April 2006
Sleepless in America:
Is Your Child ‘Bad’ or Is He Exhausted?
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Sleep
In our high-pressure, fit-it-all-in, hurry-up society, sleep is often way down on our priority list, for our children as well as ourselves. The result is a “silent epidemic” of sleep-deprivation that accounts for many of the behavior problems our overtired children display, says Mary Sheedy Kurcinka, author of the new book, Sleepless in America: Is Your Child Misbehaving or Missing Sleep? (HarperCollins, 2006).
As a parent educator, Kurcinka has been a frequent Tools for Parents lecturer and is the author of Raising Your Spirited Child and Kids, Parents, and Power Struggles.
In a recent interview, Kurcinka listed behaviors that may indicate sleep deprivation:
The child “loses it” over little things that don’t usually bother her; her emotions are intense and she’s easily frustrated.
- He is not in control of his body – he is clumsy, tripping and banging his head more often; his movements are frenzied; he does more hitting and biting.
- Her focus and attention are poor; in an effort to stay alert, she creates stimulation by moving from activity to activity; she can’t sit down to finish anything.
- He has trouble getting along with others, with frequent squabbling about little issues.
“My first question when I see these behaviors is, ‘Tell me about the child’s schedule and sleep time,’” Kurcinka says.
The connection between frenzied activity and lack of sleep seems counter-intuitive: Why would a child who needs sleep be more wired?
If we miss the “window of opportunity” for a nap or nighttime sleep – the time when our child’s body clock naturally winds down – the arousal and adrenal systems will kick in to keep the brain and body alert, Kurcinka summarizes. Often this arousal system will give the child a second wind that will last for 60 to 90 minutes. Then the over-tired child will resist falling asleep, making parents think she doesn’t “need” as much sleep as doctors recommend.
Make Sleep a Priority
“Make sleep the first thing you schedule in the child’s day,” Kurcinka advises. “Sleep can’t be something we do in our spare time.”
She suggests that parents make a chart and put in the child’s wake-up time, adjusted for his natural tendency to be a “morning lark” or a “night owl” and taking into consideration the needs of the rest of the family. Then she asks us to shade in time for naps and nighttime sleep. The recommendations and averages are generally more than most people expect:
- Infants 0-12 months:
14-18 hours in 24 hours - Toddlers 13-36 months:
13 hours (including nap) - Preschoolers 37-60 months:
12 hours (including nap) - School-age children 6-12 years:
10-11 hours - Adolescents 13-19 years:
9.25 hours - Adults 20 and older:
8.25 hours
After that, Kurcinka advises parents to plug in the rest of their activities.
Parents’ reactions vary, Kurcinka says. “Some know intuitively that their child’s problem was lack of sleep, and they’re grateful to have the data and information,” she says. “Others are resistant. They want to know, ‘Where is the spontaneity, the flexibility?’ I tell them that children who are well-rested are more flexible.”
Having a schedule with a priority on sleep “doesn’t mean you never do extra activities, but you count the cost,” she says. For example, if there’s been a late night because of an exciting soccer game and party afterwards, we should plan a quiet day, without another major activity, the next day. “Don’t cram in too much excitement.”
“Because there’s so much emphasis on brain development in the first five years of life, we want to provide as much stimulation as we can,” she adds. “But it cannot be at the expense of sleep. The research shows that giving a child a meal and putting him to bed when he’s tired will be better for his development than one more activity.”
Putting a priority on sleep means recognizing that “a good night’s sleep begins in the morning,” Kurcinka says. Decisions that we make all through the day set the body clock and determine the quality of our child’s sleep:
Regular Sleep Times – Irregularity – having different wake and sleep times each day – makes it difficult to regulate the body clock, as do irregular meal times and naps. Skipping naps leads to an over-tired, wired child who will not necessarily be able to go to bed earlier at night to catch up on sleep.
Light – Strong morning light is our body’s cue to awaken, and so it is best to get the child outside in the mornings, if possible. On the other hand, too much light in the evening, including electronic light from computers and TV screens, tricks the body clock into thinking it is time to be awake.
Exercise – Physical exercise – at least an hour a day for children – creates healthy fatigue and promotes deep, restorative sleep. Parents should watch how much time babies and toddlers are spending restrained or strapped into car seats or strollers and how much time older children are engaged in schoolwork and sedentary activities. On the other hand, too much physical activity and roughhousing in the evening make it difficult for the body to switch to sleep.
Caffeine – Finally, we need to be aware of how much stimulating caffeine our children are getting through drinks and even medication. Research shows that because of lower body size and different metabolisms, one can of a cola beverage affects a child in the same way as four cups of coffee affect an adult. Approximately half of the caffeine consumed at 3 p.m. will still be in the child’s body at 7 p.m.
Set the Stage for Sleep
Just as we cannot force a child to eat certain foods, we cannot MAKE a child sleep, Kurcinka says. “What we can do is provide an environment that values sleep and is conducive to it.”
The first step is to be aware of our child’s “window” for sleep, which is often much earlier than parents expect it to be. “For example, I asked the parents of a 4-year-old boy who awoke at 6:30 a.m. and had a one-hour nap during the day to describe his behavior at 7:15 p.m. They described things like rubbing his eyes, snuggling up against mom and grabbing his blanket. This was his window. If the parents missed it, he became active again.”
The goal is to get the child out of what Kurcinka calls the “red zone” of tense energy into the “green zone” of calm energy, which can lead to calm tiredness and restorative sleep. We can learn to notice and compensate for common triggers for tension, such as parental stress, separations, upsetting events, major life changes and previous lack of sleep, as well as triggers for excitement, such as over stimulation, over scheduling, anticipation, growth spurts, competition and pressure to perform. If our children are tense because of these triggers, we may need to slow down the pace of their day and give them more time to connect with us and calm down at night.
We can teach our children to recognize when they are in the “red zone,” describing it in terms like “I’m bubbling over,” “My body is humming” or “I feel like there’s bees buzzing inside of me.” They can learn to calm themselves or to tell parents when they’re keyed up.
We can also provide them a “sleeping nest” by clearing extraneous stuff from their sleeping room, or at least putting toys away in containers and removing TVs, computers and cell phones. Especially if we have children who are sensitive to light, tactile discomfort or noise, we’ll want to keep our child’s sleeping space “simple, safe and serene,” Kurcinka says.
Most children also benefit from a predictable and unrushed bedtime routine or ritual, which may include:
- A clear transition activity, a signal to begin getting ready for bed. This may be a snack, dimming lights or putting away toys. It may be a bath if our child finds it soothing. Going to the bathroom, brushing teeth and getting into pajamas are included here.
- Connecting and calming activities to sooth the child – such as reading together, recounting the day, telling stories or singing quiet songs.
- Cues for sleep, such as a massage or backrub, goodnight kiss, lullaby or prayer. We might turn on a fan, white noise machine or night-light or tuck the child in.
- Switch to sleep is the last memory the child has as he falls asleep. Sometimes, we may need to stay near, rub the back a little more or sit on the bed until the child is ready to drift off.
One Size Does Not Fit All
A central tenet of Kurcinka’s book is that no one solution works for every child and family. Parents need to be sensitive and responsive to their child’s individual cues as a child’s natural temperament influences her ability to go to sleep.
Intense children move more quickly, react more powerfully to emotions and events, and startle and get keyed up more easily than most children. They need more help and time to wind down at night and may benefit from more touch.
Sensitive children are more aware of noises, differences in tastes, textures, sights and sounds and of the emotions of others. They need to have a quieter, less stimulating “nest” to sleep in and will need clothing and bedclothes that do not chafe or irritate them.
Adaptable children easily move from one activity to another and are not usually upset with changes. There can be more flexibility in the times and places they sleep. Less adaptable children need established routines and need to be well prepared if there must be a change.
Some children have regular or predictable body rhythms so that they fall asleep about the same time most days and are hungry at regular intervals. This is usually an advantage, unless they must switch their schedules. Parents must make more effort to gently nudge irregular children onto a schedule by creating routines and providing support for them to wind down.
Finally, high-energy children often have a short “window” for sleep and may not give parents many cues that they are tired. They will need to have lots of physical and mental exercise throughout the day and may need medical help for Restless Leg Syndrome (unpleasant creeping, crawling, itching or burning sensations in the legs).
Similarly, the family’s comfort levels and traditions will determine whether young children co-sleep with parents in the same bed or in a crib in the same room or whether they sleep by themselves in their own rooms. There is no one right or wrong way to sleep.
In no case does Kurcinka recommend leaving a child alone to cry. “There’s no need to do that, and we don’t know what the long term impact is,” she says. “In order to sleep well, your child must feel safe. Sensitive, responsive care blocks the stress reaction.” Instead, she advises parents in her classes to realize that every child is unique in every situation, that it’s all right to listen to what their child needs and to offer comfort, and that they should do what works best for their families.
“Listen to your heart,” she advises. “Sometimes it takes time to make changes, but you can.”
Wenda Reed is editor of Seattle’s
Child and Puget Sound Parent.
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Northwest Parent Media
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