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Saturday, May 15, 2004
Cranky, irritable, overly sensitive if that describes both you and your toddler, the problem might be that no one's getting enough sleep.
A National Sleep Foundation poll, released this spring, found that the average child does not meet even minimum sleep recommendations.
Parents also sleep slightly less than the adult average (6.8 vs. 7 hours), with half awakened by a child at night in a given week.
Sleep is vital if parents and kids want to function at their best. Lack of sleep can leave people lethargic, forgetful and more likely to make mistakes. It's also linked to behavioral and attention problems in kids.
Sometimes it can be hard to tell if kids are sleep deprived because they adapt, said Rebecca Huntley, the West Seattle author of "The Sleep Book for Tired Parents." "But once parents work on sleep issues, they realize their child was overly tired. Then they see a different kid, one who's not whiny and grumpy."
Keep a consistent bedtime. The National Sleep Foundation poll found most children went to bed between 8 and 9 p.m., bumping to around 9:30 p.m. for 9- and 10-year-olds.
Parents should block out a period before a child's bedtime for one-on-one rituals.
A bedtime routine signals sleep to children, who don't watch clocks. It also "helps ease the transition between being with parents and being alone," Huntley said. "It lets them physically and emotionally wind down."
Keep TVs and computers out of bedrooms. Children with a TV in their room (four out of 10 school-age children and nearly a third of preschoolers) tend to get less sleep and go to bed later.
Make the hour before bed quiet time but do not include TV or video games. Though kids might seem to veg, research has found that the tube is stimulating.
Learn your child's sleepy signals. "Children who are overly tired have a harder time getting to sleep and a harder time staying asleep," Huntley said.
It's common for anxiety new school, divorce, toilet training to show up at bedtime with difficulty separating from parents, trouble falling asleep or nightmares.
Don't punish with early bedtimes or reward with late nights.
If your child is diagnosed with attention-deficit hyperactivity disorder, you might consult a sleep specialist. Symptoms of sleep deprivation are similar to those of ADHD: difficulty staying focused and completing tasks, impulsive behavior.
Watch for disorders such as sleep apnea, which is more common now with childhood obesity on the rise. Doctors also see more children with anxiety and mood disorders, which present as sleeping problems, noted Dr. Ralph Pascualy, medical director of the Swedish Sleep Medicine Institute.
BABIES AND TODDLERS
For babies over 4 months, pick a sleep technique that fits your values and your child's temperament. "A lot of different methods will work if you as a parent are comfortable with it," Huntley said.
Be consistent. "The reason most techniques fail is because parents don't apply them every single night," Pascualy said. Stick with it for four to six weeks.
Put infants and toddlers to bed drowsy but not asleep. Children who are put to bed asleep average an hour less of sleep a night than those who go to bed awake, according to the sleep poll. Children put to bed asleep are also much more likely to wake up at night.
Don't ditch naps. Even if toddlers seem to want to give them up, keep a quiet rest time in the afternoon.
Drop the words "nap" or "sleep." Instead, tell toddlers they need to rest their bodies or give their muscles a break.
Avoid short-term solutions that turn into bad habits. If your goal is independent sleeping, don't let your toddler crawl in bed with you for just one night.
Don't reward night-time waking with attention. Be unemotional don't scold, don't play.
To encourage kids to sleep in, put them to bed half an hour earlier. "Sleep begets sleep," writes Dr. Marc Weissbluth in "Healthy Sleep Habits, Happy Child." "This is not logical, but it is biological."
PRESCHOOL AND SCHOOL-AGE
More than any other age group, preschoolers stall and resist going to bed. Keep an extremely consistent bedtime routine, such as reading three books and singing two songs. Never vary or they'll keep pushing for more. Make a poster with pictures outlining the routine. "Then the poster becomes the bad guy," Huntley said.
A child who races around or seems hyper is not getting a "second wind"; he's overly tired.
Be boring. If a child keeps getting up, don't give him any attention. Read instead of watch TV.
Serve a snack such as a muffin or fresh fruit an hour or two before bedtime.
Let children listen to stories on tape or music to encourage them to stay in bed. "If you can keep them horizontal, they will go to sleep," Huntley said.
Make sure they get regular exercise, but avoid physical activity near bedtime.
Cut back on TV time or extracurricular activities if these make it impossible for children to finish homework and get to bed in time to get nine to 10 hours' sleep. "It's a common misconception that school-age children only need eight hours of sleep but many need 10," Pascualy said.
Set a realistic bedtime. Teens starting as young as 13 are biologically inclined to fall asleep most easily about 11 p.m. Try 9:45-10 p.m. as a compromise. Expecting teens to be in bed too early can actually contribute to insomnia.
Advocate for high schools to delay start times to better fit with adolescents' physiological clocks.
Suggest teens rearrange their evening so they end with calming activities. Shower at night, which also frees up more morning time.
Cut off contact with friends an hour before bed. This means no phones, no instant messaging, no e-mail. Fragmented sleep from teens waking up to cellphone text messages is a new concern.
Encourage short power naps. Half an hour is OK; two or three hours will affect nighttime sleep.
Encourage teens to keep beds for sleeping only, not homework.
Enforce a curfew so teens don't mess up their sleep rhythms with too-late nights. Likewise, don't let them sleep in more than two hours. Creating an irregular sleep pattern makes it more difficult to snooze. Also, experts say "catching up" on sleep over the weekend doesn't work.
Watch the coffee and Coke. Teens tend to overmedicate with caffeine to counteract their sleepiness. Try bright light as a natural pick-me-up.
Don't sacrifice sleep, especially for moms. "Women are usually the first ones to get up in the morning and the last ones to go to bed," said Dr. Meir Kryger, author of "A Woman's Guide to Sleep Disorders." When kids wake at night, it's nearly always mom who goes to them, the sleep poll found.
Pregnancy can bring such sleep-related problems as sleep apnea (often because of weight gain) and restless leg syndrome (which has been linked to iron deficiency), Kryger said.
Know how you won't let your toddler drink before bed? You shouldn't either. As people get older, waking up to go to the bathroom is a common sleep disturbance.
Don't underestimate your lack of sleep. "One hour a day for a week adds up to a whole night of sleep lost," noted nurse practitioner Joseph Zelk, who works with the Eastside Sleeping Disorders Clinic at Overlake Hospital Medical Center in Bellevue.
Use a fan or other type of white noise. Don't worry you won't hear nighttime kid noises: "I know of nothing more arousing, particularly for women, than children's calling," said Pascualy.
Additional sources: "Caring for Your Baby and Young Child," American Academy of Pediatrics. "The Mom Book," by Stacy DeBroff. "Healthy Teens, Body and Soul: A Parent's Complete Guide," by Dr. Andrea Marks and Betty Rothbart.
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