Preschoolers May Have Problems with Sleep

Preschoolers May Have Problems with Sleep

Sleep problems do not just plague teenagers who burn the candle at both ends or adults anxious about paying their bills.

Even preschoolers can have trouble sleeping, and experts suspect the main difficulty for children ages one to five is simply a lack of restful slumber, according to a study reported in the journal Sleep.

"Twelve to 15 hours a night is recommended based on best guesses," says Christine Acebo, Ph.D., at Brown University Medical School in East Providence, Rhode Island.

Part of the problem, she explains, is that no rigorous studies have been done to test the effects of various amounts of sleep on young children.

"We don't really know how much sleep they need," she says.

Find the Cause and Provide Help

Few young children get the recommended 12 to 15 hours of sleep, Dr. Acebo found.

When she tracked 169 children, ages one to five, she found that the older kids got less than 9.5 hours of sleep in a 24-hour period, including naps. And the one- and two-year-olds got 10.5 to 11 hours in each 24-hour period.

Dr. Acebo found that children in lower-income families spent more time in bed at night, but woke up more frequently during the night than children from higher-income families.

The children from low-income families also tended to have variable bedtimes, which can trigger sleep problems, the researchers found.

She suspects the variable bedtimes could be due to the parents' changing work schedules. They may have to work alternating shifts, for instance.

Besides a lack of sleep, young children often struggle with other conditions, Dr. Acebo says, such as restless leg syndrome, a neurological disorder that typically affects older adults. Restless leg syndrome is characterized by unpleasant sensations in the legs.

Or, children, like adults, can suffer from sleep apnea, in which they have episodes of upper airway obstruction, interrupting breathing, and compromising sleep.

"There are a fair number of kids who have sleep problems such as sleep apnea from enlarged tonsils and adenoids," notes Dr. Acebo.

Some sleep problems may be traced to feelings of insecurity in a child, says another sleep expert, Dr. Rafael Pelayo, at the Stanford University Sleep Disorders Clinic in Palo Alto, Cal.

"We want children to go to bed feeling safe, comfortable, and loved," he says.

If they do not feel that way, it is understandable they may have trouble falling or staying asleep.

Sufficient sleep is crucial not only for proper growth and development, but for a child's behavior, too, as any parent of a crabby preschooler already knows.

On a more scientific level, researchers from Northwestern University Medical School studied the link between adequate sleep and behavior.

They evaluated 510 children, ages two to five, asking parents to report the amount of sleep their child got and then to describe the youngster's behavior the next day.

The result: A lack of sleep during the night or naps translated into next-day behavior problems.

So, what is the experts' advice for parents of preschoolers?

"Keep regularly scheduled bedtimes and have good routines for bedtime," Dr. Acebo says.

Those routines might include a bedtime story or anything else that is relaxing, she says. The point is to ease them to sleep in a relaxed manner.

Safety and Comfort Paramount

Dr. Pelayo prefers to give a broader recommendation to parents.

"I don't get caught up in details [such as have your child go to bed at the same time very night] on purpose," he says.

Instead, he emphasizes that parents should make a child feel safe and comfortable and that the household should not be too chaotic. A child will fall asleep more easily if the environment is conducive, says Dr. Pelayo.

He does caution parents not to tell a child she can stay up later and use a later bedtime as a reward for good behavior. That sends the wrong message, he says - that sleep or having to go to bed is punishment.

Another habit that some parents get into is to establish too early a bedtime for the age of the child.

"Sometimes the kids have inappropriate [too early] bedtimes because the parent wants a break, they want earlier bedtimes," says Dr. Pelayo.

Occasional lack of sleep or sleep problems are probably nothing to worry about, says Dr. Acebo. However, if a child aged one to five seems sleepy during the day, outside of his or her regular nap time, then that is "something to tend to," she says.

In these cases, a call or a visit to your pediatrician may be in order, says Dr. Acebo.

Always consult your child's physician for more information.