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A guide to a healthy ‘sleep hygiene’

How parents can help their kids get some shut-eye for optimum learning in the classroom.
/ Source: TODAY

Kids are heading back to school, but many won’t be awake enough to learn. Pediatrician and “Today” contributor Dr. Mark Widome says that parents need to take an inventory of their kids sleep needs, and guide them toward healthy “sleep hygiene”, so they can do their best in school.

WHAT DIFFERENCE DOES IT MAKE?

Does it make a difference whether your school-age child gets an hour more or an hour less of sleep at night? A recent study from Israel suggests how important small changes in the amount of sleep children get at night are to their ability to perform well during the school day. Researchers at Tel Aviv University asked a group of seventy-seven 4th and 6th graders to either go to bed an hour earlier or an hour later than they usually do. After three consecutive nights of either increased or decreased sleep the students then completed computerized tests to assess how well they are likely to perform in the classroom.

The researchers found that those students who got an hour of extra sleep performed better on tests of memory, attention, and reaction time. And those children getting an hour’s less sleep reported more fatigue late in the day than the group that went to bed early.

HOW MUCH SLEEP DO THEY REALLY NEED?

How much sleep does your school-age child need to perform his best in school, and is he or she getting it? Different kids seem to need different amounts of sleep, but these needs seem to be constant over time. Whether an individual is rested after a night’s sleep depends not only on the quantity of their sleep, but also its quality. Restless, interrupted sleep is not as efficient as quiet, uninterrupted sleep. Studies in the sleep laboratory suggest that, on average, school-age children need about 9 and a half hours of sleep a night in order to wake spontaneously the next morning and feel fully rested.

SIGNS OF INSUFFICIENT SLEEP

Kids who get less sleep than their bodies and brains need will perform less well during the day. Sleep deprivation is cumulative. Children who are not getting enough sleep will incur an increasing “sleep debt” over time, causing them to perform less well and feel more sleepy with each succeeding day of insufficient sleep. Parents should look for some of the following signs that their children’s sleep may be insufficient either in quantity or quality:

The child does not wake up spontaneously in the morning, but must be awakened by the parent, sometimes with great difficulty.

The child often has a rushed or missed breakfast in the morning because he or she frequently oversleeps.

The child appears sleepy during the day either to the teacher, the parent or both. Some sleep-deprived children fall asleep in school, particularly when they are bored.

Parents and teachers note that the student is having trouble concentrating on work or finishing tasks.

The child seems irritable, particularly late in the day. This may also be reflected in behavior problems and unexpectedly poor academic performance.

The child falls asleep after coming home from school in the afternoon.

The child sleeps much longer and later on weekends than during the week (repaying an accumulated “sleep debt”).

BETTER SLEEP HYGIENE

Some of the steps that parents can take to help their children achieve better “sleep hygiene” (and be at their best during the day) include:

Keep a sleep diary

Parents can better define whether their children are getting adequate sleep by keeping a sleep diary for one or two weeks, noting the times their children go to bed and awake, and whether waking is spontaneous. The diary should also record observations of daytime sleepiness, irritability, ability to concentration, and performance of schoolwork.

Watching your child sleep at random times through the night may also be revealing. Record these observations in the sleep diary as well. Restless and fitful sleep may suggest poor sleep quality. This can sometimes be caused by upper airway problems that may need the attention of the pediatrician. In the extreme, some of these children will exhibit sleep apnea, usually accompanied by loud snoring and chest movements that are irregular and labored. In other instances, restless sleep may be the result of medications that the child is taking.

In any event, sharing the sleep diary and your nighttime observations of your child’s sleep with your child’s pediatrician may be helpful if you are seeing daytime symptoms of sleepiness, poor performance, or deteriorating behavior that you suspect may be due to a sleep problem.

Other sleep tips

Setting a regular and consistent bedtime for the child, one that varies little from weekday to weekend. Set that time early enough that your child awakes spontaneously in the morning or can be awakened with little difficulty.

Eliminate caffeinated beverages from your child’s diet.

Review with your child’s physician whether there are any medicines (such as some asthma medicines and decongestants) that may be interfering with the quality of your child’s sleep. Ask about alternatives.

Create an evening environment conducive to falling asleep. In particular, do not allow television or other “screen activities” right up until bedtime. Having a “buffer zone” between TV and computer use and bedtime allows for a winding down time before sleep. This also makes it less likely that you will have to negotiate “one more TV program” or “one more computer game” before bedtime. A corollary of this principle is the recommendation that children not have TVs in their bedrooms.

Mark Widome is Professor of Pediatrics at the Penn State Children’s Hospital. He writes frequently on topics of interest to parents and is a regular contributor to the Today show.