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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

A Parent's Life A Parent's Life

Is Your Child Getting Enough Sleep?

September 12, 2013

By Henry H. Bernstein D.O.


Did you hear about National Sleep Awareness Week? This public education campaign happens each year during the week when clocks "spring forward" (return to Daylight Savings Time) and most Americans lose an hour of sleep. It is sponsored by the National Sleep Foundation (NSF), a group that does things to improve health and safety for people of all ages by helping them understand sleep and sleep problems better. Fortunately, there are things you can do to promote healthy sleep habits for your family.

Getting enough sleep is important for all of us, but especially for children because good sleep means better growth and mental development. Children's bodies need sleep so they can grow, heal injuries and fight infections. Their brains need sleep so that they can pay attention, solve problems and remember what they learn. Children who get enough sleep tend to be healthier, do better in school, and have fewer behavior problems.

Just how much sleep does your child need? This depends on the child — some need more, others need less. However, children tend to need a certain number of hours of sleep based on their age. Here are some guidelines from the NSF:

Hours Of Sleep
Needed Daily
Newborns (0 – 2 months)
12 – 18
Infants (3 – 11 months)
14 – 15
Toddlers (1 – 3 years)
12 – 14
Preschoolers (3 – 5 years)
11 – 13
School-aged (5 – 10 years
10 – 11
Teens (10 - 17 years)
8.5 – 9.5

It seems that many children do not get as much sleep as they should, and many families have nightly struggles at bedtime. As many as one in three children has some type of sleep problem, either having a hard time falling asleep, or waking up during the night. Of course, this usually means less sleep for others in the family as well. A recent poll of parents conducted by the NSF found that 60% of children under the age of 18 complained of being tired during the day, and 15% said they fell asleep at school during the year.

Difficulty falling asleep is the most frequent sleep complaint among parents of young children. In many cases, this problem is due to using different bedtime routines instead of the same bedtime routine each night. Some studies have shown that children who have a hard time falling asleep can learn to go to sleep, if adults begin to set clear limits around bedtime.

For example, make a regular time to go to bed each night, and prepare for bedtime the same way, such as having a drink, going to the bathroom, taking a bath, brushing teeth, then reading one story. Having a regular time to go to bed (and to get up in the morning) helps to set the body’s natural clock (circadian rhythm), so that the child starts to feel tired around the same time each night. Bedtime routines help young children make the physical and emotional transition from their busy days to restful sleep.

Once children have fallen asleep, they may have difficulty staying asleep. It is normal for them to awaken several times during the night, but problems may occur when children cannot fall back to sleep on their own. The most common reason for this is that the child has never learned to fall asleep without help. Children who fall asleep while they are being held, rocked or fed often find it difficult to fall back to sleep without the parent doing these same things. In this case, the nighttime awakenings are best treated by using a regular bedtime routine, which includes putting the child to bed while still awake.

Many teens do not get enough sleep, particularly during the school year, because they are busy going to school, doing after-school activities, working, playing sports, doing homework, and hanging out with their friends. To make time to do all these things, teens often stay up very late. They do not get the sleep they need since they have to get up early the next morning for more of the same. Although they feel they can make up for it by sleeping late on weekends, in fact, they cannot. Most teens end up being sleep-deprived (not getting as much sleep as their minds and bodies need) and always feeling tired.

Have your teen follow these simple steps to make sure he is getting the most (and best quality) sleep possible each night.

  • Go to bed and wake up the same time every day, during the school week and on weekends. Keeping a regular sleep schedule helps the body set its internal clock, making it easier to fall asleep at night and wake up in the morning.
  • Do not nap during the day. If necessary, a nap should not last longer than 30 minutes.
  • Relax as much as possible for an hour or so before bedtime, perhaps by listening to music, reading or meditating. Try not to study right up until bedtime.
  • Exercise regularly, but never right before bedtime.
  • Do not drink beverages or eat foods that contain caffeine (for example, coffee, tea, soft drinks, and chocolate) after lunchtime.
  • Do not pull "all-nighters" to study for a test. One night of missed sleep can upset the sleep cycle for weeks.
  • Avoid watching violent TV shows or movies before bedtime.

On the other hand, do not be too harsh on your teen for wanting to sleep in. Research has shown that teenagers' bodies naturally want to stay up late at night and wake up later in the morning. In response to these findings, some school districts are changing their schedules so that older kids start later.

Henry H. Bernstein, D.O. is a senior lecturer in Pediatrics at Harvard Medical School. In addition, he is chief of General Academic Pediatrics at Children's Hospital at Dartmouth and professor of pediatrics at Dartmouth Medical School. He is the former associate chief of General Pediatrics and director of Primary Care at Children's Hospital Boston.

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