Sleep aid

 

Average Sleep requirements /day

Newborn: 16-20hrs

6mo: 13-14hrs

Toddlers (1-3yr): 12hrs

Preschoolers (3-6yr): 11-12hrs

Middle Childhood (6-12yr): 10-11hrs

Adolescents (>12yr): 9hrs

 

By 3months approximately 70% infants can sleep from midnight through to 6am (bottle-fed slightly more than breastfed infants).

 

By 6months this increases to 90%

 

Night waking increases however between 6 and 9months

 

When it comes to sleep problems, patients (in this case children) can have problems in 3 different areas related to sleep. They can have difficulty initiating sleep defined by subjective sleep latency being greater than 20-30minutes. They can have difficulty maintaining sleep defined by subjective time awake after sleep onset being greater than 20-30minutes. They can suffer from early morning awakening with difficulty returning to sleep.

 

Advice to parents that may minimize the problem of night waking

  • After a parent-child bedtime routine, place the infant in the sleep setting while the child is still awake (i.e. do not rock an infant to sleep).

  • The parent should not be present as the child falls asleep.

  • Gradually eliminate night feedings (infants by 6months receive sufficient daytime nutrition to allow this).

  • Transitional objects (e.g. blanket, teddy bear, item of parents clothing) may minimize separation anxiety.

  • Create a consistent sleep schedule and a bedtime routine.

  • Avoid giving items in late afternoon or evening that contain caffeine (e.g. chocolate, soda)

Disturbed Sleep: Dyssomnia vs Parasomnia

Dyssomnias are believed to be the consequence of central nervous system (CNS) abnormalities that alter the sleep process. Patients with dyssomnias present with difficulty initiating or maintaining sleep or they have excessive daytime somnolence. Essentially they are primary disturbances in the quantity, quality, or timing of sleep.

Parasomnias result in disruption of an existing state of sleep. Arousals, partial arousals, and sleep-stage transition impositions define this category. Examples are night terrors, sleep walking, sleep talking, and bruxism (the involuntary habitual grinding of the teeth).

Most children outgrow their parasomnias, therefore watchful waiting with follow-up is usually sufficient. Specific management practices may apply. If the child is younger than 10 years of age, the likelihood of progressive symptomatology and disease is comparable to that of an adult in the case of some parasomnias.

Criteria for Insomnia disorder

  • Significant distress or impairment

  • Occurring at least 3 nights per week

  • Present for at least 3 months

  • Occurring despite sufficient time for sleep

  • The insomnia is not better explained or occurs exclusively in conjunction with another sleep-wake disorder.

Good Sleep Hygiene for older children & teenagers

  • Consistent earlier bedtime

  • Consistent wake up time, weekdays and weekends

  • Avoid caffeine in evenings

  • Avoid stimulating activities such as TV or video games before bed

  • Avoid heavy meals prior to bed

 

 

The "ABCs" of "SLEEPING"

Age appropriate Bedtimes and wake-times with Consistency

 

Schedules and routines are addressed and age-appropriate

Location is reasonable and appropriate

Exercise and diet is included and focused on healthy living

Electronics removed from the bedroom or before bed

Positivity is encouraged all-round 

Independence when falling asleep is a goal or reality

Needs of child are met during the day

Great sleep will be the result

References:

Canadian Pediatric Society