Whilst some children seem to fall asleep as soon as their head hits the pillow, others find sleep extremely challenging. Sleep is essential for every human being, therefore, it is very important that we put in the work to support our children to get to sleep, stay asleep and increase their quality of sleep. It is well known through research that sleep disturbances are highly prevalent amongst children and adolescents with developmental delays. This post will discuss the amount of sleep recommended for different age groups, some sleep disturbances and some tips for supporting children with sleep.
Inadequate sleep can have the following impacts on our children:
Sleepiness or hyperactivity
Increased daytime challenging behaviours
Heightened sensitivity to sensory inputs
Poor emotional regulation
Reduced motor performance and endurance
Increased family stress levels
Quality of sleep
Supporting both quantity and quality of sleep is important. If we sleep for the recommended hours, however we are waking or experiencing other sleep disturbances, then the quality of our sleep is impacted. We need to develop an understanding of any potential sleep disturbances our children may be experiencing, and talking to your GP or Paediatrician is also recommended.
Some common types of sleep disturbances include:
Night wakings
Night time fears
Nightmares
Night terrors and sleepwalking
Rhythmic movements
Teeth grinding
Breathing difficulties
Restless leg syndrome
Overwhelming sleepiness
Delayed sleep phase syndrome - as a result of a shift in sleep-wake rhythm
Insomnia
Excessive daytime sleepiness
Nocturnal seizures
Nocturnal enuresis (bed wetting)
Quantity of sleep
Here are the amounts of sleep we would anticipate for the following age groups:
Newborns - Newborns can sleep for 14-17 hours per 24 hour period, including 2-3 daytime naps. It can take 4-6 weeks to develop a sleep routine for a newborn at home. At around 3-4 months of age, sleeping throughout the night is considered 5 consecutive hours of sleep between feeds.
Infants (4-12 months of age) - The average sleep needed for infants is 12-15 hours including 1-2 daytime naps.
Toddlers (1-3 years of age) - The average sleep needed for toddlers is 11-14 hours including 1-2 daytime naps.
Preschoolers (3-5 years of age) - The average sleep needed for preschoolers is 10-13 hours per 24 hour period, including a daytime nap. During this time, daytime naps should decrease from one to none.
School aged children (6-13 years of age) - The average sleep needed for school aged children is 9-11 hours per 24 hour period. School aged children shouldn’t be tired throughout the day, and if they are, this is a red flag and you should seek support.
Adolescents (13-18 years of age) - The average sleep needed for adolescents is between 8 and 10 hours per 24 hour period.
Health assessments
It is important that if sleep is a concern for your child, that you not only discuss this with your therapist, but also with your paediatrician or GP. Health assessments need to form a part in supporting your child’s sleep patterns to rule out any medical conditions that might be impacting upon sleep. For example, this may include completing assessments for ears, nose and throat, considering food allergies, mental health conditions, pain or medication.
Positive sleep practices
Just because a child needs a certain number of hours of sleep, it doesn’t always mean they will sleep for that amount of time. Positive sleep practices are strategies for supporting sleep routine, to support your child achieve the required quantity and quality of sleep.
The following are strategies that you can try at home. We recommend trying these strategies for some time before ruling them out. As with everything we recommend in therapy, we need to see the impact over a period of time, at least 4 weeks before we can get a good understanding of the impact.
Set up a bedtime routine
Relax before bed - the last 30 minutes before bedtime should be a quiet activity in bed such as reading
Keep the hour before bed relaxing, no extraneous activity or screen time
Spend more time outside during the day
Keep screen time and use of technology limited - there is a lot of research out there on the impacts of blue light on our sleep
Avoid caffeine and large meals close to bedtime
Provide a comfortable sleep environment - room temperature should be warm to cool to support sleep
Ensure regular sleep and wake times
Limit naps to developmentally appropriate times for younger children, and for older children to 15-20 minutes (max)
Positive modelling of sleep habits by parents/caregivers - make sleep a priority
Other important things to consider
Sleep strategies provided by your therapist or health care team will take a lot of hard work from you as a parent or caregiver, and therefore, it is important that all factors are considered when undertaking sleep training. Some things to consider before diving into sleep training include:
Your readiness as a parent or caregiver - establishing new sleep patterns can take several weeks or even months and it can be a very demanding time for both the child and the family as a whole.
Are you in a position to be able to prioritise sleep training? Consider whether there are other conflicting demands, such as at work, moving house, starting school, going on a holiday. If this is the case, it might be worth waiting until a more settled routine has resumed before commencing sleep training.
Agreeing on a sleep plan - it is important that all parties involved agree on the sleep plan, to ensure the best outcome of the training and goal achievement.
Letting your child’s teacher know - it is a good idea to let your child’s teacher know if you have started sleep training so that they can be aware of the impact this could potentially have on their learning and participation at school.
Some helpful websites
For more information on supporting you with sleep training:
Raising Children's Network - https://raisingchildren.net.au/search?query=sleep
Sleep Health Foundation - https://www.sleephealthfoundation.org.au
Your therapist will work closely with you, your child and any other health professionals in order to collate the appropriate sleep information and create a sleep plan appropriate for your child. If you have concerns about your child’s sleep patterns, please talk to your therapist. Sleep is highly individualised, and we recommend that you speak to your Occupational Therapist if your child has challenges with their sleep, as it can have profound impacts on their everyday functioning.