1. Health

For the start of school, and the rest of the year too, pay attention to 'sleep hygiene'

Child sleeping with toy.
Published Aug. 21, 2015

As families prepare for the start of another school year, we're reminded of a critical activity that's often overlooked: getting children, even high school aged teens, back to an earlier sleep-wake schedule.

All summer long many kids enjoyed staying up later and sleeping in the next morning, sometimes shifting their normal sleep-wake schedule by several hours. Now, it's time to shift back and lots of parents and kids are wondering: How do we do it?

"Parents forget to ask about good sleep behaviors for children and many doctors forget to discuss it with families," said Dr. John Prpich, a pediatric pulmonologist and medical director of the pediatric respiratory therapy department at St. Joseph's Children's Hospital in Tampa. Prpich said it's a process that should begin at least a week before school starts, preferably two weeks before, so kids have a better chance to get the new school year off to a good start. "Poor sleep has an enormous impact on school performance," he said. "It just sets children up for problems before they ever get to school."

Odd as it may sound, there is a right way and a wrong way to go to sleep at night. The process of shutting down before bedtime is referred to as sleep hygiene and it makes a big difference for people of all ages, especially for school aged children. Developing the right sleep habits at an early age can be critical for success in school and for overall health.

Dr. Prpich spoke with the Tampa Bay Times about sleep, sleep disorders in children and the potential consequences of not getting good quality sleep every night. Here are some highlights from that conversation.

Why is sleep so important to school-aged children and teens?

It's fundamental to their well-being and their success in school. Without proper sleep they can't learn, focus on problems, pay attention in class. That can lead to frustration, poor learning, behavior problems. It just sets kids up for defeat. Families may not even realize they engage in bad sleep behaviors. So many kids end up on medications for attention deficit disorder when what they really need is a good night's sleep.

How much sleep is enough?

That's a topic of much debate and research. In general, the need for sleep decreases with age. The CDC says pre-schoolers need 11 to 12 hours of sleep a night; elementary school kids about 10 hours a night; and teens nine to 10 hours a night. That's tough when kids have to be at school before 8 a.m., some as early as 6:30 to 6:45 a.m. It would be much better to allow them to sleep in in the morning. They do much better in school with more sleep at night.

Is there value in napping, or should that be discouraged?

If you have good sleep behaviors, it shouldn't be necessary to nap during the day. If your child falls asleep in the car on the way home from school or naps as soon as he gets home, that's probably a red flag that he isn't getting enough sleep at night or it isn't good quality sleep. Naps usually don't include REM sleep, so it's less restful sleep. It's better to sleep longer at night than to nap during the day. Children and teens shouldn't be sleepy during the day.

Should there be a sleep schedule, a specific bedtime?

Yes. Our body wants a regular schedule. Changing the sleep schedule isn't good. It makes falling asleep and staying asleep difficult. Set a bedtime and stick to it even on weekends. Good sleep hygiene, the process of how we go to sleep, is also very important. An hour before sleep, quiet everything down, turn off all electronics (TVs, tablets, cellphones), dim the lights, make the room a comfortable, cool temperature. Young kids may take a bath, quietly read a book. This process triggers sleep hormones that tell the brain it's time to sleep. It works for all ages. Oh, and no caffeinated beverages for at least 4 hours before bedtime.

Any best way to get kids back on schedule for the start of school?

Don't try to do it in one night. The brain prefers slow changes, so do it over a week or two. Back up bedtime gradually.

What sleep disorders are common in children? Symptoms?

Obstructive sleep apnea is most common. Snoring is not normal in children. The reasons for it are different in children than in adults. Snoring, noisy breathing, daytime sleepiness, difficulty waking up in the morning are all potential signs of sleep problems. So is hyperactivity, which may be caused by being overtired. Also, be on the watch for sleepwalking, sleep talking, teeth grinding, nightmares, screaming during sleep, restless legs. If you notice any of this, bring it up with your pediatrician and consider requesting a sleep study.

Anything else?

Don't ignore symptoms that seem unusual. When very young kids snore, don't laugh it off and say he just takes after his Uncle Charlie. Snoring may be caused by enlarged tonsils or adenoids. Surgery can be curative. Or, in mild cases we have medication that may help shrink the structures, making surgery unnecessary. Just don't ignore these things. Left untreated, sleep problems and poor sleep hygiene can have a significant effect on learning and on heart health.

Contact Irene Maher at


  1. Dr. Paul McRae was the first black chief of staff at Bayfront Medical Center in St. Petersburg. Dr. McRae died on September 13, 2019. He was photographed here in the Tampa Bay Times photo studio for the 2008 Dr. Carter G Woodson Museum's "Legends Honorees" gala. BOYZELL HOSEY  |  BOYZELL HOSEY  |  Times
    ‘His extraordinary example paved the way for so many others.’
  2. Michael Jenkins spent seven days at North Tampa Behavioral Health last July. Since then, he says his three children have been afraid he’ll leave and not come home. JOHN PENDYGRAFT   |   Times
    The patients have no choice, and the hospital is making millions.
  3. Samantha Perez takes a call for someone in need of counseling at the Crisis Center of Tampa Bay earlier this year. The center handles calls dealing with suicide, sexual assault, homelessness and other traumatic situations. They also do outreach and counseling, and operate Transcare, an ambulance service. JONES, OCTAVIO  |  Tampa Bay Times
    Florida’s mental health care system saves lives.
  4. The Florida Department of Health in Hillsborough County identified a positive case of hepatitis A in a food service worker at Hamburger Mary's in Ybor City on Oct. 22, 2018. [JOSH FIALLO | Times] JOSH FIALLO | TIMES  |  JOSH FIALLO | Times
    Slightly more than 200,000 people have been vaccinated this year — a huge jump from the 49,324 people vaccinated in all of 2018.
  5. FILE - In this Feb. 20, 2014, file photo, a patron exhales vapor from an e-cigarette at a store in New York. Under the Trump administration, former FDA commissioner Scott Gottlieb kicked off his tenure in 2017 with the goal of making cigarettes less addictive by drastically cutting nicotine levels. He also rebooted the agency’s effort to ban menthol flavoring in cigarettes. But those efforts have been largely eclipsed by the need to respond to an unexpected explosion in e-cigarette use by teens. AP
    Hundreds of people nationwide have come down with lung illness related to vaping.
  6. This May 2018, photo provided by Joseph Jenkins shows his son, Jay, in the emergency room of the Lexington Medical Center in Lexington, S.C. Jay Jenkins suffered acute respiratory failure and drifted into a coma, according to his medical records, after he says he vaped a product labeled as a smokable form of the cannabis extract CBD. Lab testing commissioned as part of an Associated Press investigation into CBD vapes showed the cartridge that Jenkins says he puffed contained a synthetic marijuana compound blamed for at least 11 deaths in Europe. JOSEPH JENKINS  |  AP
    The vapor that Jenkins inhaled didn’t relax him. After two puffs, he ended up in a coma.
  7. H. Lee Moffitt Cancer Center & Research Institute is the centerpiece of Project Arthur, an 800-acre corporate park that could include up 24 million square feet of office and industrial space on nearly 7,000 acres of what is now ranch land, but targeted for development in central Pasco. Times
    The H. Lee Moffitt facility is the centerpiece of an economic development effort in a proposed 800-acre corporate park.
  8. Taylor Bland-Ball, 22, posted this photo and open letter to Judge Thomas Palermo to her Instagram account on September 10, the day after she lost custody of her 4-year-old son Noah McAdams. The boy's parents wanted to treat his leukemia with natural health care remedies instead of chemotherapy. [Instagram] ANASTASIA DAWSON  |  Instagram
    The couple refused chemotherapy for their son, instead seeking alternative treatments including dietary plans, alkaline water and THC and CBD oil treatments
  9. Sharon Hayes, the new chief executive officer at Bayfront Health St. Petersburg, says she will draw on her roots in nursing as she engineers a turnaround for the hospital. SCOTT KEELER  |   Times
    The city’s largest hospital has suffered setbacks under a corporate owner, but a new leader says it’s time for an infusion of “love and attention.”
  10. An architect's rendering shows part of a planned research center and hospital on N McKinley Drive in Tampa for the Moffitt Cancer Center. During the 2020 legislative session in Tallahassee, the center will seek an increased share of Florida's cigarette tax to finance the McKinley Drive project and other improvements. Moffitt officials said Thursday that the increase initially would finance $205 million, to be paired with $332 million they have already allocated for the project. Moffitt Cancer Center
    Florida lawmakers are the key to unlocking the money, which would pay for more hospital beds and research space.