If you are worried that your child is not getting the required amount of sleep, or is sleeping at unusual hours while being fully awake at the ‘wrong time of day,’ the first thing to do is understand that normal sleep patterns change throughout childhood. After you have a clearer understanding of what ‘normal’ means in terms of sleep patterns in children, you may see that there is no problem at all. Perhaps what you are experiencing is normal for that particular developmental age. On the other hand, you may find that your child has fallen prey to one of the recognized sleep disorders in children.
Normal Sleep Patterns Change With Age
When infants come home from the hospital, parents expect that they are going to be subjected to being awakened several times throughout the night because that’s what newborns do! They sleep almost around the clock except for those feedings that seem to be required every three to four hours for the first few months of life outside the womb. However, as children grow their sleep patterns change and they will normally begin sleeping for longer periods of time which, thankfully, allows for mom and dad to eventually get a good night’s sleep.
Sleep Patterns in Infants and Children
Like adults, children cycle through REM (rapid eye movement) and NREM (non-REM) sleep patterns throughout the night. These cycles actually begin in the womb but as a child develops, he or she will begin to sleep for longer periods during the night and fewer ‘naps’ will be required during the day. By the time children are 6 months old they should be sleeping approximately 13 hours each day with the longest span somewhere around 7 hours in duration. By the time children are 2 they should be sleeping around 12 hours daily, of course including naps, and by the time they are 4 years old they will sleep anywhere from 10 to 12 hours with only one nap at the most.
Sleep Patterns in Adolescents
Usually children will continue sleeping somewhere around 10 hours a night until they reach adolescence, that magical age that most parents dread. Not only do their sleep patterns change significantly, but so too do their socio-cultural activities as well. Most of the time what we are wont to call sleep disorders in adolescence is normal for that stage in the child’s development. In a perfect world, a teenager should be getting perhaps 9 hours of sleep per day, but in the real world you will be lucky if your child sleeps 7 or 8 at best. While a portion of the problem rests with their rapidly changing social demands, part of it is in the body’s pattern of producing melatonin that triggers sleep and cortisol that signals a child to awaken.
How to Recognize Sleep Disorders in Children
After you understand what ‘normal’ sleep patterns are for the developmental stage of your child you can better recognize whether or not there is a potential problem. Also, there are several different types of sleep disorders in children to be aware of and the treatment for each differs based on the root cause. Once you notice that your child is not getting the required amount of sleep or at the appropriate times of day, you can better discuss the problem with a medical professional or social worker. Following are some of the most common sleep disorders you might come up against.
Bedwetting at Night
This is perhaps one of the most misunderstood sleep disorders which will prompt parents to react inappropriately. Contrary to popular opinion, bedwetting is rarely caused by drinking too much before bedtime. By allowing yourself to become the strict enforcer of no drinks after a certain time in the evening you may actually be exacerbating the problem! Bedwetting is most often a sign of some emotional stress and the worst thing that you could do would be to add to that stress by becoming a disciplinarian. Child psychologists have noted that quite often a child begins wetting the bed after a divorce, separation or even the loss of a parent. Sometimes bedwetting has to do with a genetic problem with the lower bladder that may require medication.
Night Terrors and/or Sleep-Onset Anxiety
Night terrors are not quite the same thing as sleep-onset anxiety, but both are caused by some emotional stressor. Sleep-onset anxiety is generally the inability to fall asleep because the child is fretting about something. It could be a real worry, such as some problem the child is experiencing at school or it could be some unfounded fear which requires medical or psychological intervention. Night terrors, on the other hand, occur when the child is asleep during NREM. Most often children between the ages of 4 and 8 would be susceptible to night terrors while sleep-onset anxiety is experienced in pre and post pubescent children. Most often a child will not wake up during a night terrors episode so do not try to wake him/her. Simply make sure your child is comfortable. There are various treatments for sleep-onset anxiety which may be discussed with your pediatrician if calming routines at bedtime are not effective.
Typically, sleep walking begins between the ages of 8 and 12 and will usually resolve itself by the time your child reaches adolescence. You may notice that your child sits up in bed and begins mumbling unintelligible ‘gibberish.’ From there, he or she may start wandering around the house. Many children have even been found wandering outside the house which can present a very real danger. If you should happen to wake children during a sleep walking episode, they will usually be extremely disoriented and will not understand how they ‘got there.’ The best treatment is to take precautionary methods. If at all possible, keep your child’s bedroom downstairs on a first floor and install locks to the outer doors which a child couldn’t open on his or her own. Again, sleep walking will normally disappear as children reach puberty so the only thing to do is keep them safe in the interim.
There are actually quite a number of less common sleep disorders in children including narcolepsy, obstructive sleep apnea, delayed sleep-phase syndrome and circadian rhythm sleep disorder. While obstructive sleep apnea is more common in adults, children have also been diagnosed with this disorder. The thing to be aware of is that some sleep disorders will normally resolve themselves as the child grows older while others may indeed need medical or pharmacological intervention. If the sleep disorder is interfering with your child’s activities or lifestyle during the day it is imperative to speak with your pediatrician about the problem. Your doctor may order a sleep study or may simply prescribe a medication or refer you to a behavioral counselor. The key is in recognizing the problem and seeking help if it is an ongoing occurrence.