struggles.”
She says that although the stressors that keep kids awake today have changed — chief among them too much screen, according to a 2020 report from the National Institute of Child Health and Human Development (NICHD) — the behaviors that lack of sleep causes have not. Without enough sleep, younger kids may:
- start to “lose it” over little things that don’t usually bother them.
- become emotionally intense and easily frustrated.
- lack control of their bodies – for example, becoming clumsy or tripping more often, or kids’ movements are frenzied.
- hit or bite more.
- lose focus and show poor attention/
- in an effort to stay alert, a child may create stimulation by moving from activity to activity. It becomes harder to sit down to finish anything.
- have trouble getting along with others, with frequent squabbling about little issues.
“My first question when I see these behaviors is, ‘Tell me about the child’s schedule and sleep time,'” Kurcinka told Seattle’s Child.
In tweens and teens, among other concerns, sleep deprivation can result in:
- an inability to concentrate.
- poor grades.
- drowsy-driving incidents.
- anxiety, depression, thoughts of suicide, and even suicide attempts.
Why do young kids ramp up with lack of sleep?
The connection between younger kids’ frenzied activity and lack of sleep seems counter-intuitive: Why would a child who needs sleep be more wired?
Kurcinka explained it this way: When the window of opportunity for a nap or nighttime sleep is missed for a child – that is, the time when a child’s body clock naturally winds down – arousal and adrenal systems will kick in to keep the brain and body alert. Often this arousal system will give the child a second wind that will last for 60 to 90 minutes. At that point, the now overtired child may resist falling asleep, leaving parents to believe a child doesn’t “need” as much sleep as the CDC recommends.
Make Sleep a Priority
In her books, Kurcinka advises parents to help ensure that kids get enough sleep by charting sleep times. Write down the child’s wake-up time, then shade in the hours that should be spent in nighttime sleep and nap times. Combined, the shaded areas should add up to:
- Infants 0-12 months: 14-18 hours in 24 hours
• Toddlers 13-36 months: 13 hours (including nap)
• Preschoolers 37-60 months: 12 hours (including nap)
• School-age children: 6-12 years: 10-11 hours
• Adolescents: 13-19 years: 9.25 hours
Sleep then activity
Make sleep times the priority by plugging in the rest of a child’s activities around sleep, rather than plugging in sleep around activities.
When asked whether prioritizing sleep inhibits flexibility, Kurcinka is quick to remind parents that children who are well-rested are more flexible than tired kids.
Operating on a schedule that prioritizes sleep “doesn’t mean you never do extra activities, but you count the cost,” she said. For example, if there’s been a late night because of an exciting soccer game and a party afterward, plan a quiet day, without another major activity, the next day.
“Because there’s so much emphasis on brain development in the first five years of life, we want to provide as much stimulation as we can,” she noted. “But it cannot be at the expense of sleep. The research shows that giving a child a meal and putting him to bed when he’s tired will be better for his development than one more activity.”
All-day decisions that enhance kid sleep
Putting a priority on sleep means recognizing that a good night’s sleep begins in the morning, experts say. Decisions made all through the day set the body clock and determine the quality of a child’s sleep:
- Regular Sleep Times – Irregularity – having different wake and sleep times each day – makes it difficult to regulate the body clock, as do irregular meal times and naps. Skipping naps leads to an over-tired, wired child who will not necessarily be able to go to bed earlier at night to catch up on sleep.
- Light – Strong morning light is our body’s cue to awaken, and so it is best to get the child outside in the mornings, if possible. On the other hand, too much light in the evening, including electronic light from computers and TV screens, tricks the body clock into thinking it is time to be awake.
- Exercise – Physical exercise – at least an hour a day for children – creates healthy fatigue and promotes deep, restorative sleep. Parents should watch how much time babies and toddlers are spending restrained or strapped into car seats or strollers and how much time older children are engaged in schoolwork and sedentary activities. On the other hand, too much physical activity and roughhousing in the evening make it difficult for the body to switch to sleep.
- Caffeine – Finally, be aware of how much stimulating caffeine our children are getting through drinks and even medication. Research shows that because of lower body size and different metabolisms, one can of a caffeinated soda affects a child in the same way as four cups of coffee affect an adult. Approximately half of the caffeine consumed at 3 p.m. will still be in the child’s body at 7 p.m.
Set the stage for sleep
Of course, parents can’t make a child sleep. Instead, Kurcinka urges parents to provide an environment that “values sleep and is conducive to it.”
The first step is to be aware of a child’s “window” for sleep, which is often much earlier than parents expect it to be.
“I asked the parents of a 4-year-old boy who awoke at 6:30 a.m. and had a one-hour nap during the day to describe his behavior at 7:15 p.m.,” Kurcinka explained. “They described things like rubbing his eyes, snuggling up against mom, and grabbing his blanket. This was his window. If the parents missed it, he became active again.”
Getting from red to green
The goal is to get the child out of the “red zone” of tense energy into the “green zone” of calm energy, which can lead to calm tiredness and restorative sleep. Kids can learn to notice and compensate for common triggers for tension – things like parental stress, separations, upsetting events, major life changes, and previous lack of sleep, as well as triggers for excitement, such as overstimulation, overscheduling, anticipation, growth spurts, competition and pressure to perform. If children are tense because of these triggers, parents may need to slow down the pace of their day and give them more time to connect with us and calm down at night.
Teach our children to recognize when they are in the “red zone.” Ask them to describe in terms like “I’m bubbling over,” “My body is humming” or “I feel like there’s bees buzzing inside of me.” By learning to recognize and describe such feelings, children start the process of learning to calm themselves or to tell parents when they’re keyed up.
The sleep nest
Provide kids with a “sleeping nest” by clearing extraneous stuff from their sleeping room, or at least putting toys away in containers and removing TVs, computers, and cell phones. Especially for children who are sensitive to light, tactile discomfort, or noise, keep the sleeping space “simple, safe, and serene,” Kurcinka said.
- Most children also benefit from a predictable and unrushed bedtime routine or ritual, which may include: A clear transition activity, a signal to begin getting ready for bed. This may be a snack, dimming lights, or putting away toys. It may be a bath if our child finds it soothing. Going to the bathroom, brushing your teeth, and getting into pajamas are included here.
- Connecting and calming activities to soothe the child – such as reading together, recounting the day, telling stories, or singing quiet songs.
- Cues for sleep, such as a massage or back rub, goodnight kiss, lullaby, or prayer. Try turning on a fan, white noise machine, or night light or tuck the child in.
- Switching to sleep is the last memory the child has as he falls asleep. You may need to stay near, rub the back a little more or sit on the bed until the child is ready to drift off.
One Size Does Not Fit All
No one solution works for every child and family, many experts agree. Parents need to be sensitive and responsive to their child’s individual cues as a child’s natural temperament influences her ability to go to sleep.
Intense children move more quickly, react more powerfully to emotions and events, and startle and get keyed up more easily than most children. They need more help and time to wind down at night and may benefit from more touch.
Sensitive children are more aware of noises, differences in tastes, textures, sights and sounds and of the emotions of others. They need to have a quieter, less stimulating “nest” to sleep in and will need clothing and bedclothes that do not chafe or irritate them.
Adaptable children easily move from one activity to another and are not usually upset with changes. There can be more flexibility in the times and places they sleep. Less adaptable children need established routines and need to be well prepared if there must be a change.
Some children have regular or predictable body rhythms so that they fall asleep at about the same time most days and are hungry at regular intervals. This is usually an advantage unless they must switch their schedules. Parents must make more effort to gently nudge irregular children onto a schedule by creating routines and providing support for them to wind down.
Finally, high-energy children often have a short “window” for sleep and may not give parents many cues that they are tired. They will need to have lots of physical and mental exercise throughout the day and may need medical help for Restless Leg Syndrome (unpleasant creeping, crawling, itching or burning sensations in the legs).
Similarly, the family’s comfort levels and traditions will determine whether young children co-sleep with parents in the same bed or in a crib in the same room or whether they sleep by themselves in their own rooms. There is no one right or wrong way to sleep, www.sleepmedsite.com.
Don’t let them cry aloe
In no case does Kurcinka recommend leaving a child alone to cry.
“There’s no need to do that, and we don’t know what the long-term impact is,” she told Seattle’s Child. “In order to sleep well, your child must feel safe. Sensitive, responsive care blocks the stress reaction.” Instead, she advises parents in her classes to realize that every child is unique in every situation, that it’s all right to listen to what their child needs and to offer comfort, and that they should do what works best for their families.
“Listen to your heart,” she advises. “Sometimes it takes time to make changes, but you can.”
Parents should note that some children are genetically predisposed to insomnia. Those children may have more insomnia-related sleep issues, such as difficulty falling asleep or frequently waking up during the night, according to a 2023 study published Wednesday in the Journal of Child Psychology and Psychiatry. And major events like the COVID pandemic can lead to upticks in the number of children with sleep problems. A two-year study conducted by the University of Washington found that the number of children experiencing sleep disturbances nearly doubled during the pandemic.