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.
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.
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