This week we are continuing a theme of addressing sleep and broadening the topic for sleep problems beyond the newborn period.
Take-home points for pediatric sleep problems:
- Epidemiology: In community surveys, 25% to 50% of preschoolers and up to 40% of adolescents experience sleep-related problems. These are common problems so it pays to know them well!
- Sleep duration varies by age: There is substantial variation in need for sleep, but generally, newborns sleep 16-20 hours and most can sleep through the night by 3-6 months. Infants sleep 13 to 15 hours, 2 to 5 year olds sleep 11 to 12 hours, school-age kids sleep 10 to 11 hours, and adolescents ideally 9 hours.
- Educate parents about normal sleep patterns, consistency in sleep routines, and appropriate sleep environment to prevent sleep problems. The natural rhythm of sleep follows a 70-100 minute cycle through deep sleep/REM/arousal. For many children, transitioning between sleep stages leads to a wakeful state. This can be a problem when combined with the developmental phase of separation anxiety and lead to increased nighttime demand for the parent. Appropriate parental response (through gradual removal of parent role) will lead to improved sleep habits. Sleep routines: key is consistent schedule and the 4 Bs: (Bath), Brush, Book, Bed. (In our house we add "Ballads" and do nighttime songs. 🙂 Environment: quiet, low nightlight, cool, and definitely no TV or other devices in the bedroom.
- Screening: Ask about BEARS: Bedtime problems, Excessive sleepiness, Awakenings at night, Regularity and duration, and Snoring. If you can only do one, ask about snoring to screen for obstructive sleep apnea (OSA). See articles for diagnostic criteria of specific disorders.
- Referral and resources: When concern for OSA, or other sleep disorder that is interfering with function, consult with a sleep specialist. Our own SCH sleep clinic experts provide handouts and info here.
Wishing you a happy Memorial Day weekend and time to remember all those who have served.