School is back in session and, as always, many students are still trying to shake off their beloved summer schedule of staying up late and sleeping in late, while struggling to pay attention in class.

Returning to a positive sleep routine can be achieved after a few weeks of faithfully adhering to a schedule, but the best plan for long-term success is to never veer from good sleep habits in the first place.

Good sleep hygiene begins when children are as young as 3 months old. Infants should be put to bed awake and allowed to fall asleep on their own. Pediatricians encourage parents to not pick up a crying infant from his or her crib so the baby can learn to self-soothe and fall asleep alone.

The same advice applies to older children. The best sleepers are those who fall asleep on their own.

There are several things parents can do to set their child up for good sleep.

Create a Sleep-Conducive Environment

An environment that is conducive to complete relaxation will help ensure children can fall asleep easily and remain asleep throughout the night. Continuous sleep allows their minds and bodies to enter the very important Rapid Eye Movement (REM) stage of sleep, the period of sleep several hours into resting that allows the body to completely relax and rejuvenate.

• The ideal room environment is cool in temperature.

• Quiet (may use soft noise to help sleep).

• Dark (no outside light, possibly a nightlight).

• Free of all electronics (phones, TVs, video games, etc.).

Maintain a Schedule

It’s important to create a schedule for children that includes margin. That means there is time for homework, extracurricular activities, travel between locations and a healthy pre-bedtime routine that won’t push a child well past their bedtime.

Again, the key to successful sleep is keeping with routine, and kinks in the schedule can quickly derail a child’s week.

Weekends can’t be an exception to the sleep plan; otherwise, Monday will be a day of recovery.

Set Boundaries

Children also must set boundaries for their evenings, as there are a number of influences on their ability to wind down at night.

• Screen time should be limited to two hours for children 2 and older.

• No screen time for children under age 2.

• All electronics should be turned off one hour before bedtime.

• No caffeinated drinks, candy or sweets after dinner.

• No naps after school.

Children will occasionally experience the inability to go to sleep. Rather than lying in bed awake for hours, it is best to get out of bed, go to another room and not return to bed until 15 minutes before it’s possible to fall asleep. It may be necessary to repeat this for the next few days if falling asleep at the normal bedtime is difficult.

Set a Nightly Routine

The most effective process for settling down will be as unique as each child. What works for one may be different for another. A few proven suggestions include:

• A warm bath or shower.

• Reading.

• Writing in a journal.

• Listening to calming music.

• Visiting with Mom or Dad about the day.

Measuring Sleep

The American Academy of Pediatrics and the American Academy of Sleep Medicine recommend different amounts of sleep in each age bracket:

4-12 months old: 12-16 hours per day, including naps

1-2 years old: 11-14 hours per day, including naps

3-5 years old: 10-13 hours per day, including naps

6-12 years old: nine-12 hours per day

13-18 years old: 8-10 hours per day

Sleep Disorders

While many of these strategies can help, some children deal with more complex issues such as a variety of sleep disorders. Sleep disorders are as common in children as they are in adults.

Insomnia is the inability to go to sleep or stay asleep. While short-term insomnia can be the result of a poor sleep routine, too much screen time, stress or other factors that can be corrected, it also can be a more serious sleep disorder that should be evaluated by a physician. In contrast, children who are excessively sleepy on a consistent basis often have underlying health issues.

Snoring is common and can signal a more serious condition known as obstructive sleep apnea. Those with apnea experience closing of their airway which results in the drop of their oxygen level. The body wakes you so you don’t suffocate in your sleep. One out of 10 people snore and one out of 100 have sleep apnea. Parents should be sure to mention their child’s snoring or excessive exhaustion to their doctor.

Narcolepsy is a less common, but inherited, sleep disorder. Children may fall asleep at inappropriate times during the day, despite a normal night’s sleep. They are actually entering REM sleep while they are awake, which can potentially be dangerous, but this disorder can be treated.

Good sleep is crucial for both children and adults. Bodies that are sleep-deprived are more prone to attention deficit, diabetes, high blood pressure, high cholesterol, hyperactivity and obesity.

Parents whose children sleep walk, sleep talk, wet the bed, grind their teeth or have repeated nightmares or night terrors should discuss this with their child’s pediatrician. Weight gain and hyperactivity also can be indicators that a child is missing sleep.

Numerous studies correlate academic success with the number of hours of quality sleep. The sooner children can develop and maintain a consistent routine for getting good sleep, the more likely they are to succeed in school, sports and other activities. Those habits ultimately can continue into adulthood.

This article first appeared in our 2018 September issue.  

Alan Lucas, M.D., pediatrics, is the medical director of the Conway Regional Nursery. He co-founded Arkansas Pediatrics of Conway in 1995 and has practiced pediatrics in central Arkansas for more than 30 years. He earned his medical degree from the University of Arkansas for Medical Sciences and completed his pediatric residency at Arkansas Children’s Hospital.