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Children's Health: Sleep and Your Preschooler
Establishing a Bedtime Routine
Preschoolers sleep about 10 to 12 hours during each 24-hour period, but there's no need to be rigid about which 10 to 12 hours these are. The most important thing is to help kids develop good habits for getting to sleep.
A bedtime routine is a great way to ensure that your preschooler gets enough sleep. Here are a few things to keep in mind when establishing one:
Include a winding-down period during the half hour before bedtime.
Stick to a bedtime, alerting your child both half an hour and 10 minutes beforehand.
Set fixed times for going to bed, waking up, and taking naps.
Keep consistent playtimes and mealtimes.
Avoid stimulants, such as caffeine, near bedtime.
Make the bedroom quiet, cozy, and conducive to sleeping.
Use the bed only for sleeping — not for playing or watching TV.
Limit food and drink before bedtime.
Allow your child to choose which pajamas to wear, which stuffed animal to take to bed, etc.
Consider playing soft, soothing music.
Tuck your child into bed snugly for a feeling of security.
A Note on Naps
Most preschoolers do still need naps during the day. They tend to be very active — running around, playing, going to school, and exploring their surroundings — so it's a good idea to give them a special opportunity to slow down. Even if your child can't fall asleep, try to set aside some quiet time during the day for relaxing. (And you'll probably benefit from a break too!)
The best way to encourage napping is to set up a routine for your child, just as you do for bedtime. Your preschooler, not wanting to miss out on any of the action, may resist a nap, but it's important to keep the routine firm and consistent. Explain that this is quiet time and that you want your child to start out in bed, but that it's OK to play in the bedroom quietly if he or she can't sleep.
How long should naps last? For however long you feel your child needs to get some rest. Usually, about an hour is sufficient. But there will be times when your child has been going full tilt and will need a longer nap, and others when you hear your child chattering away, playing through the entire naptime.
Sleeping Problems
Preschoolers may have nightmares, or night terrors, and there may be many nights when they have trouble falling asleep.
It may help if you create a "nighttime kit" to keep near your child's bed for these times. That kit might include a flashlight, a favorite book, and a cassette or CD to play. Explain the kit, then put it in a special place where your child can get to it in the middle of the night.
Objects like stuffed animals and blankets also can help kids feel safe. If your child doesn't have a favorite toy and getting to sleep has become consistently difficult, then it might be worth going out together to pick out a warm, soft blanket or stuffed animal.
Some parents get into the habit of lying down next to their young kids until they fall asleep. While this may do the trick temporarily, it won't help sleeping patterns in the long term. It's important to provide comfort and reassurance, but kids need to fall asleep independently for when parents aren't around. If you establish a routine where you have to be there for your child to go to sleep, then it will be difficult for both of you — and unfair to your child — if you start leaving beforehand.
If you're worried about your child's sleeping patterns, talk with your doctor. Although there isn't one sure way to raise a good sleeper, most kids have the ability to sleep well and work through any sleeping problems. The key is to try from early on to establish healthy bedtime habits.
Reviewed by: Steven Dowshen, MD
Children's Health: All About Sleep
Sleep — or lack of it — is probably the most-discussed aspect of baby care. New parents discover its vital importance those first few weeks and months. The quality and quantity of an infant's sleep affects the well-being of everyone in the household.
And sleep struggles rarely end with a growing child's move from crib to bed. It simply changes form. Instead of cries, it's pleas or refusals. Instead of a feeding at 3:00 AM, it's a nightmare or request for water.
So how do you get your child to bed through the cries, screams, avoidance tactics, and pleas? How should you respond when you're awakened in the middle of the night? And how much sleep is enough for your kids?
How Much Is Enough?
It all depends on a child's age. Charts that list the hours of sleep likely to be required by an infant or a 2-year-old may cause concern when individual differences aren't considered. These numbers are simply averages reported for large groups of kids of particular ages.
There's no magical number of hours required by all kids in a certain age group. Two-year-old Sarah might sleep from 8:00 PM to 8:00 AM, whereas 2-year-old Johnny is just as alert the next day after sleeping from 9:00 PM to 6:00 AM.
Still, sleep is very important to kids' well-being. The link between a lack of sleep and a child's behavior isn't always obvious. When adults are tired, they can be grumpy or have low energy, but kids can become hyper, disagreeable, and have extremes in behavior.
Most kids' sleep requirements fall within a predictable range of hours based on their age, but each child is a unique individual with distinct sleep needs.
Here are some approximate numbers based on age, accompanied by age-appropriate pro-sleep tactics.
Babies (up to 6 Months)
There is no sleep formula for newborns because their internal clocks aren't fully developed yet. They generally sleep or drowse for 16 to 20 hours a day, divided about equally between night and day.
Newborns should be awakened every 3 to 4 hours until their weight gain is established, which typically happens within the first couple of weeks. After that, it's OK if a baby sleeps for longer periods of time. But don't get your slumber hopes up just yet — most infants won't snooze for extended periods of time because they get hungry.
After the first couple of weeks, infants may sleep for as long as 4 or 5 hours — this is about how long their small bellies can go between feedings. If babies do sleep a good stretch at night, they may want to nurse or get the bottle more frequently during the day.
Just when parents feel that sleeping through the night seems like a far-off dream, their baby's sleep time usually begins to shift toward night. At 3 months, a baby averages about 13 hours of sleep in a 24 hour period (4-5 hours of sleep during the day broken into several naps and 8-9 hours at night, usually with an interruption or two). About 90% of babies this age sleep through the night, meaning 5 to 6 hours in a row.
But it's important to recognize that babies aren't always awake when they sound like they are; they can cry and make all sorts of other noises during light sleep. Even if they do wake up in the night, they may only be awake for a few minutes before falling asleep again on their own.
If a baby under 6 months old continues to cry, it's time to respond. Your baby may be genuinely uncomfortable: hungry, wet, cold, or even sick. But routine nighttime awakenings for changing and feeding should be as quick and quiet as possible. Don't provide any unnecessary stimulation, such as talking, playing, or turning on the lights. Encourage the idea that nighttime is for sleeping. You have to teach this because your baby doesn't care what time it is as long as his or her needs are met.
Ideally, your baby should be placed in the crib before falling asleep. And it's not too early to establish a simple bedtime routine. Any soothing activities, performed consistently and in the same order each night, can make up the routine. Your baby will associate these with sleeping, and they'll help him or her wind down.
The goal is for babies to fall asleep independently, and to learn to soothe themselves and go back to sleep if they should wake up in the middle of the night.
Babies (up to 6 Months)
There is no sleep formula for newborns because their internal clocks aren't fully developed yet. They generally sleep or drowse for 16 to 20 hours a day, divided about equally between night and day.
Newborns should be awakened every 3 to 4 hours until their weight gain is established, which typically happens within the first couple of weeks. After that, it's OK if a baby sleeps for longer periods of time. But don't get your slumber hopes up just yet — most infants won't snooze for extended periods of time because they get hungry.
After the first couple of weeks, infants may sleep for as long as 4 or 5 hours — this is about how long their small bellies can go between feedings. If babies do sleep a good stretch at night, they may want to nurse or get the bottle more frequently during the day.
Just when parents feel that sleeping through the night seems like a far-off dream, their baby's sleep time usually begins to shift toward night. At 3 months, a baby averages about 13 hours of sleep in a 24 hour period (4-5 hours of sleep during the day broken into several naps and 8-9 hours at night, usually with an interruption or two). About 90% of babies this age sleep through the night, meaning 5 to 6 hours in a row.
But it's important to recognize that babies aren't always awake when they sound like they are; they can cry and make all sorts of other noises during light sleep. Even if they do wake up in the night, they may only be awake for a few minutes before falling asleep again on their own.
If a baby under 6 months old continues to cry, it's time to respond. Your baby may be genuinely uncomfortable: hungry, wet, cold, or even sick. But routine nighttime awakenings for changing and feeding should be as quick and quiet as possible. Don't provide any unnecessary stimulation, such as talking, playing, or turning on the lights. Encourage the idea that nighttime is for sleeping. You have to teach this because your baby doesn't care what time it is as long as his or her needs are met.
Ideally, your baby should be placed in the crib before falling asleep. And it's not too early to establish a simple bedtime routine. Any soothing activities, performed consistently and in the same order each night, can make up the routine. Your baby will associate these with sleeping, and they'll help him or her wind down.
The goal is for babies to fall asleep independently, and to learn to soothe themselves and go back to sleep if they should wake up in the middle of the night.
Preschoolers
Preschoolers sleep about 10 to 12 hours per night. A preschool child who gets adequate rest at night may no longer needs a daytime nap. Instead, a quiet time may be substituted.
Most nursery schools and kindergartens have quiet periods when the kids lie on mats or just rest. As kids give up their naps, bedtimes may come earlier than during the toddler years.
School-Age Children and Preteens
School-age kids need 10 to 12 hours of sleep a night. Bedtime difficulties can arise at this age for a variety of reasons. Homework, sports and after-school activities, TVs, computers, and video games, as well as hectic family schedules might contribute to kids not getting enough sleep.
Lack of sleep can cause irritable or hyper types of behavior and may make it difficult for kids to pay attention in school. It is important to have a consistent bedtime, especially on school nights. Be sure to leave enough time before bed to allow your child to unwind before lights out.
Teens
Adolescents need about 8½ to 9½ hours of sleep per night, but many don't get it. Because of early school start times on top of schedules packed with school, homework, friends, and activities, they're typically chronically sleep deprived.
And sleep deprivation adds up over time, so an hour less per night is like a full night without sleep by the end of the week. Among other things, an insufficient amount of sleep can lead to:
decreased attentiveness
decreased short-term memory
inconsistent performance
delayed response time
These can cause bad tempers, problems in school, stimulant use, and driving accidents (more than half of "asleep-at-the-wheel" car accidents are caused by teens).
Teens also experience a change in their sleep patterns — their bodies want to stay up late and wake up later, which often leads to them trying to catch up on sleep during the weekend. This sleep schedule irregularity can actually aggravate the problems and make getting to sleep at a reasonable hour during the week even harder.
Ideally, a teen should try to go to bed at the same time every night and wake up at the same time every morning, allowing for at least 8 to 9 hours of sleep.
Bedtime Routines
No matter what your child's age, establish a bedtime routine that encourages good sleep habits. These tips can help kids ease into a good night's sleep:
Include a winding-down period in the routine.
Stick to a bedtime, alerting your child both half an hour and 10 minutes beforehand.
Encourage older kids and teens to set and maintain a bedtime that allows for the full hours of sleep needed at their age.
Reviewed by: Mary L. Gavin, MD
