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Sleep And Your Child
Deirdre Budd
Of all the issues that parents find challenging today, sleep rates amongst the top three. Especially if you are an expat who has moved abroad and left the security of your support network at home, your partner is always travelling and you are feeling isolated and exhausted. As expats, your family has enough pressures. You all need as much sleep as you can get.
The Importance Of Sleep
Sleep is important to allow the brain to rationalise the events of the day, to consolidate learning, to rest and repair, and to grow. It is while we sleep that the growth hormone is released.
As Thomas To Phaire said in the sixteenth century in The Book of the Child - the first text book of paediatric medicine.
"Sleep is as essential to a child as good nutrition."
Sleep: Is It Determined By Genes?
Sleep is thought to be affected to some extent by our genes. If our parents or grandparents have a sleep disorder there is a greater probability that our children may develop a similar disorder. For example, Narcolepsy often recurs in families.
Sleep: Is It A Learned Behavior?
When the world began, people woke, hunted, gathered and worked during daylight. When nightfall came, people slept. As we have developed as a civilisation, our sleep/wake pattern has altered. We have electric lighting, so there is no need to retire to bed when it gets dark. Plus all the good television shows come on after dark, right? Beware: our children are born into this lifestyle and many parents expect their children to wake and sleep when they do, which can lead to children's sleeping issues.
Infants demonstrate a basic rhythm to waking and sleeping. From the age of 2-4 months our children learn to sleep at appropriate times. Until a child is about 6 years old, they have a very flexible circadian rhythm (body clock). Their natural inclination is to follow the pattern of our ancestors, sleep at night and wake in the daytime. As parents we have a profound effect on setting that circadian rhythm.
Common Sleep Problems
Sleep disorders are complex, and some children experience more than one simple sleep disorder. Resolving these issues takes time. In order to do so it is very important to correctly identify the sleep disorder, and to differentiate between a sleep disorder and a physical or mental health problem.
The nature of a sleep disturbance varies with the age of the child. In the first few months of life, night waking is not uncommon. We expect this but by 6 months of age a healthy, mature baby should no longer physically require a night feed and should be able to sleep for 10-11 hours at night.
A baby who is slow to settle may have reflux, or colic, or may simply never have learned to self-soothe to sleep. If we develop a habit of holding or rocking baby until baby is soundly asleep baby tends to think he/she can only sleep when such pre conditions are present.
A toddler may resist bed time, or have night terrors, or nightmares. This can become a vicious circle. These events are most frequent when there is already a sleep deficit, and, they are themselves causes of sleep deficit. Finding a way to break this cycle can be difficult. Providing reassurance to a small child, who lacks the vocabulary to express their concerns, can be very frustrating.
A school aged child may still have nightmares or may have anxieties about school or family. Again, these concerns may not be expressed but may result in night waking.
There are over 30 recognised and classified parasomnias (partial arousals), such as sleep walking, sleep talking - some which start to become apparent at this age.
Psychiatric disorders and some medical conditions can co-exist with sleep disorders. Children who have chronic health problems and are on some types of medication may experience sleep disorders. It is estimated that 60 percent of children with handicapping conditions and pervasive developmental disorders also have sleep disorders. In a healthy child population this figure is around 25 percent.
Circadian Rhythm disorders are not uncommon. Children who go to bed but cannot get to sleep for some time, are then sleepy when they need to wake up and go to school, and find concentrating in class difficult - and may require work to re-set their body clock. Since the circadian rhythm is set at around age six and work after this to alter poor patterns is more difficult, it is best to identify and alter poor sleep patterns before this. However, parents often become angry and frustrated with children who experience delayed phase sleep disorders/early sleep phase disorders. But take heart, these can be resolved.
Physiological changes at puberty can also result in sleep disorders. Sleep is a very important, biologically complex process which we cannot thrive without.
What Can We Do To Encourage Good Sleeping Habits?
The best way to encourage positive sleeping habits is to observe good "sleep hygiene" principals: |
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Have a fixed bed and wake time. The earlier in your child's life that this is established the more likely your child will accept and adopt it. Fixed sleep and wake times help to set the circadian rhythm. |
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In the last hour before bedtime, quiet play, reading a story, drawing, listening to music, is soothing and will help your child to wind down. You may want your child to talk about their day so that they can empty their head of concerns about school, or friendships. Listen to your child. This last hour is theirs. If you can give them your undivided attention you will improve your relationship and increase your child's trust in you. Your child should be calmer and more amenable to bed time. |
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Develop and maintain a short 20 minute pre-bed routine. This should consist of three things which are always done in the same order, at the same time of night, no matter where in the world you are. This will cue your child that bedtime is not far away. |
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If your child still naps, try to have these naps completed by 3pm/3.30pm (if your child is on a 7pm bedtime and 7am wake time). If bed and wake time are later then extend the time of the last nap accordingly.) Naps are very important and should never be eliminated in the hope that the more tired your child is, the more likely they will not wake in the night. This is just not how it works. |
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