All about Sleep
Sleep is important for normal functioning of human body. We sleep for about a third of our life time (about eight hours of sleep a day). Sleep helps to restores brain and body function. Sleep evolves with developmental changes and maturation of the brain as children progress from infancy through to adolescence. Some parts of the brain are actively functioning during sleep. The typical sleep requirements vary with age and individual factors.
Newborns (1-2 months)
Full term babies typically sleep for about 16 to 18 hours a day. During sleep, you can witness some body movements, smiling, grimace, sucking movements, occasional twitch of fingers and feet. They wake to feed every three to five hours. Premature babies may sleep for about 20 hours a day. Their sleep patterns are quite irregular until about six to eight weeks.
Sleep Tips for Newborns
- Observe baby's sleep patterns and identify signs of sleepiness
- Put baby in the crib when drowsy, not asleep
- Place baby to sleep on his/her back with face and head clear of blankets and other soft items
- Encourage night time sleep
- The crib should be safety approved
- A quiet and dark room at a comfortable temperature
- No TV or videos should be used to settle the baby for sleep
- Soft music (not loud) can help to soothe the baby
Infants (3-11 months)
Infants typically sleep 10-14 hours during the night. They have one to four times of day nap of 30 minutes to two-hour duration and they become fewer as they reach age one. Time spent asleep starts to diminish as infants spend more time awake, moving, rolling and learning. During the infancy period sleep routine can be established, so that the timing of the sleep periods can be made regular.
When infants are put to bed drowsy but not asleep, they are more likely to become "self- soothers" which enables them to fall asleep independently at bedtime and put themselves back to sleep during the night when they wake. Those who have become accustomed to parental assistance at bedtime often become "signalers" and cry for their parents to help them return to sleep during the night.
Between six and 12 months, infants may also experience separation anxiety, a normal developmental phase. For night time awakenings: Try not to pick up your baby, turn on the lights, sing, talk or play. All of these activities do not allow your baby to learn to fall asleep on his or her own and encourage repeat awakenings. If they can initiate sleep on their own they usually sleep through the night giving parents a good night sleep.
Sleep Tips for Infants
Parents should encourage good sleep practices from an early age. Healthy sleep habits include
- Consistent bedtime routine
- Consistent sleep schedule
- Enjoyable bedtime routine
- To put to sleep when they are drowsy but not asleep
- Dark comfortable room
- Soft music can help to soothe
- Avoid co-sleeping
- Avoid night feeding after 6 months of age
- Avoiding electronic gadgets use for bedtime (e.g.; mobile phones, TV etc.)
- Encourage baby to fall asleep independently and to become "self-soothers"
Toddlers (1-3 years)
Most toddlers sleep about 11 to 14 hours in a 24 hour period. At about 18 months of age, their naptimes in the day will decrease to once a day usually lasting between one and three hours. Naps should not occur too close to bedtime as they may delay sleep onset at night.
Many toddlers experience sleep problems including resisting going to bed and nighttime awakenings. Nighttime fears and nightmares are also common at this age. Comfort and hold your child at these times. Let your toddler talk about the dream if he or she wants to, and stay until your child is calm. Then encourage your child to go back to sleep as soon as possible.
Preschoolers (3-5 years)
Preschoolers sleep about 10 to 13 hours in a 24 hour period, with many giving up their daytime nap by the age of five years old. Bedtime struggles, nighttime awakenings and parasomnias (confusional arousals, night terrors) are common at this age. It is important to have a regular bedtime routine and a regular bedtime schedule.
Sleep Tips for Toddlers & Preschoolers from the American Academy of Pediatrics:
- Maintain a consistent bedtime and awaking
- Aim for an early bedtime. Most children will sleep better and longer when they go to bed early
- Encourage regular daily naps
- Have a relaxing bedtime routine that ends in the room where the child sleeps. A good pre-bed ritual is story time
- Create a cozy sleep environment. The child should have the same sleeping environment every night. It should be cool, quiet and dark and without a TV
- Encourage falling asleep independently
- Help your child to be healthy and fit. Too much TV watching and a lack of activity prevents good sleep. Children who get ample daily exercise fall asleep more quickly, sleep better, stay asleep longer, and wake up feeling refreshed. Avoid activity in the hour before bedtime though, since exercise is stimulating
- Try not to return to your child's room every time he complains or calls out. When your child calls out, try the following:
- Wait several seconds before answering. Your response time can be longer each time to give your child the message that it is time for sleep. It also gives him the opportunity to fall asleep on his own
- Reassure your child that you are there. If you need to go into his room, do not stimulate the child or stay too long
- Move farther from your child's bed every time you reassure him, until you can do this verbally without entering his room
School-aged Children and Preteens (5-12 years)
School-aged children need nine to 11 hours of sleep a night. Bedtime problems can arise at this age due to several reasons, e.g. homework, sports, extracurricular, social activities, TVs, computers, video games and caffeine intake. These might delay bedtime resulting in sleep deprivation. Lack of sleep can cause emotional disturbances (e.g. mood swings), behavioural problems (e.g. hyperactivity) and cognitive problems that may impact on their ability to concentrate and learn at school.
Sleep Tips for School-aged Children
- Teach school-aged children about healthy sleep habits
- Continue to emphasise the need for regular and consistent sleep schedule and bedtime routine
- Ensure that the child's bedroom is conducive for sleeping – keep it dim, cool and quiet
- Keep TV and computers out of the bedroom
- Avoid caffeine at least a few hours before bedtime
Teenage children need about eight to 10 hours of sleep. Ideally, a teen should try to have a consistent sleep schedule on school days and non-school days. However, they may be sleep deprived because of early wake times for school, and from staying up late to do their homework, socialising with friends, etc. An insufficient amount of sleep can lead to poor attention, inability to concentrate and perform. Furthermore, some teenagers may develop a change in their 'body clock' at this age (delayed sleep phase), and have a tendency to stay up late in the night. This may affect their sleep duration on school days (when they have to wake up early for school). Catching up on sleep during the weekend may cause irregularity in their sleep schedule, and they may have difficulty waking up early when the school week starts again.
Consult a doctor if you observe any of the following symptoms:
- A newborn or infant is extremely and consistently fussy
- A child is having problems breathing or breathing is noisy
- A child snores, especially if the snoring is loud
- Unusual night-time awakenings
- Difficulty falling asleep and maintaining sleep, especially if you see daytime sleepiness and/or behavioural problems
- Morning headaches
Infant Sleep Safety and SIDS (Sudden Infant Death Syndrome) Risk Reduction - from American Academy of Pediatrics (AAP):
- Always place your baby on his or her back for every sleep time
- Always use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep
- The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing). The AAP and the U.S. Consumer Product Safety Commission (CPSC) recommend against bringing your infant to sleep in bed with you for safety reasons. Although many cultures endorse co sleeping, there is a risk that the baby can suffocate or strangle, and studies have shown that there's a higher incidence of SIDS (sudden infant death syndrome) in households where the baby slept in the parent’s bed.
- Avoid covering the infant’s head or overheating
- Keep cribs free of toys, stuffed animals, and extra bedding
- Don’t cover the heads of babies with a blanket or over bundle them in clothing and blankets.
- If a blanket is used, place the child’s feet to the foot of the crib and tuck in a light blanket along the sides and foot of the mattress. The blanket should not come up higher than the infant’s chest. Sleep clothing, such as sleepers, sleep sacks, and wearable blankets, are good alternatives to blankets
- Dress the baby lightly for sleep. Keep the room at a temperature that is comfortable for a lightly clothed adult
- Do not use wedges or infant positioners, since there’s no evidence that they reduce the risk of SIDS
- Place the crib in an area that is always smoke free
- Have supervised “tummy time” for babies who are awake. This will help babies strengthen their muscles and develop normally
If your baby has a medical condition, there may be an exception to these recommendations. Your baby's doctor can best advise you on the right sleep position for your little one.