Sleep — or lack of it — is probably the most-discussed aspect of baby
care. New parents discover its vital importance those first few weeks
and months. The quality and quantity of an infant's sleep affects the
well-being of everyone in the household.
And sleep struggles rarely end with a growing
child's move from crib to bed. It simply changes form. Instead of
cries, it's pleas or refusals. Instead of a feeding at 3:00 AM, it's a
nightmare or request for water.
So how do you get your child to bed through the
cries, screams, avoidance tactics, and pleas? How should you respond
when you're awakened in the middle of the night? And how much sleep is
enough for your kids?
How Much Is Enough?
It all depends on a child's age. Charts that list the hours of sleep
likely to be required by an infant or a 2-year-old may cause concern
when individual differences aren't considered. These numbers are simply
averages reported for large groups of kids of particular ages.
There's no magical number of hours required by all
kids in a certain age group. Two-year-old Sarah might sleep from 8:00 PM
to 8:00 AM, whereas 2-year-old Johnny is just as alert the next day
after sleeping from 9:00 PM to 6:00 AM.
Still, sleep is very important to kids' well-being. The link between a
lack of sleep and a child's behavior isn't always obvious. When adults
are tired, they can be grumpy or have low energy, but kids can become
hyper, disagreeable, and have extremes in behavior.
Most kids' sleep requirements fall within a predictable range of
hours based on their age, but each child is a unique individual with
distinct sleep needs.
Here are some approximate numbers based on age, accompanied by age-appropriate pro-sleep tactics.
Babies (up to 6 Months)
There is no sleep formula for newborns because their internal clocks
aren't fully developed yet. They generally sleep or drowse for 16 to 20
hours a day, divided about equally between night and day.
Newborns should be awakened every 3 to 4 hours until their weight
gain is established, which typically happens within the first couple of
weeks. After that, it's OK if a baby sleeps for longer periods of time.
But don't get your slumber hopes up just yet — most infants won't snooze
for extended periods of time because they get hungry.
After the first couple of weeks, infants may sleep for as long as 4
or 5 hours — this is about how long their small bellies can go between
feedings. If babies do sleep a good stretch at night, they may want to
nurse or get the bottle more frequently during the day.
Just when parents feel that sleeping through the night seems like a
far-off dream, their baby's sleep time usually begins to shift toward
night. At 3 months, a baby averages about 13 hours of sleep in a 24 hour
period (4-5 hours of sleep during the day broken into several naps and
8-9 hours at night, usually with an interruption or two). About 90% of
babies this age sleep through the night, meaning 5 to 6 hours in a row.
But it's important to recognize that babies aren't always awake when they sound
like they are; they can cry and make all sorts of other noises during
light sleep. Even if they do wake up in the night, they may only be
awake for a few minutes before falling asleep again on their own.
If a baby under 6 months old continues to cry, it's time to respond.
Your baby may be genuinely uncomfortable: hungry, wet, cold, or even
sick. But routine nighttime awakenings for changing and feeding should
be as quick and quiet as possible. Don't provide any unnecessary
stimulation, such as talking, playing, or turning on the lights.
Encourage the idea that nighttime is for sleeping. You have to teach
this because your baby doesn't care what time it is as long as his or
her needs are met.
Ideally, your baby should be placed in the crib before falling
asleep. And it's not too early to establish a simple bedtime routine.
Any soothing activities, performed consistently and in the same order
each night, can make up the routine. Your baby will associate these with
sleeping, and they'll help him or her wind down.
The goal is for babies to fall asleep independently, and to learn to
soothe themselves and go back to sleep if they should wake up in the
middle of the night.
6 to 12 Months
At 6 months, an infant may nap about 3 hours during the day and sleep
about 9 to 11 hours at night. At this age, you can begin to change your
response to an infant who awakens and cries during the night.
Parents can give babies a little more time to settle down on their
own and go back to sleep. If they don't, comfort them without picking
them up (talk softly, rub their backs), then leave — unless they appear
to be sick. Sick babies need to be picked up and cared for. If your baby
doesn't seem sick and continues to cry, you can wait a little longer,
then repeat the short crib-side visit.
Between 6 and 12 months, separation anxiety,
a normal developmental phase, comes into play. But the rules for
nighttime awakenings are the same through a baby's first birthday: Try
not to pick up your baby, turn on the lights, sing, talk, play, or feed
your child. All of these activities do not allow your baby to learn to
fall asleep on his or her own and encourage repeat awakenings.
Toddlers
From ages 1 to 3, most toddlers sleep about 10 to 13 hours.
Separation anxiety, or just the desire to be up with mom and dad (and
not miss anything), can motivate a child to stay awake. So can simple
toddler-style contrariness.
Parents sometimes make the mistake of thinking that keeping a child
up will make him or her sleepier for bedtime. In fact, though, kids can
have a harder time sleeping if they're overtired. Set regular
bedtimes and naptimes. Though most toddlers take naps during the day,
you don't have to force your child to nap. But it's important to
schedule some quiet time, even if your child chooses not to sleep.
Establishing a bedtime routine helps kids relax and get ready for
sleep. For a toddler, the routine may be from 15 to 30 minutes long and
include calming activities such as reading a story, bathing, and
listening to soft music.
Whatever the nightly ritual is, your toddler will probably insist
that it be the same every night. Just don't allow rituals to become too
long or too complicated. Whenever possible, allow your toddler to make
bedtime choices within the routine: which pajamas to wear, which stuffed
animal to take to bed, what music to play. This gives your little one a
sense of control over the routine.
But even the best sleepers give parents an occasional wake-up call. Teething
can awaken a toddler and so can dreams. Active dreaming begins at this
age, and for very young children, dreams can be pretty alarming.
Nightmares are particularly frightening to a toddler, who can't
distinguish imagination from reality. (So carefully select what TV
programs, if any, your toddler sees before bedtime.)
Comfort and hold your child at these times. Let your toddler talk
about the dream if he or she wants to, and stay until your child is
calm. Then encourage your child to go back to sleep as soon as possible.
Preschoolers
Preschoolers sleep about 10 to 12 hours per night. A preschool child
who gets adequate rest at night may no longer needs a daytime nap.
Instead, a quiet time may be substituted.
Most nursery schools and kindergartens have quiet periods when the
kids lie on mats or just rest. As kids give up their naps, bedtimes may
come earlier than during the toddler years.
School-Age Children and Preteens
School-age kids need 10 to 12 hours of sleep a night. Bedtime
difficulties can arise at this age for a variety of reasons. Homework,
sports and after-school activities, TVs, computers, and video games, as
well as hectic family schedules might contribute to kids not getting
enough sleep.
Lack of sleep can cause irritable or hyper types of behavior and may
make it difficult for kids to pay attention in school. It is important
to have a consistent bedtime, especially on school nights. Be sure to
leave enough time before bed to allow your child to unwind before lights
out.
Teens
Adolescents need about 8½ to 9½ hours of sleep per night, but many
don't get it. Because of early school start times on top of schedules
packed with school, homework, friends, and activities, they're typically
chronically sleep deprived.
And sleep deprivation adds up over time, so an hour less per night is
like a full night without sleep by the end of the week. Among other
things, an insufficient amount of sleep can lead to:
- decreased attentiveness
- decreased short-term memory
- inconsistent performance
- delayed response time
These can cause bad tempers, problems in school, stimulant use, and
driving accidents (more than half of "asleep-at-the-wheel" car accidents
are caused by teens).
Teens also experience a change in their sleep patterns — their bodies
want to stay up late and wake up later, which often leads to them
trying to catch up on sleep during the weekend. This sleep schedule
irregularity can actually aggravate the problems and make getting to
sleep at a reasonable hour during the week even harder.
Ideally, a teen should try to go to bed at the same time every night
and wake up at the same time every morning, allowing for at least 8 to 9
hours of sleep.
Bedtime Routines
No matter what your child's age, establish a bedtime routine that
encourages good sleep habits. These tips can help kids ease into a good
night's sleep:
- Include a winding-down period in the routine.
- Stick to a bedtime, alerting your child both half an hour and 10 minutes beforehand.
- Encourage older kids and teens to set and maintain a bedtime that allows for the full hours of sleep needed at their age.
Reviewed by: Mary L. Gavin, MD
Date reviewed: January 2011
Date reviewed: January 2011
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