2. OBJECTIVES
To understand the facts of sleep
To understand about childhood sleep
disturbance
To do ideal things to maintain proper sleep
pattern
3. WHAT IS SLEEP?
A state of unconsciousness but still able to
awaken by normal sensory stimuli.
Or
A natural periodic state of rest for the mind and
body, in which the eyes usually close and
unconsciousness is completely or partially lost,
so that there is a decrease in bodily movement
and responsiveness to external stimuli.
4. Stages of sleep
The two stages of sleep include rapid eye
movement (REM) sleep and non-REM sleep, and
these alternate multiple times through the night with
increasingly longer and deeper REM periods
occurring toward morning. Cultural and genetic factors are
responsible for variations in sleep behaviour but not
in sleep requirements.
5. Why sleep is important to children?
• Sleep plays a crucial role in the development of young minds.
In addition to having a direct effect on happiness.
• Research shows that sleep impacts alertness and attention
-cognitive performance
-mood
- vocabulary acquisition
-learning and memory
Sleep also has important effects on growth, especially
in early infancy. In toddlers, napping appears to be necessary
for memory consolidation, executive attention, and motor skill
6. How much sleep should children get
at different ages?
As children grow, sleep needs change
considerably. Newborns have a fragmented
awake–sleep pattern and require the greatest total
sleep time. Sleep times gradually decrease from
infancy to adolescent. Adequate sleep duration is
necessary for optimal daily function and good
health.
7. Childhood Sleep Guidelines
• The American Academy of Paediatrics (AAP) has issued a
Statement of Endorsement supporting the American Academy
of Sleep Medicine (AASM) guidelines outlining recommended
sleep duration for children from infants to teens
• Also, these recommended hours of sleep is followed by Indian
Academy of Paediatrics (IAP).
9. Recommended sleeping hours:
• Infants -4 months to 12 months should sleep 12 to 16 hours per 24
hours (including naps) on a regular basis to promote optimal
health.
• Children 1 to 2 years of age should sleep 11 to 14 hours per 24
hours (including naps) on a regular basis to promote optimal
health.
• Children 3 to 5 years of age should sleep 10 to 13 hours per 24
hours (including naps) on a regular basis to promote optimal
health.
10. • Children 6 to 12 years of age should sleep 9 to 12 hours per 24
hours on a regular basis to promote optimal health.
• Teenagers 13 to 18 years of age should sleep 8 to 10 hours per
24 hours on a regular basis to promote optimal health.
Sleeping the number of recommended hours on a regular
basis is associated with better health outcomes including:
improved attention, behaviour, learning, memory, emotional
regulation, quality of life, and mental and physical health.
11. Issues related to sleep disturbance
• Insufficient sleep leads to poor health.
• Adverse effects include day-time sleepiness,
irritability, behavioural problems, learning
difficulties, poor academic performances, and
increased likelihood traffic accidents in young people.
• Regularly sleeping fewer than the number of
recommended hours is associated with attention,
behaviour, and learning problems.
12. • There is also emerging evidence that poor sleep in childhood
may carry future cardiovascular risks in the form of
hypertension, obesity, diabetes, and depression.
• Insufficient sleep in teenagers is associated with increased risk
of self-harm, suicidal thoughts, and suicide attempts.
• Regularly sleeping more than the recommended hours may be
associated with adverse health outcomes such as hypertension,
diabetes, obesity, and mental health problems.
Parents who are concerned that their child is sleeping too
little or too much should consult their healthcare provider for
evaluation of a possible sleep disorder.
13. NOTE
* Recommendations for infants younger than 4 months are not
included due to the wide range of normal variation in duration and
patterns of sleep, and insufficient evidence for associations with
health outcomes.
* Realize that teens require more sleep, not less.
sleep-wake cycles begin to shift up to two hours later at the
start of puberty.
At the same time, most high schools require students to get to
school earlier and earlier.
The AAP has been advocating for middle and high schools delay the
start of class to 8:30 a.m. or later. It is important that parents and
local school boards work together to implement high school start
times that allow teens to get the healthy sleep they need.
14. MAINTAIN PROPER SLEEP
PATTERN
• Adequate sleep duration for age on a regular basis leads to improved
attention, behaviour, learning, memory, emotional regulation,
quality of life, and Mental and physical health.
• Not getting enough sleep each night is associated with an increase
in injuries, hypertension, obesity and depression, especially for teens
who may experience increased risk of self-harm or suicidal
thoughts.
• In addition to these recommendations, the AAP suggests that all
screens be turned off 60 minutes before bedtime and that TV,
computers and other screens not be allowed in children's bedrooms.
• For infants and young children, establishing a bedtime routine is
important to ensuring children get adequate sleep each night.
16. Sleeping Environment
• Make sure your babies bed and bedding are comfortable.
• Remove distractions.
• Get the TV and mobile devices out of the bedroom.
• Avoid watching or listening to upsetting, violent, or scary
materials within 2 hours of bedtime. That includes the news,
conflict-filled talk shows, and high-anxiety dramas. (Ideally,
don't expose younger children to such material at all).
• Use the bed only for sleep, not for TV, reading, working, using
a smart phone or tablet, or playing electronic games.
17. What is safe sleeping and why is it
important?
• All babies should be put to sleep on their backs but let them
find their own sleep position, if they roll over during the
night. Back to sleep is the safest position for healthy babies.
• •
•
Room sharing but not bed sharing with parents or siblings
for first 6–12 months
• •
•
Use a separate sleep space (cot) with a firm surface, tight-
fitting bed sheet, and no soft pillows or stuffed toys.
• •
•
Swaddling the baby is fine. Keep baby’s head and face
uncovered.
• •
•
Discourage smoking as exposure to second-hand smoke
harms babies. Smoking is linked to SUDI even when
parents smoke away from their infants.
19. Sleeping Routines
• Consider eating a light snack containing a protein (e.g., seeds,
nuts, low-fat milk, hard-boiled eggs) and a complex
carbohydrate (e.g., whole grain cracker or toast, slices of fruit
or vegetables) within 2 hours before bed.
• Each night, help your children to brush their teeth
• Take a warm bath or shower within an hour before bedtime.
• Make it routine. Head to bed at the same time daily. Staying up
late or sleeping in can shift your sleep schedule to make you
"jet-lagged" even at home.
20. • Avoid getting in the habit of using TV or a tablet to soothe
your child to sleep.
• It is important that they learn to calm down by themselves and
with your help through a soothing bedtime routine.
• Reading an age-appropriate book together is helpful for
younger children.
The AAP recommends keeping all screens—TVs, computers,
laptops, tablets, and phones out of children's bedrooms,
especially at night. To prevent sleep disruption, turn off all
screens at least 60 minutes/1 hour before bedtime.
21. During the Day
• Limit daytime naps to 45 minutes, maximum.
• Avoid overscheduling.
In addition to homework, many children today have
scheduled evening activities (i.e., sports games, lessons,
appointments, etc.) that pose challenges to getting a good
night's sleep. Take time to wind down and give your children
the downtime that they need.
23. Each night, help your children to brush their teeth.
Read a favourite book (or two)!
Get to bed at a regular time each night.
24. Reference
• Indian Academy of Paediatrics (IAP) Guidelines
• The American Academy of Paediatrics
• Journal of Clinical Sleep Medicine
• Sleep foundation Academy
