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Sleep Problems Can Strike Preschoolers, Too

Most don't get enough sleep, experts suspect

THURSDAY, Nov. 30, 2006 (HealthDay News) -- Sleep problems don't just plague teenagers who burn the candle at both ends or adults anxious about paying their bills.

Even preschoolers can have trouble sleeping, and experts suspect the main difficulty for kids ages 1 to 5 is simply a lack of restful slumber.

"Twelve to 15 hours a night is recommended based on best guesses," said Christine Acebo, an assistant professor of psychiatry and human behavior at Brown University Medical School. Part of the problem, she explained, is that no rigorous studies have been done to test the effects of various amounts of sleep on young children. "We don't really know how much sleep they need."

However, in a recent study published in the journal Sleep, Acebo found that few young children get the recommended 12 to 15 hours of sleep. When she tracked 169 children, ages 1 to 5, she found that the older kids got less than 9.5 hours of sleep in a 24-hour period, including naps. And the 1- and 2-year-olds got 10.5 to 11 hours in each 24-hour period.

Acebo, who's also assistant director of the Bradley Hospital Sleep and Chronobiology Research Laboratory in Providence, R.I., also found that children in lower-income families spent more time in bed at night, but woke up more frequently during the night than children from higher-income families. The children from low-income families also tended to have variable bedtimes, which can trigger sleep problems, the researchers found. She suspects the variable bedtimes could be due to the parents' changing work schedules. They may have to work alternating shifts, for instance.

Besides a lack of sleep, young children often struggle with other conditions, Acebo said, such as restless leg syndrome, a neurological disorder that typically affects older adults. Restless legs syndrome is characterized by unpleasant sensations in the legs. Or, children, like adults, can suffer from sleep apnea, in which they have episodes of upper airway obstruction, interrupting breathing and compromising sleep.

"There are a fair number of kids who have sleep problems such as sleep apnea from enlarged tonsils and adenoids," Acebo said.

Some sleep problems may be traced to feelings of insecurity in a child, said another sleep expert, Dr. Rafael Pelayo, a pediatric neurologist and assistant professor at the Stanford University Sleep Disorders Clinic. "We want children to go to bed feeling safe, comfortable and loved," he said. If they don't feel that way, it's understandable they may have trouble falling or staying asleep.

Sufficient sleep is crucial not only for proper growth and development, but for a child's behavior, too, as any parent of a crabby preschooler already knows. On a more scientific level, researchers from Northwestern University Medical School studied the link between adequate sleep and behavior. They evaluated 510 children, ages 2 to 5, asking parents to report the amount of sleep their child got and then to describe the youngster's behavior the next day. The result: A lack of sleep during the night or naps translated into next-day behavior problems.

So, what's the experts' advice for parents of preschoolers?

"Keep regularly scheduled bedtimes and have good routines for bedtime," Acebo said. Those routines might include a bedtime story or anything else that is relaxing, she said. The point is to ease them to sleep in a relaxed manner.

Pelayo prefered to give a broader recommendation to parents. "I don't get caught up in details [such as have your child go to bed at the same time very night] on purpose," he said. Instead, he emphasizes that parents should make a child feel safe and comfortable and that the household shouldn't be too chaotic. A child will fall asleep more easily if the environment is conducive, he said.

Pelayo does caution parents not to tell a child she can stay up later and use a later bedtime as a reward for good behavior. That sends the wrong message, he said -- that sleep or having to go to bed is punishment. Another habit that some parents get into is to establish too early a bedtime for the age of the child. "Sometimes the kids have inappropriate [too early] bedtimes because the parent wants a break, they want earlier bedtimes," Pelayo said.

Occasional lack or sleep or sleep problems are probably nothing to worry about, Acebo said. However, if a child aged one to five seems sleepy during the day, outside of his or her regular nap time, then that is "something to tend to," she said. In these cases, a call or a visit to your pediatrician may be in order, the expert said.

More information

To learn more about children and sleep, visit the National Sleep Foundation.

SOURCES: Christine Acebo, Ph.D., sleep researcher, assistant director, Bradley Hospital Sleep and Chronobiology Research Laboratory, and assistant professor, Brown Medical School, Providence, R.I.; Rafael Pelayo, M.D., assistant professor and pediatric neurologist, Stanford University Sleep Disorders Center, Palo Alto, Calif.; December 2005, Sleep
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