SLEEP: FROM RESTLESS TO RESTFUL

sleep restful

SLEEP.  Have you ever had a busy week with little sleep (deadlines to meet, sick kids, too many things to get done, etc.) and thought to yourself, “I’ll just get caught up on sleep this weekend?”

Sleep debt, the term by which this phenomenon is known, is the amount of sleep you should be getting each night relative to the amount you really get.  Contrary to what you might believe, sleep debt can NOT be made up on the weekend.  However, you CAN treat your sleep debt similar to financial debt and work to improve your sleep patterns over the long term (for example, getting an extra hour of sleep a night and working this into your new sleep hygiene habit).

Are you getting enough sleep?  According to the National Sleep Foundation (www.sleepfoundation.org), the recommended nightly hours of sleep by age ranges are as follows:

  • Newborns (0-3 months): 14-17 hours per day
  • Infants (4-11 months): 12-15 hours
  • Toddlers (1-2 years): 11-14 hours
  • Preschoolers (3-5 years): 10-13 hours
  • School age children (6-13 years): 9-11 hours
  • Teenagers (14-17 years): 8-10 hours
  • Young adults (18-25 years) and Adults (26-64 years): 7-9 hours
  • Older adults (65+ years): 7-8 hours

So why is sleep so important?  There are so many areas that are affected when a person does not get adequate sleep.  In children, multiple studies have demonstrated that mood, activity level, sustained attention, frustration tolerance, cognition, decision-making, speech, and memory can all be affected (all of these executive functions that we work so hard on in therapy!).  For adolescents, the same is true when deprived of adequate sleep, which hinders school performance along with overall physical health and mental health.

Children with mental health disorders, such as depression, anxiety, and ADHD often already experience sleep disturbances, which can exacerbate these disorders and create an unending cycle that can be challenging to break.  Children with other diagnoses such as autism also often experience poor sleep patterns, both in quality and quantity.  All of this impacts a child’s ability to successfully participate in daily childhood occupations.

In 2018 a study from researchers at Penn State¹ found that children at age 9 who had no bedtime routine later had a higher body mass index (BMI) at age 15 along with a shorter sleep duration.  The study also noted that those who had optimal sleep routines as children carried that through to adolescence with sufficient sleep patterns.

A study of more than 11,000 subjects aged 9-11 just came out last month from the University of Warwick², and researchers found that depression, anxiety, impulsive behavior, and poor cognitive performance in children is affected by the amount of sleep they have. The article states, “longitudinal data analysis showed that the psychiatric problems, especially the depressive problems, were significantly associated with short sleep duration 1 year later.”  The researchers revealed that brain structure is associated with childhood sleep problems, which in turn is related to depression.

These examples are just the tip of the iceberg.  There is a lot more research demonstrating adverse effects of poor sleep and sleep deprivation.

What are some ways that we can help our kids sleep better and longer?

  • Physical Activity:  Physical activity increases the body’s temperature.  When it lowers, this drop can help children get to sleep easier.  A minimum of one hour of physical activity each day is recommended.
  • Routines:  Establishing a consistent bed time and wake time are important for good sleep hygiene.  This routine should also be followed on weekends, holidays, and other “special” days when you might be out of a normal daily schedule.
  • Screen Time Rules:  Daily screen time should be limited, and should end at least one hour prior to bed time.  An even better routine is to end all screen time by 5pm to give the brain and body more time to adjust and prepare for bed time.
  • Nutrition: Paying attention to what your child eats for the few hours prior to bed time is important to good sleep as well.  For example, limit high sugar foods several hours before bed, such as ice cream, cookies, and cake.  If your child complains that they are hungry, offer a light snack that is higher in whole grains or protein, such as a banana, crackers with peanut butter, or cheese.  Make a list of “acceptable” foods your child can eat after dinner but before bed so they have a choice, albeit limited.
  • Environment: Make sure your child’s environment is conducive to sleep.  The room should be dark (maybe use a night light and/or black-out shades) along with a comfortable temperature.  Noise outside the bedroom can make falling asleep difficult, so try to keep the environment quiet.  Using a white noise machine can sometimes help with this too.

There are other specific recommendations that our therapists can provide to you based upon your child’s individual needs (such as sensory-based needs), mental health, diagnosis, and family dynamic.  Ask your therapist in our office for more suggestions!

How can our occupational and physical therapists help?  The OTs and PTs at Pediatric Achievements are skilled and knowledgeable at recognizing the signs and symptoms of sleep deprivation in children and how it relates to their behaviors and participation in activities.  We work to educate parents, caregivers, and the children themselves on why sleep is important.  We can assess and track normal sleep patterns, habits, and daily routines to make individualized suggestions for improved sleep.  Sometimes children experience unusually high levels of stress and anxiety that can keep them awake at night, so we work with children to determine any underlying causes of a restless night.  We provide strategies to the child and the parents/caregivers that are individualized to their needs.

We are here to help you and your child go from restless to RESTFUL SLEEP!

This blog post was written by Erin Clemens, OTR/L, BCP, CIMI, occupational therapist and owner of Pediatric Achievements, LLC.  For private consultations please contact Erin directly at: erin@pediatricachievements.com

¹Penn State. (2018, December 6). Regular bedtimes and sufficient sleep for children may lead to healthier teens. ScienceDaily. Retrieved March 5, 2020 from http://www.sciencedaily.com/releases/2018/12/181206114752.htm
²Cheng, W., Rolls, E., Gong, W. et al. Sleep duration, brain structure, and psychiatric and cognitive problems in children. Mol Psychiatry (2020). https://doi.org/10.1038/s41380-020-0663-2

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