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Helping your child get enough sleep

Pharmaceutical IndustryChemical IndustryFood and Drug AdministrationAmerican Academy of PediatricsFranklin Square Medical Center

The beginning of the school year often means morning battles between parents and their children who don't want to get out of bed in the morning. But a good night's sleep is crucial to a student's performance in school. Dr. Scott Krugman, chairman of the department of pediatrics at MedStar Franklin Square Medical Center and the vice president of the Maryland Chapter of the American Academy of Pediatrics, talks about children's sleep patterns and how to get them on a workable sleep schedule.

Why do kids have hard time getting on a sleep schedule when school starts?

Most children experience difficulty getting back on a sleep schedule when school starts because they have spent the summer staying up late. Both the prolonged sunlight in the evening and the lack of a fixed routine and schedule contribute to causing a child's normal sleep cycle to shift from a reasonable sleep hour to a late one. Sleeping in late on top of a late bedtime leads to the body adjusting to this new cycle. When children try to switch suddenly back to a school pattern, they often have trouble falling asleep at a "reasonable" bedtime and when awoken early, have difficulty staying awake in the morning. This sleep cycle (or circadian rhythm) shift is particularly challenging in teenagers since they are more prone to stay up late and unfortunately have the earliest school start time. Anxiety about school is another potential reason a child might have trouble falling asleep, especially if they are starting school for the first time or starting a new school.

How much sleep do children need a night?

The amount of sleep varies with age. Most elementary school children need at least 10 hours of sleep per night though some may sleep more. By high school, the total sleep time should be at minimum eight hours, preferably nine. Unfortunately, half of all adolescents sleep less than seven hours a night.

How can lack of sleep interfere with children's school performance?

Inadequate sleep [either total time or poor quality] can cause a variety of issues in school. First is daytime sleepiness, which might lead to actual sleeping or drowsiness in class. Children who are not awake cannot pay attention and are unable to remember what they learn. Children with a lack of sleep often have similar symptoms as those found in attention-deficit hyperactivity disorder. Additionally, a lack of sleep has been associated with learning difficulties and memory problems.

Are children able to catch up on lost sleep?

Unfortunately, our brains do not act like a repository in which a lack of a few hours of sleep one night can be made up for a few nights later by sleeping in. Sleeping in may actually worsen a sleep cycle disorder. It is more important to set up a routine with a fixed bedtime and ensure adequate sleep every night.

How can parents get kids back on a sleep schedule?

If parents could pick a set sleep time and routine and stick with it every day, the child usually adapts and adjusts to the schedule. Unfortunately, most parents and children do not adhere to this type of routine. Starting to shift from a summer schedule to a school schedule a few weeks prior to the start of school can be helpful, as most children will not change their cycle instantly.

If kids can't adjust are their own, are there safe medical remedies to help with sleep?

If a child cannot adapt to an earlier bed time and is diagnosed with sleep cycle disorder by a physician, then the natural occurring hormone melatonin may be recommended. Melatonin can be purchased as a nutritional supplement from a pharmacy or health foods store. As a hormone in the body, melatonin regulates the sleep cycle. By taking the supplement at the same time every night, about an hour before bedtime, and sticking with a fixed bedtime and wake time, the melatonin will augment the routine and help adjust the sleep cycle. In general, the supplement does not cause children to become "sleepy" and it is not a sedative. Most children tolerate it well. It does, however need to be taken every day, not as needed, and the dose may need to be adjusted after some time. Melatonin supplements are not regulated medications by the Food and Drug Administration and not all tablets contain the exact amount that is noted on the bottle. Other sleep medications rarely will be used to help children sleep, but these should only be prescribed by a physician comfortable with diagnosing and treating sleep disorders in children.

andrea.walker@baltsun.com

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