Sleep Issues
Preventing flattened skulls in infants: In July 2003, the American Academy of Pediatrics reported an increase in the incidence of flattened skulls because of the increased emphasis on placing babies to sleep on their backs to avoid the possibility of Sudden Infant Death Syndrome. According to the AAP, flattened skulls could be avoided by placing infants on their stomachs while they’re awake, and also by shifting their heads during the night when they are put to sleep on their back.
Each Age Produces its Own Challenges: Each age — baby, toddler, child, teen, young adult, parent, older adult, senior — can pose its own unique challenges in the sleep department. But don’t assume that a sleep problem cannot be resolved. Many times, professionals can help you make changes that can resolve or lessen your problem.
Many factors can affect a good night’s sleep, and many people sabotage themselves without realizing it. Some of the factors include stress, snoring (ours or spouse’s), restless leg syndrome or other disorder, outside noise, too much light, swing work shifts, uncomfortable room temperature, room stuffiness, disruptive room decor, inadequate pillows, old mattresses, smoking, alcohol, erratic sleep schedules, new baby, children’s sleep disorders, daytime napping for more than an hour, drugs, certain prescription medications (such as medications for ADHD, for example), extreme exhaustion, interference from pets, watching television or playing video games just before bedtime, inadequate daily exercise, exercising too close to bedtime, poor diet, eating too close to bedtime, too much caffeine (in coffee, tea, sodas, chocolate), consuming caffeine too close to bedtime, excess weight, uncomfortable clothing, nasal abnormalities, humidity, colds, allergies, doing work in bed, unresolved arguments, arguing with someone just before bedtime…
Getting enough sleep is important. Several studies suggest that most people – children, teens and adults – don’t get enough sleep (from elementary to high school, for example, children need nine to 11 hours of sleep a night). Sleepiness can lead to misbehavior, learning and concentration difficulties, poor grades in school, accidents at school or work, motor vehicle accidents, chronic fatigue, snoring, headaches, tension, out-of-control situations, and — later, research indicates — heart disease. Some researchers suggest that many of the problems addressed by pediatricians might have a basis in the children being overtired (including possibly hyperactivity, illnesses, difficulties in school and/or depression). Some researchers indicate that symptoms of long-term fatigue mimic those of attention-deficit disorder and might therefore be leading to misdiagnoses.
How Can You Tell if Your Child is Sleep Deprived? Several of the links below offer self-assessment surveys you can take, but one way to gauge if you or your child is sleep-deprived is to judge daytime behavior. Is the person in question alert, energetic and motivated? Does the person wake up easily in the morning? Does the person take more than 45 minutes to fall asleep at night, or have trouble going back to sleep if awakened? Does the person snore loudly or seem to struggle to breath while sleeping? If the person constantly needs an alarm clock, needs to sleep in, wakes up cranky, gets cranky in the afternoon, has problems concentrating, remembering things or paying attention to instructions, falls asleep easily during the day, is prone to accidents or needs a cold shower to wake up — he or she probably isn’t getting enough sleep. Catching up on the weekend doesn’t work well, say experts, because the body doesn’t use that kind of rest as well. It also throws the natural body rhythm off, making it harder for the person to fall asleep at a regular time during the week.
If your child doesn’t have a regular bedtime, doesn’t sleep in his or her own bed, wakes up crying or must be woken up by an alarm clock, needs to sleep in on the weekends, has erratic sleep hours, has trouble concentrating or is accident-prone — chances are good that the child suffers from a shortage of quality sleep.
Having Trouble Getting Your Toddler to Stay in Bed in the Morning? Remember that toddlers have no idea of when 6 o’clock or 7 o’clock is. They wake up when they wake up. So try getting a radio alarm clock. Set it for the time you want your child to wake up, and teach your toddler (except for bathroom trips or being sick or scared) to stay in bed until the music comes on.
Having Trouble Getting Your Child to Bed at Night? Here are a few tips for getting your child to sleep at night.
Have a routine. Your child should know when bedtime is. It should not happen on the couch, the floor, in the car, or in your bed. Bedtime should be the child’s bed, and it should be the same time every night (not just when she falls asleep from exhaustion). She should do the same quiet and relaxing things every night before bed (bath or shower, put on pajamas, have a snack and read a book, brush teeth, say prayers perhaps, choose a bedtime friend, then snuggle for a few minutes (you might sing a quiet song or tell another quick story of your own–especially a funny or happy store about family), before turning out the lights. Have a quiet period before bedtime. Turn off the television and video games, and put away noisy toys. Read a few books together, play a quiet board or card game, or put together a puzzle. Avoid discussing contentious issues, and let children say goodnight to everyone and anything that suits them. Don’t put a TV in your child’s room, and if a toy is too tempting to ignore, remove it from the bedroom as well. Give a brief countdown so that bedtime doesn’t sneak up (“5 minutes, 3 minutes, 1 minute…”). Don’t brook argument. Your child should know that no amount of complaint changes bedtime. Make sure that only very, very special occasions change bedtime. Avoid turning bedtime into a fight, an argument, or a game. It just is. When it’s bedtime, refuse to engage in debates or games. If your child “just won’t go to bed,” it’s because you aren’t making it happen. Children are susceptible to gentle suggestion. “I know you’re very sleepy” will work wonders on her little body, which will begin to say to itself, “Gee, yes, I am sleepy.” Bring a friend. Children sometimes feel lonely or scared in their beds all by themselves. Let them choose a special stuffed animal or toy to go to sleep with (but make sure this is not a noisy toy or one that can be turned on). You can hang a dreamcatcher on the wall and explain the Native American belief that dreamcatchers catch bad dreams before they start. Install a night light in the corner (or glow-in-the-dark constellations on the ceiling) to chase away dark shadows. Also, a family picture and pictures of favorite people placed carefully on the dresser (or a guardian angel somewhere in the room) can help make them feel loved and safe. Get him to relax. Your child can get muscle aches and tensions just like anyone else. Soothe him by rubbing his back, shoulders or forehead. Make sure your child isn’t hungry (some people can’t sleep when they’re hungry), but make sure bedtime snacks are healthy and fairly light. Don’t give him caffeinated soda or anything sugary or heavy. Avoid staying until the child is asleep. Your children need to learn to go to sleep on their own. It can help to cuddle and let them feel your body warmth, but resist staying there until they’re asleep. Get them to bed before they go to sleep, stay for a while, and then when you feel them relax and start to breathe deeply, kiss them goodnight, tuck them in, give one more hug, and then leave. Give them water. Some children cannot sleep when they’re thirsty. If your child needs water to drink in the middle of the night, leave a sippy cup on the floor or nightstand. Resist withholding water just so that your child sleeps through the night. Your child can learn to wake up and go to the bathroom, then go back to bed. If your child has a problem with wetting the bed, however, see your pediatrician for suggestions on how to handle the issue without allowing your child to become dehydrated. Check medications. Some medications, such as those commonly prescribed for ADHD, can cause sleep problems. (Interestingly, research shows that insufficient sleep can cause behavior problems similar to those attributed to ADHD. If a sleepy child is misdiagnosed with ADHD and prescribed medication, therefore, the medication has the potential to simply worsen the situation). Find out what’s wrong. If all else fails, and your child is still reluctant to go to bed, make sure there isn’t another issue troubling her. Perhaps she’s afraid. Perhaps she has an unresolved issue or worry and needs some discussion about it or reassurance. Perhaps she has allergies and cannot breathe. Perhaps there are loud noises coming from the house next door. Perhaps her bed is not comfortable. Perhaps she feels threatened (a common indicator of sexual or other physical abuse, for example, is difficulty sleeping). Perhaps she can hear someone in the house arguing. Or, perhaps her sleep is disturbed by a physical issue such as sleep apnea, restless-legs syndrome, night terrors, nightmares, or sleepwalking.
Kids Who Snore: The American Academy of Sleep Medicine says that about 1 percent of children who snore, do so because they suffer from sleep and breathing problems. If they struggle to breathe while snoring, they might be suffering from obstructive sleep apnea syndrome (OSAS). A study published in the April, 2002 issue of Pediatrics says that obstructive sleep apnea is linked to behavioral problems (sometimes leading to a misdiagnosis of attention deficit disorders), learning difficulties, daytime tiredness, high blood pressure, slower growth and possibly even bed-wetting. Surgery can remove tonsils and adenoids that prevent proper breathing.
Possible misdiagnosis of ADHD: A growing number of experts suggest that children who suffer from obstructive sleep apnea (OSAS) might end up being misdiagnosed as having ADHD because the daytime symptoms are similar. If you suspect your child has a sleep problem, see one of the sites below for more information, or talk to your pediatrician about referral to a sleep specialist.
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Garfield Star Sleeper – written for children KidsHealth.org – “Sleep and Your Newborn” KidsHealth.org – (written for teens) – “Teens and Sleep” National Center on Sleep Disorders Research American Academy of Child & Adolescent Psychiatry – tips for resolving children’s sleep problems National Sleep Foundation American Academy of Sleep Medicine American Sleep Apnea Association National Institute of Neurological Disorders and Stroke/Sleep Apnea Sleepnet.com Sleepnet.com – guide to sleep disorder centers Narcolepsy Network Academy of Dental Sleep Medicine Sleep Research Society SleepQuest, Inc. Restless Legs Syndrome Foundation Society for Light Treatment and Biological Rhythms – “dedicated to fostering research, professional development and clinical applications in the fields of light therapy and biological rhythms.” No More Sleepless Nights – a book by Peter Hauri, Ph.D. & Shirley Linde, Ph.D. Solve Your Child’s Sleep Problems: New, Revised, and Expanded Edition – a book by Richard Ferber, M.D. MayoClinic.com – a guide to how much sleep children need, and tips for setting regular bedtimes MayoClinic.com – “10 Tips for Better Sleep” Medem – “Children’s Health & Sleep Issues” dr.greene.com – information on many sleep issues
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