Sleep is no less important than food, drink, or safety in the lives of children. Although this may seem apparent, many of us actually do not allow our children to get the critical sleep they need to develop and function properly.
It's certainly not something we do on purpose. As a matter of fact, we often don't think much of it, and that is the problem. With parents working long hours, schedules packed with school, after-school activities, and other lifestyle factors, naps are missed, bedtimes are pushed back, mornings start earlier and nights may be anything but peaceful. Missing naps or going to bed a little late may not seem like a big deal, but it is. It all adds up, with consequences that may last a lifetime.
To understand the critical nature of sleep to our children's growth and development, we need to understand more about what sleep does, what healthy sleep is, and what happens when children do not get either the right amount of sleep, the best quality sleep, or both. We also need to understand the role sleep plays in being alert or drowsy, stressed or relaxed, and how that in turn may affect temperament, learning, and social behavior.
In his book Healthy Sleep Habits, Happy Child, Marc Weissbluth, MD, provides these insightful comments on the functions of sleep:
"Sleep is the power source that keeps your mind alert and calm. Every night and at every nap, sleep recharges the brain's battery. Sleeping well increases brainpower just as weight lifting builds stronger muscles, because sleeping well increases your attention span and allows you to be physically relaxed and mentally alert at the same time. Then you are at your personal best."
Essentials of Healthy Sleep
Healthy sleep requires:
- A sufficient amount of sleep
- Uninterrupted (good quality) sleep
- The proper number of age-appropriate naps
- A sleep schedule that is in sync with the child's natural biological rhythms (internal clock or circadian rhythm)
If, over time, any of these essentials are not optimal, symptoms of sleep deprivation may occur.
Optimal alertness: Healthy sleep allows us to function optimally when we are awake, to have what is called optimal alertness. We have all experienced varying degrees of being awake, from groggy to alert to hyper-alert. Being optimally alert is the state in which we are most receptive to and interactive with our environment, when we have the greatest attention span and can learn the most. You can see this in a child who is calm and attentive, pleasant, with wide eyes looking around, absorbing everything, one who socially interacts with ease. Altered states of alertness interfere with learning and behavior.
Length of sleep: Children simply must have a sufficient amount of sleep to grow, develop, and function optimally. How much is right for your child varies by age. Remember, each child is unique and individual variation occurs.
Quality of sleep: Quality sleep is uninterrupted sleep that allows your child to move through all the different and necessary stages of sleep. The quality of sleep is as important as the quantity, playing its essential role in nervous system development.
Naps: Naps play a large role in the healthy sleep of children. They help optimize your child's alertness and have an impact on her learning and development. Naps are also quite different from night sleep. Not only are they not the same kind of sleep, naps at different times of the day serve different functions. That is one reason why the timing of naps is important, and why they need to occur in sync with your child's natural biological rhythms.
In sync: We wake; we are alert; we become drowsy; we sleep. This ebb and flow, the fluctuations in alertness, all happen as part of our natural daily biological rhythms.
These rhythms are irregular in the first few months of a child's life, but gradually become more regular and develop with maturity. When sleep (naps and nighttime) is in sync with these rhythms, it is most effective, most restorative. When out of sync, it is not and can disturb the rest of the rhythm or cycle, making it more difficult to fall asleep or stay asleep, for example. This may result in your child becoming overtired and stressed. So it is important to be aware of the timing of your child's sleep needs and adjust your schedule as best you can to be in sync with hers.
Consequences of Sleep Disturbances
Sleep disturbances, for whatever reason, have significant and often serious consequences. In his book Healthy Sleep Habits, Happy Child, Weissbluth states:
"Sleep problems not only disrupt a child's nights -- they disrupt his days, too, by making him less mentally alert, more inattentive, unable to concentrate, and easily distracted. They also make him more physically impulsive, hyperactive, or lazy."
Chronic sleep deprivation: It is important to realize that the effects of chronic sleep deprivation are cumulative: daytime sleepiness increases progressively. This means that even small sleep changes, over time, will have significant negative effects. Likewise, small changes allowing a bit more sleep may have similarly positive effects. It all depends on the type and degree of the sleep problem.
Fatigue : Even seemingly minor sleep deprivation causes fatigue in children. And for a child, simply being awake a certain amount of time is over-stimulating and fatiguing, even if she is not engaged in any activity at all.
Especially during the day, with friends and family, she wants to be part of the action and so her natural response to fatigue is to "fight it." That is, she tries to remain awake and alert. This results in the secretion of hormones like adrenaline, which then cause her to become hyper alert. She is now wide-awake but exhausted. Fussiness, irritability and crankiness soon follow. She also cannot be attentive and learn well at this time. This is why overtired children often appear wide-awake, wired, and hyperactive. Now you have a situation where she is so pumped up she cannot easily fall asleep.
Interestingly this also often induces night awakenings. So don't be fooled by your seemingly wide-awake, not-tired child and put her to bed later. Putting her to bed earlier is actually the remedy. Sometimes even 15-20 minutes earlier may have a significant impact and be all that is needed. You may also be surprised to find that a well rested child is easier to put to bed.
Sleep on These
Following are some observations from various studies illustrating some of the difficulties faced and the behavioral changes in children with sleep problems (from Wiessbluth's Healthy Sleep Habits, Happy Child and On Becoming Baby Wise, by Gary Ezzo and Robert Bucknam, MD):
- Children do not "outgrow" sleep problems; problems must be solved.
- Children who sleep longer during the day have longer attention spans.
- Babies who sleep less in the daytime appear more fitful and socially demanding, and they are less able to entertain or amuse themselves.
Toddlers who sleep more are more fun to be around, more sociable, and less demanding. Children who sleep less can behave somewhat like hyperactive children.
- Small but constant deficits in sleep over time tend to have escalating and perhaps long-term effects on brain function.
- Children with higher IQs -- in every age group studied -- slept longer.
- For ADHD children, improvements in sleep dramatically improved peer relations and classroom performance.
- Healthy sleep positively affects neurologic development and appears to be the right medicine for the prevention of many learning and behavioral problems.
What Parents Can Do
As parents, it is our responsibility to be sensitive to and protect our children's sleep, just as we do their safety, just as we ensure that they regularly get breakfast, lunch, and dinner. We are primarily responsible for their sleep habits so it is important to start healthy ones early; it is much easier to instill good habits than correct bad ones.
Infuse the importance of sleep with daily attention to it and you will likely have a happier, self-assured, less demanding, and more sociable child. And you just might get some more sleep yourself.
Originally published June 2, 2003.
Medically updated Oct. 21, 2004.