Sleep is important for all of us, but while we’re growing, and while our brains are still developing, sleep plays an even greater role. By the age of two, the average baby has spent more than 9,500 hours asleep; that’s around 1,500 more hours sleeping than they have spent awake… suggesting that something pretty important is going on.
Between the ages of 2 and 5, most children spend similar amounts of time awake and asleep. Throughout childhood and adolescence, sleep still accounts for 40% of each 24 hourday. Sleep typically falls to less than 33% of our time in adulthood, but that is still a huge proportion of our lives!
Why is sleep important for children?
The majority of human growth hormone, which is essential for normal growth, is produced during the deeper stages of sleep. We strengthen important memories, freeing up new capacity to learn. The immune system goes to work, fighting infections. We process emotions, enabling us to wake up feeling refreshed.
Too little sleep at every age can have a negative impact on emotional, cognitive, social and physical functioning, but for children, this could have lifelong consequences.
If lack of sleep interferes with learning and mood, and leads to behavioural problems at school, this can impact on academic outcomes. For example, in a large study of 1,691 participants aged 10-19 years, regularly getting 1 hour less than the recommended hours of sleep (see table) predicted lower academic achievement scores, especially for older children (Eide 2012).
Whereas adults tend to feel more sleepy when sleep-deprived, children can often become more aggressive, or hyperactive. In a large study which followed 1,492 children to age 6, those getting fewer than 10 hours sleep as toddlers and preschoolers were more likely to be hyperactive, and had lower cognitive performance (Tourchette 2007).
In the short term, children who are short of sleep have more accidents. In preschoolers, getting fewer than 8 hours sleep was associated with double the risk of accidental falls compared with those getting more than 10 hours sleep (Boto 2012).
In the longer term, short sleep has been linked to weight gain, high blood pressure and obesity in childhood, which can be difficult to reverse (Paruthi 2016).
Lack of sleep has also been linked to risk taking and higher rates of substance abuse in teenagers, while teens regularly getting 9-10 hours of sleep tend to have higher life satisfaction and better quality relationships (Segura-Jimenez 2015).
How much sleep is recommended at different age groups?
In 2016 an expert panel from the American Academy of Sleep Medicine gave the following recommendations for the amount of sleep needed for optimal health at different age groups (Paruthi et al 2016):
|Age||Recommended sleep for optimal health|
|Infants 4-12 months||12 to 16 hours (including naps)|
|1 to 2 years||11 to 14 hours (including naps)|
|3 to 5 years||10 to 13 hours (including naps)|
|6 to 12 years||9 to 12 hours|
|13 to 18 years||8 to 10 hours|
Interestingly, the panel could not reach agreement on a recommendation for newborns in the first 3 months of life, since there is so much natural variation on what is ‘normal’. Another expert panel recommended 14 to 17 hours sleep for newborns (Hirschkowitz et al. 2015).
It’s important to remember that this is an average, and sleep needs will vary depending on what has happened that day, and how well a child slept the night before. There will be children who naturally need a little more, or a little less. The quality of sleep is also very important; sleep disruption, such as from noise, travel or illness, will result in a greater need for recovery sleep.
What can parents do to help their children to sleep well?
Every child will develop their own preferences around sleep, and these will change at different ages. While it might be impossible to prescribe a recipe for every child to sleep well, there are some general principles which could help at any age:
1. Be a role model: nurture your own sleep
Children learn huge amounts from their parents’ attitudes and behaviours. If you make a point of switching off devices before bed, and leaving them out of the bedroom, you’re much more likely to convince a teenager that this is a good idea. If you are anxious about your own sleep, your children are likely to pick up on this.
2. Stick to a consistent bedtime routine
Bedtime routines are a consistent, repetitive set of activities which help a child to relax and wind down. Research shows that children who follow a regular bedtime routine are more likely to go to sleep earlier, fall asleep faster, sleep for longer, and wake up less during the night. The activities will vary depending on age, and what the family enjoys, but a bath or shower, brushing teeth, and a bedtime story are popular in the UK. Reading a story not only helps with language development, but can also increase parent-child bonding, promote creativity, and help children and parents to relax.
3. Create a positive sleep environment
The ideal sleep environment is comfortable, dark, quiet and not too hot. Keep screens out of the bedroom. While darkness is ideal from a sleep quality perspective, many young children develop a fear of the dark, so a dim night light, preferably with a gentle red or orange light, can help while they overcome this. In order to relax for sleep, we all need to feel safe. Young children can often be helped by a favourite soft toy, or blanket - also called a ‘transitional object’. These can help give children the confidence to fall asleep independently.
4. Regular sleep-wake patterns, all week
Waking up at the same time and preparing for bed at the sleep time all week is one of the best ways to promote good sleep quality. This helps all of our internal body clocks to work together. Young children tend to have quite strong circadian rhythms, and often wake up ‘like clockwork’. As teenagers, the body clock often shifts - as if to a later timezone - which makes waking up early much harder. Although a weekend lie-in is tempting, it will only make getting out of bed on Monday morning even more difficult. Encourage your child to stick to a regular wake up time.
4. Look out for signs of sleep deprivation
Signs that your child might not be getting enough sleep include changes in mood (whiny, irritable, moody), difficulty learning (shorter attention span, difficulty solving problems, or remembering things), behaviour problems (misbehaving, aggression, being hyperactive or uncooperative) and poor health (vulnerable to colds, more injuries, slow growth). For younger children, napping is a good way to meet their overall sleep needs. You could also experiment with moving the bedtime routine earlier by 15-30 minutes each week until your child is well rested.
There are a number of sleep disorders that can affect children, as well as adults, including insomnia, sleep apnoea and restless legs syndrome. Insomnia is the most common, and often hits at puberty, especially for girls. Teenagers can benefit from Cognitive Behavioural Therapy for Insomnia, which is also the first line treatment for adults. If you’re worried that your child is experiencing difficulties during the day because they aren’t sleeping well, and you’re not sure how to help them, speak to a medical professional for advice.