Good Sleep Habits for Children

What is normal sleep?
Normal sleep comprises of cycles of non-rapid eye movement (NREM) sleep, alternating with rapid eye movement (REM) sleep. NREM sleep consists of light sleep and deep sleep, whilst REM sleep is when dreaming occurs.

Why is sleep important?
Children need plenty of sleep to restore, rest and repair the body. Sleep also aids cognitive functioning and learning. Growth hormone levels are also at their highest during sleep.
Evidence suggests that sleep disruption or insufficient sleep has potentially harmful effects on a child’s learning, memory, attention, concentration, mood, health and overall quality of life. Sleep loss has been linked to weight gain, obesity, diabetes, depression, and poorer immunity. Daytime sleepiness results in poor school performance and an increased incidence of learning disorders. There may also be an adverse impact on parental and family functioning.
A recent study in Singapore showed that Singaporean preschoolers sleep significantly less than recommended and have poor sleep habits.

How much sleep is needed over a 24-hour period?
Newborn

• 16 to 20 hours
• Newborns usually will wake every three to five hours a night for necessary feeds.

• 13 to 15 hours
• From five to six months of age, most healthy babies do not need overnight feeding and are able to sleep about nine to ten hours through the night or only wake once. They will still need two to three naps during the day.

• 11 to 12 hours
• Toddlers should be able to sleep nine to ten hours through the night, and may need one to two naps a day.
• To achieve this, most children this age should have a bedtime at around 8.00pm to 9.00pm.

• 10 to 11 hours

Tips to getting a good night’s sleep
Bedtime problems and frequent night wakings are common in young children. Helping your child develop good sleep habits can be a challenge, and it is normal to get upset when a child keeps you awake at night. However, it is important to persist in your efforts as it is important for the overall well-being of your child.

Infants (< 1 year old)

• Teach your baby to sleep on his own from five to six months, by using a routine.
• Have a consistent bedtime and soothing routine:
  Read him a story, listen to quiet music, or give him a bath and gentle massage.
• Keep the bedroom quiet and dark, and at a comfortable temperature.
• Put your baby to bed when drowsy but still awake.
  This will help your baby learn to fall asleep on his own in his own bed.
• Use a familiar soothing musical lullaby.
• Repeat this same routine at the same time every night.
• Avoid holding, rocking or feeding your baby to sleep, as he will expect you to do the same again every time he wakes up during the night.
• Comfort your child without picking him up.
• Keep your baby calm and quiet if you need to feed or change him during the night, and keep the lights low.

• Infants less than a year old are at greatest risk of something called Sudden Infant Death Syndrome (SIDS) during sleep. It is sometimes referred to as ‘cot death’
• The cause is not known, but certain risk factors have been identified, such as smoking or sleeping prone (lying on the stomach).
• Other risk factors include prematurity, too high or low a room temperature, excessive bedding, clothing or stuffed toys in the cot.
• Co-sleeping or bed-sharing with your baby also increases the risk of SIDS.
• It is therefore advised that babies sleep in a separate cot, without pillows, soft toys or cot bumpers, until one year old. Your baby should also be put to sleep on his back, not front. If using a blanket, make sure that it only covers up to the baby’s chest and the arms are exposed, and put your baby’s feet touching the end of the cot so that he cannot wriggle further down under the blanket during sleep.

• Establish a consistent bedtime routine as for an infant.
• Show your child the clock and have a fixed bedtime and wake up time on school and non-school nights.
• A light snack high in tryptophan may help to induce sleepiness (eg. milk, bananas).
• Give your child a 10 minute warning before bedtime.
• After the 10 minutes, take him to pass urine and brush his teeth.
• Allow your child to take a favourite item to bed each night, such as a teddy bear, special blanket, or some other favourite toy.
• Use your bedtime routine: Read a story together, kiss and hug your child, put on a familiar lullaby, turn the lights down and leave the room.

What do I do if my child cries for me at bedtime or in the night?

• Even after you have established good sleep habits, your child may have night-time waking due to nightmares, as active dreaming begins at a toddler age. Comfort your child as necessary and encourage him to go back to sleep in his own bed.
• Do not respond or return to your child’s room every time he cries, complains or calls out, unless he has been unwell. Instead, try the following:
  • Wait several seconds before answering and make your response time longer each time he calls.
  • Remind him each time he calls that it is time to go to sleep.
  • Check on him, but do not turn on the light, pick him up, or play with him.
  • Give him a chance to fall asleep on his own.
  • If your child is still unable to settle himself, consider what else may be bothering him. He may be hungry, wet or soiled, or otherwise not feeling well. If so, address this and put him back to bed.
  • Praise your child the next morning for staying in bed.
• Try to be understanding. A negative response by a parent can sometimes make a sleep problem worse.

When to seek help?
Please consult your doctor if your child has

• Problems going to bed/falling asleep
• Excessive sleepiness during the day
• Frequent night-waking
• Night terrors or sleepwalking
• Snoring or difficulty breathing at night

Further reading on good sleep habits

• AAP Guide to Your Child’s Sleep, by the American Academy of Paediatrics.
• Solve Your Child’s Sleep Problems, by Richard Ferber.
• The No-Cry Sleep Solution, by Elizabeth Pantley.

• Have a bedroom without TV or video games.
• Avoid TV, computer games, smartphones and gadgets at least one hour before bedtime.
• Do not use the bedroom for time-out or punishment.
• Avoid giving your child products containing sugar and caffeine for several hours before bedtime. These include chocolate, coca-cola, coffee and tea.
• Avoid heavy meals within two hours of bedtime.
• Try not to let your child sleep in the same bed with you. This could make it harder for him to fall asleep when alone.