HEALTH SENSE
Children need good sleep too By Dr. Harry Yuan
I
t is common knowledge that adequate good-quality sleep is important in the development of children. Yet childhood insomnia is the most common sleep complaint from parents. Although certain sleep disorders may cause insomnia, the difficulty in initiating or maintaining sleep may be due to poor sleep habits or suboptimal sleep environment. Getting adequate sleep is vital and translates to better quality of life for children of all ages. Good sleep habits are important. They include bedtimes, wake times, types of activities around bedtimes, sleep schedules, sleep environment, and diet. Good sleep habit is achieved by optimizing behaviors that promote sleep and avoiding those that sabotage it. Training the mind to recognize bedtime is one method of promoting sleep. For example, having the same bedtimes and wake times daily help our bodies synchronize our internal clocks (circadian rhythm) with the environmental clock (time) and prepares us to fall asleep as bedtime approaches. Similarly, having the same bedtime routine nightly also signals our mind that sleep is approaching. Other factors that can influence the ability to fall asleep are the environment 28
ALASKA PULSE — January 2020
and certain daytime activities. Ideally, the room should be quiet and dark. A room temperature on the cooler side (between 65-70 degrees Fahrenheit) with blankets to stay warm is optimal. Avoid using the bedroom for any other activities aside from sleeping. Screen time on any electronic devices within two hours of bedtime exposes the eyes to an excessive amount of light and should be avoided. Exercise during the day can promote better sleep, but it may disrupt the ability to fall asleep if done within four hours of bedtime. Caffeine can exert its waking effect up to six hours after ingestion and should be avoided later in the day. The American Academy of Pediatrics has stated that adequate sleep in children leads to improved behavior, better learning, and higher quality of life. Children with inadequate sleep are at increased risk for obesity, depression and hypertension.
Therefore, the AAP has endorsed the recommendation from the American Academy of Sleep Medicine regarding sleep hours for different age groups. (The listed hours are per 24 hours including naps): • Age 4 months to 12 months: 12 to 16 hours • Age 1 to 2 years: 11 to 14 hours • Age 3 to 5 years: 10 to 13 hours • Age 6 to 12 years: 9 to 12 hours • Age 13 to 18 years: 8 to 10 hours Aside from certain sleep habits and sleep environment, another common cause of insomnia in children is obstructive sleep apnea. Unlike adults, children with obstructive sleep apnea may have difficulty falling asleep and have frequent nighttime awakenings as well as symptoms similar to attention deficit and hyperactivity disorder like difficulty focusing, poor school performance and hyperactivity. In fact, up to 25 percent of children diagnosed with ADHD may actually have undiagnosed poor sleep that is manifesting the ADHD symptoms. It is important to treat obstructive sleep apnea not only to address the presenting symptoms but also to prevent complications that can develop in the future. Dr. Harry Yuan, MPH, FCCP, FAASM, is pediatric medical director at the Alaska Sleep Clinic.
