Childhood Sleep Issues

By Laurie Mooney, M.D., Clinical Director of the Samaritan Sleep Center
Located in the Samaritan Professional Park
Second Floor, Ashland Medical Center
2212 Mifflin Avenue
Ashland, Ohio 44805

419-289-7139

A frequently asked question is, "How much sleep does my child need?" What we know about sleep requirements is based on averages of large populations. An individual child needs an amount of sleep that will allow him or her to wake up easily in the morning at the desired time, function optimally all day, feel alert and awake.

Having said that, the average child aged 1-5 years old generally needs 10-12 hours of sleep at night. Naps are usually eliminated by age 2-3 years. Children in this age range typically should be falling asleep in 15-30 minutes. In the 6-11 year old range, children's sleep needs decrease very slightly to an average of 9.5 to 11 hours per night. The average time to fall asleep at this age is 15 minutes.

Children still napping beyond 6 years of age are either not getting enough sleep at night, or could potentially have another sleep disorder. Children 12-18 years old need between 8.5 to 9.5 hours, although after age 15 years, requirements may increase again with growth spurts. Adults need an average of 7.5 to 8 hours of sleep. One way to determine your child's specific sleep needs is to note the hours slept during the summer when they are allowed to sleep uninterrupted in the morning.

Several sleep disorders in children can be considered behavioral, which means that with improved habits and environmental conditions, they may be easily resolved. These include insufficient sleep syndrome (not enough hours of sleep), limit-setting sleep disorder (strict bedtime is not enforced or child manipulates adult to stay up later), sleep-onset association disorder (child develops need for certain conditions to fall asleep such as bottle or pacifier/ thumb sucking, television, music, or lights on), and environmental sleep disorder (noise, lights or other disruption prevents child from falling or staying asleep). Children need routine, and teaching them good sleep habits from a young age will set them up to be good adult sleepers.

Other sleep disorders may occur in children because of genetic inheritance, anatomical factors, other medical conditions, medications, or unknown reasons. Some of the more common sleep disorders in children include bedwetting (enuresis), confusional arousals, sleepwalking, night terrors, nightmares, sleep apnea, snoring, restless legs syndrome, and narcolepsy.

One important difference in sleep disorders in children is that the symptoms or manifestations may be almost opposite as those in adults. Where adults mainly exhibit daytime sleepiness from a sleep disorder, children may be hyperactive, aggressive, defiant, act out. They often have difficulty with attention and learning, and have behavior issues in and out of school. Falling asleep in school is abnormal, and should raise concern. If a child has these problems, consider sleep disorders as a possibility and discuss with the child's physician.

If your child has delayed his or her sleep cycle over the summer, advance the sleep phase and convert them back to their school patterns. Move bedtime earlier by 15 minutes every few days, until they are back to going to bed at their "school-night" time. This time can be calculated by figuring hours needed before wake time. During the school year, avoid big changes in bedtimes on weekends. The more regular the bedtime is, the better a child's performance will be. Some other general recommendations for better sleep include avoiding caffeine, avoiding eating or heavy exercise before bed, keeping the child's bedroom quiet, fairly dark, and a comfortable temperature.