Are Your Kids Keeping You Up? An Overview of Sleep Behavior Disturbances in Children

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Author:

Mark Yarbrough, M.D.

New York Presbyterian Hospital

Medically Reviewed On: March 31, 2006

Problems with sleep behaviors are commonly seen in children. Sleep is of primary importance at all stages of human development, and in the newborn, is the primary activity other than eating. Childhood sleep disturbances affect not only the child but also the whole family. There is an abundance of different beliefs and lore on this topic. Sifting through the enormous amount of material, approaches, and opinions about kids' sleep can be daunting for parents. There is not one correct way to deal with your child in regard to sleep. Each child is unique and has his own special set of circumstances and needs. What's important is for parents to identify what they feel comfortable with and what they feel is best for their child. I will delineate here some general principles and guidelines that I have found to be helpful for parents in making choices about how to handle their child's sleep. I will also discuss some of the most common childhood sleep disturbances and some of their treatments.

Development of Sleep

When addressing difficulties that your child may be having with sleep, it is important to be aware of the general developmental progression of sleep behavior in kids. Newborns alternate between sleep and wakefulness every 3-4 hours, awakening often associated with hunger. As the child grows this develops into what is called a "diurnal" pattern. This means there are progressively longer periods of wakefulness during the daytime as well as longer periods of sustained sleep at nighttime. By about 12 weeks, an infant may sleep at night for periods up to 8 hours. At 3-4 months, more than 70% of infants are sleeping for sustained periods of time at night. This is sometimes referred to as "settling in" and it occurs as the infant's brain matures. If we look at EEG patterns (an EEG is an instrument that measures brain waves) we can see the patterns becoming increasingly organized into distinctive stages differentiating sleep from wakefulness. An infant probably spends 16 hours of a 24-hour period asleep. This decreases to 12 hours in the second year of life, 10 hours by age 3, and to 9 hours from ages 8-12. Remember that this varies according to the child. With some children, this kicks in quite early and with others it happens much later on. This is simply a variation in normal development.

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