According to the National Sleep Foundation (NSF) we spend one-third of our lives asleep. And this is not wasted time. Among other things, sleep greatly contributes to a healthy immune system and a balanced appetite. For children, not getting enough sleep can wreak havoc on their physical and emotional health.
“Sleep deprivation for all children of all ages can lead to problems,” says Anne W. Batson, APRN, FNP-BC, Nurse Practitioner at Community Sleep Specialists in Indianapolis. In a 2014 NSF Sleep in America poll, a correlation between poor sleep and over-use of technology such as smart-phones, tablets, computers or televisions (especially in the bedroom) was found to be a pervasive issue. Batson, a mother of two, whose children experienced a variety of sleep problems growing up, always felt strongly about developing boundaries concerning electronics. “I was adamant that neither of them could have a television in their rooms, and that their computers had to stay downstairs. Electronics in the bedroom of kids from grade school through college is a huge cause of sleep deprivation.”
Another boundary parents can enforce is having an established bedtime routine starting when children are small. Heather Rafool, a Noblesville mother of three, describes the many ways that her 2 ½ year-old daughter would try to delay her bedtime. She would ask for a drink of water. She would need to use the restroom. She would need a hug. Rafool said that they finally told her that she would need to do all of those things before she went to bed – and when she was in bed it was time to sleep. Period. After a couple of days without responding to any more of her “pleas” this new routine worked. “She has boundaries; she is happier,” Rafool said.
While Rafool’s 2 ½ year-old is sleeping soundly now, her 6 year-old will sometimes awaken her by screaming and flailing – a night terror. Rafool says these incidences come and go in phases, sometimes with months in between. “He never really wakes up. It’s hard to console him. And he doesn’t remember it the next day.”
Batson said a night terror typically occurs in the first third of the night, and is the most dramatic of the sleep disorders. “Night terrors can result in bodily injury because the child may seem awake and might be partially aware of their surroundings but at the same time, has a misperception of the environment. There is no comforting or consoling a child who is having a night terror and attempting to might result in getting hit or kicked. The behavior may be violent and the parents’ best approach is to do whatever is necessary to keep everyone safe. In most cases, the child will have complete amnesia for the activity.”
The difference between a nightmare and a night terror seems to be that the child is aware of the nightmare. “Between 10-50% of children ages 3-5 years old are affected by an occasional nightmare,” says Batson. “Parents should be aware that post-traumatic stress disorder is the most common cause of recurring nightmares in children and teens and can persist throughout a lifetime if the traumatic event is not addressed.”
Bedwetting (enuresis) is prevalent in 30% of 4 year old children and should not be considered abnormal until the child is continuing to wet the bed at least twice weekly beyond the age of 5 years old. Current thought is that bedwetting is a combination of three factors: 1) lack of a substance called arginine vasopressin that decreases urine production in sleep 2) over-activity of an immature bladder and 3) inability for a child to awaken in response to a full bladder. Treatments are geared towards addressing one or more of these issues. Medications are available to alter urine production and relax the bladder muscles to increase bladder capacity. There are also alarms that can alert and sensitize a sleepy child to respond quickly if they start to urinate. This is a condition that requires the input of the pediatrician to help select the appropriate course of action. It’s important to remember that children, no matter what age, should never be punished for bed-wetting.
Sleep issues in children can affect the whole family. If your best efforts at home are not resolving a problem, be sure to talk with your pediatrician for guidance. A good night’s sleep can help everyone feel rested, refreshed and ready to take on the day.