On School-aged Children’s Sleep: Some Information for Parents

The week before children even return to school is a good time for parents to remind themselves of the importance of sleep and basics of sleep. It’s a good time also to help their children adjust their sleep routines. This blog post provides a bit of information for parents on children’s sleep, along with some recommended readings.

Recommended Amount of Sleep

The first thing to keep in mind is that children need a lot more sleep than most of them get on average.

• Children of ages 6-12 need at least 9 to 12 hours of sleep
• Children of ages 13-18 need 8 to 10 hours.

Some children may need more sleep than this.

Quality and Timing of Sleep

Not all sleep is equally efficient or effective. There are circadian issues to consider. The biological clocks of many children shift forward as they progress through the teen-age years; they tend to prefer to stay up later and sleep in later (this is not laziness). Unfortunately, accommodation is only rarely made for this fact: many teen-agers need to start school too early in the day.

Substances that stimulate the brain, like caffeine and methylphenidates (e.g., Ritalin®), can also affect sleep quality or how restorative sleep is. Psychological stressors (e.g., family or social conflicts) can also affect sleep.

The Importance of Sleep

It would be difficult to overestimate the importance of sleep for children. Even one night’s lack of sleep can affect the child’s cognition, moods and emotions the next day. In particular, lack of sleep makes it difficult to concentrate, make decisions and learn. This can lead to behavior problems at home and at school. It also increases the likelihood of having an accident (e.g., falling off a bicycle or for teen-agers, car accidents). Lack of sleep can lead to overeating. Over the long run, it can also interfere with physical and mental health. Insomnia, for instance has been identified as a contributor to many mental and physical illnesses.

So it is in the child’s and the family’s best interest for children to get an adequate amount and quality of sleep.

It’s important for parents to educate themselves and make decisions in accordance with these facts. Equally, however parents need to manage their own stress with respect to their children’s sleep. (Losing sleep over one’s children’s sleep is not going to help them.)

Knowledge-based Parenting: Learning about Parenting, and Seeking Counseling

We recommend some readings about sleep below. I would like to point out, first, that parents will benefit more from any book designed to help with specific psychological matters (sleep being a set of such matters) if they also continue lifelong learning about parenting and psychology from reputable sources.

For example, some of the most significant issues children face around sleep have to do with children resisting parental influence around sleep, and more specifically how parents respond to such resistance. Recommendations for dealing with these problems make use of “behavioural” concepts. That is, they require an understanding of the basic principles of “behaviorism”, meaning how the parent (and the rest of the child’s environment) responds to the child’s behavior (rewards, punishments, etc.). Those principles are helpful with many, perhaps most, behavioural challenges parents face with their children.

As another example, social modeling is important across a range of parenting issues.

We’re not suggesting that every parent should have a degree in Psychology. But lifelong learning about psychology makes parenting more effective and efficient. Parents can apply what they learn in one context to another.

Making good decisions is easier in any complex domain when one has mastered helpful knowledge and can think in terms of its models. At first it is difficult to apply a model. But the more one applies a model, the easier it is to apply them.

Parents who feel that the specific challenges they face with respect to their children’s sleep are beyond their abilities, having read literature from experts such as Richard Ferber or Jodi A. Mindell, should consider seeking counsel from therapists who are specifically educated about sleep. Feel free to ask them before or at the first meeting (which should be free) to list their credentials about sleep in particular. If possible, find a registered clinical psychologist who specializes in sleep, or speak to a GP.

Common Challenges to Children’s Sleep

The main objective of the app, mySleepButton, is to help our customers get to sleep more readily once they have settled into bed for sleep, and to get back to sleep after waking prematurely. (Premature waking could be due to the need to go to the washroom, a loud noise or many other factors. Keep in mind that people naturally emerge from sleep several times a night, but most tend to get back to sleep without remembering it.) Its goal is also to improve overall sleep efficiency, time spent sleeping while in bed. The app is not merely meant to be helpful for insomnia as technically defined.

Insomnia and non-clinical difficulties falling asleep are not the only problems children face around sleep. The resources listed below discuss other challenges, such as parasomnias, and problematic “sleep-onset associations” .

Many children’s sleep problems involve being resistant to falling asleep. That is, they refuse to fall asleep. They might have a temper tantrum. Or go to bed but refuse to let themselves fall asleep. By the time parents realize they have a problem, the problem may have become somewhat serious because by then the child has actually learned to control their parents to get what they want, and the parent has also learned some problematic habits. The resources below may help parents deal with these issues.

It should be noted that parents themselves can be resistant to sleep: i.e., they resist their own “executive functions” (or better judgment): late in the evening when they should be going to bed —for a variety of reasons, but often partly because their own executive functions are weakened by “circadian” issues, “sleep pressure”, and sheer fatigue — they remain active and hence awake. During the summer, when kids stay up, they observe their parents routines and can internalize them (their role models).

Children are often overscheduled with evening activities (e.g., sports and music) and even morning activities. For example, in Canada, unfortunately, children’s hockey practices are often scheduled early in the morning, when these children should be sleeping —sleep being, as noted is a critical activity. Many children feel intense academic pressure (from various sources). Some spend several hours on school work every evening.

Being human, and being children, kids also want and need time to “have fun” and socialize freely. Too often, the only unscheduled time is late in the evening, when they should be sleeping. And so they turn to their devices to chat, surf the web, and/or play computer games.

In such conditions it is nearly impossible to ensure that a child gets the amount of sleep recommended above.

Technology of course presents special challenges, some of which are discussed in the next section.

Technology and Children’s Sleep

It has long been known that technology poses special challenges to sleep. For instance, children who watch TV extensively in the evening are more likely to have troubled sleep. It has long been recommended that children not have televisions in their bedrooms.

Therefore, it should come as no surprise that interacting with computers, and mobile devices (including smartwatches) can interfere with sleep. Even the light from some of these devices can delay sleep onset..

Even while people are not interacting with their smart devices, their mere presence consumes mental (therefore brain) resources. One way to think about this is that the brain has evolved to be vigilant around agents (insects, animals, and other people). The vigilance mechanisms of the mind cannot fully distinguish between a smartphone and an animal. They are all “autonomous agents” to which the brain might need to respond.

Therefore, it is now recommend that these devices not be present in the bedroom of children. They should be far enough away that children cannot access or hear them.

However, this is not always feasible or necessarily the best thing. For instance, an electronic device might have a medical monitoring purpose. Information technology is becoming ubiquitous. There is also technology that can monitor sleep, such as Apple’s Beddit device and software (for iPhone), much better and more easily than traditional sleep logs. This can enable parents and therapists to more accurately assess children’s sleep situations and make more informed decisions. If a child wakes up and uses the device, this might register as a period of wakefulness in the logs. (Hopefully one day Apple will devise parental controls that easily enable only certain apps, such as helpful sleep apps, to be used.)

In Bed Wishing to Sleep But not Getting to It

If for reasons mentioned above, or other reasons, children spend less time physically in bed than the recommended amount of sleep time, there is a problem. In this case, sleep onset latency, sleep efficiency and sleep quality become even more important. And if the child has insomnia, they might spend enough time physically in bed, but still not be able to fall asleep.

Psychologists have devised and investigated several techniques to be used in bed to facilitate sleep onset. They include meditation, progressive relaxation and monotonous imagery training. Beaudoin proposed serial diverse imagining, which is based partly on traditional monotonous imagery training. All of these cognitive strategies are discussed elsewhere on this website.

Psychological research on pediatric insomnolence is almost exclusively behavioural. Unfortunately, there is very little research on bedtime thinking-strategies for children’s insomnia and non-clinical sleep onset latency. Given the acknowledged importance of bedtime mentation in insomnia, one would expect there to be a large body of literature on bedtime cognitive strategies (e.g., comparing reading stories to children with backward counting and traditional imagery distraction). But there isn’t. Even in the adult literature, many strategies (such as listening to podcasts, audiobooks or radio) are virtually unexplored.

We wish to help fill this void with empirical research comparing the cognitive shuffle for children to other strategies. We have reached out to child psychologists specializing in insomnia, and hope to start the collaborative research design process next quarter.

The cognitive shuffle itself (whether with an app or self-directed) has also not been formally tested with children. We provide suggestions for parents here. We suggest, for example, that if parents want to try the cognitive shuffle, they first try the DIY version if the child is sufficiently old and capable; and if technology is used, that all the device’s notifications and network functions be turned off, and the device be removed from the room once the child has fallen asleep.

NB

We are not medical doctors. Nor do we specialize in children’s issues.

Further Reading

• I recommend Richard Ferber, Solve Your Child’s Sleep Problems.. It is available on Apple’s iBookstore and elsewhere.
• Check out books on children’s sleep by Jodi A. Mindell.
• Kyla Boyse of the University of Michigan has written an extensive FAQ on sleep for parents.
• We’ve compiled a FAQ for mySleepButton and the cognitive shuffle
• If you plan to use mySleepButton for children, please read this article
• We’ve also provided some sleep tips for adults.
• Clinicians will appreciate Attarian, H. P. (Ed.) (2016). Clinical Handbook of Insomnia. Switzerland: Springer. http://doi.org/10.1007/978-3-319-41400-3 and Meltzer, L. J., & Mindell, J. A. (2014). Systematic Review and Meta-Analysis of Behavioral Interventions for Pediatric Insomnia. Journal of Pediatric Psychology, 39(8), 932–948. http://doi.org/10.1093/jpepsy/jsu041.