About sleep

By Raising Children Network

 

 

There's more to sleep than meets the eye, with deep sleep, active sleep and different sleep phases. Understanding sleep and sleep patterns is one starting point for helping your child develop healthy sleep habits and a positive attitude towards sleep.

did you know

Dreams or sleep cycles: one theory about why your most vivid dreams occur towards morning is that your brain cultivates them overnight ... another is that you simply remember more because it's closer to when you wake ... and that you're more likely to be woken mid-dream in a light sleep.

 

Why sleep?

Humans will spend about one-third of a lifetime asleep, yet science knows remarkably little about why we need to sleep, what happens when we sleep, or why we feel restored by a good sleep.

What we do know is that sleep deprivation has serious consequences and that sleep is necessary for the brain and body to develop. Undoubtedly, this is one of the reasons why very young children spend so much time sleeping. 

Although sleep is thought of as a time to rest and recuperate, a lot of activity takes place in the body and the brain during sleep. For example, when it's dark, our bodies produce extra melatonin to grow and repair cells and muscle tissues. Our bodies start to feel sleepy in response to the melatonin.

What is normal sleep?

• All humans cycle through stages of light and deep sleep.

• During quiet sleep (similar to adult non-REM sleep), a baby will breathe deeply and evenly and lie still with an occasional body jerk or `startle'.

• During active sleep (similar to adult REM or rapid eye movement sleep), a baby will breathe irregularly, twitch her arms and legs and display rapid eye movements under closed lids.

• Cycles of quiet and active sleep last 30-50 minutes in babies and up to 90 minutes in adults.

• Typically, a brief awaking occurs at the completion of each cycle. An independent sleeper puts herself back to sleep after one of these brief wakings.

More about quiet and active sleep

Sleep cycles
Quiet sleep	Quiet sleep can be light or deep. Someone in deep sleep is hard to wake. Deep sleep is a lot more peaceful and restful. It is thought that deep sleep is the time when we grow and heal. Light sleep can be very light - sometimes you might not even think you are sleeping. We can be easily woken from light sleep.
Active sleep	This is another form of light sleep in which our breathing becomes more rapid, irregular, and shallow, our eyes jerk rapidly in various directions, and our limb muscles become temporarily paralyzed. Our heart rate increases and our blood pressure rises. In adults, this is referred to as REM (rapid eye movement) sleep. We can be easily woken in REM sleep.

Sleep cycles

In the course of one night, adults and children move through repeating cycles of quiet and active sleep. For an adult, each cycle lasts about 90 minutes and ends in a brief awakening. Brief wakings between sleep cycles normally do not disrupt our sleep. If things have not changed, we normally go straight back to sleep and usually don't remember having woken in the morning. If things have changed around us, we are uncomfortable, our pillow is missing, or we are disturbed by a noise, then we might wake fully. Waking during the night is a normal part of healthy sleep - all children do it. It's just that not all children call out and not all parents wake when their children do.

Some children fall deeply asleep very quickly. Others sleep lightly, fidgeting and muttering for up to 20 minutes, before getting into deep sleep. However, typically, a larger proportion of our sleep in the early part of the night is quiet sleep (about 80%). Then, about halfway through our normal-length sleep, our sleep cycle flips so that by morning about 80% of our sleep is active sleep. This is why it's easier to be disturbed towards the end of a sleep.

How sleep cycles change over time

The amount of time we spend in each phase of sleep varies depending on our age.

At birth, full-term infants spend about half their sleeping time in active sleep. Each sleep cycle lasts only 40 minutes (compared to 90 minutes in an adult). This means that biologically, infants are programmed to sleep more lightly and have more brief awakenings than an adult. The amount of active sleep in our sleep cycle decreases with age. By three years of age, 33% of sleep is active. By the time we are teenagers, only about 20% of our sleeping time is active sleep.

When we sleep

It takes time to consolidate most of our sleep into the night-time.

Newborns sleep on and off through day and night. Around 85-90% of infants aged 6-12 months are still having daytime naps. Naps usually last 1-2 hours. Some infants will sleep longer, but up to a quarter nap for less than an hour.

From about six months, babies have their longest sleep at night. Between six and 12 months, most babies are in bed between six and 10 pm and take less than 30 minutes to get to sleep (but about 10% take longer). Most babies can sleep for a period of six hours or more at night and are waking less. About 60% will wake only once during the night and need an adult to settle them back to sleep. About one in 10 infants will call out 3-4 times a night. Waking up is partly related to the child's worry about being separated from a parent or parents. Overcoming this worry is normal and necessary for all children as a step towards becoming more independent at night. More than a third of parents report problems with a baby's sleep at this age.

From the age of 12 months, children tend to sleep better. Some toddlers start to resist going to sleep at night, preferring to stay up with the family. This is the most common sleep problem reported by parents. It peaks around 18 months and improves with age. Less than 5% of two-year-olds wake three or more times overnight.

Recognising tiredness

By Raising Children Network

 

 

Young children get overtired easily, and when they do they find it harder to get to sleep. Once you can spot those telltale signs of tiredness, you will be able to settle your child to sleep before she gets too grumpy.

It's not pretty. Your child is suddenly irritable, overactive or demanding. Chances are she's overtired.

Children show they are tired through changes in behaviour. Look for your child's “tired cues” and you can reduce stimulation and start settling her before overtiredness sets in.

Newborns

• A newborn baby will probably get overtired if she has been awake for more than 1 hours.

• At 3-6 months your baby will be overtired after 1-2 hours awake.

If your newborn is tired, she may:

• pull at her ears (this can also be a sign of sore ears)

• close her fists

• flutter her eyelids

• have jerky arm and leg movements

• yawn

• have a worried look on her face

• arch backwards

• have difficulty focusing (she may even go cross-eyed)

• suck on her fingers (this could be a good sign and mean that your baby is trying to find ways to settle herself to sleep).

Babies and toddlers

• At 6-12 months your baby will be overtired after 2-3 hours awake.

• At 12-18 months your baby will be overtired if she misses out on her morning or afternoon sleep.

If your baby or toddler is tired, she may be:

• clumsy 

• clingy 

• grizzly

• prone to crying

• demanding constant attention

• sick of her toys

• fussy with food.

Grizzling and crying can mean your child is absolutely exhausted, but it's often hard to tell the difference between tired grizzling and hungry grizzling.

If your child is showing signs of tiredness you can reduce stimulation by:

• taking her to her sleeping place

• putting toys away

• talking quietly and soothingly

• closing curtains and blinds

• turning overhead lights off - use lamps if you need to

• playing music quietly - this will help cut down on background noise.

Quiet time is important

• Give your child some quiet time in the place where she will sleep.

• Calm her with a gentle cuddle or by reading her a story or singing a quiet song.

• Your child may only need a few minutes of quiet time before she is relaxed and ready to be put in bed. If your household is noisy and active, she may need some extra quiet time before she is ready for sleep. 

Positive bedtime routines

By Centre for Community Child Health, Royal Children's Hospital, Melbourne

 

 

Bedtime battles can be less of a problem with a positive routine in the 20 minutes before tucking young children in for the night.

A positive routine involves your child in a series of pleasurable activities in the crucial 20-minute period before bedtime. It helps to soothe and calm your child, and ready her for sleep.

A positive routine goes hand-in-hand with any efforts to improve bedtime settling difficulties in babies, toddlers and preschool-aged children. A positive routine is almost always recommended when other behavioural strategies such as controlled comforting or camping out are used.

 
Most routines involve a mix of pre-bed tasks (bath, brushing teeth) and quiet, enjoyable activities (reading a story). The aim is to keep the atmosphere positive, using positive attention and praise.

A good bedtime routine smoothes the way for good night sleeping habits. Without a good routine, it can be hard for a baby to settle to sleep.

A routine can involve any number of activities. The key is that they are similar activities completed in roughly the same way each night.

Here is an example of a routine that can begin after dinner and a bath:

• breastfeed or bottle-feed (outside the bedroom)

• quiet play for 15-20 minutes (may include reading a book)

• into bedroom

• brief cuddle and kiss

• into bed.

At the end of the 20-minute `positive period', say goodnight. This is the time to be firm if your child resists. Be clear that it's now time for sleep and leave the room promptly.

Making a start: choosing the best bedtime

You may have an ideal bedtime in mind - somewhere between 7 pm and 8 pm for young children. But, when you are dealing with settling problems, the best bedtime to start with is one closest to when your child naturally falls asleep. For example, if you find that she finally falls asleep around 9 pm, set this as a temporary bedtime. This increases the chance that the routine will become firmly associated with the onset of sleep.

Moving your child's actual bedtime towards your ideal bedtime

The final step of the positive routine involves bringing your child's bedtime forward. This begins a week after introducing the `positive period' and involves bringing forward the time at which you start (by five to ten minutes each week) until your child reaches your ideal bedtime.

How long will it take?

The length of time required for the positive routine to work varies according to how quickly the `positive period' can be successfully shortened each week. Typically, the `positive period' needs to be shortened gradually rather than quickly and the routine takes a few weeks to be effective.

Research has found that a positive routine not only helps with settling problems, it can also lead to broad improvements in the quality of parent-child relationships generally.

Preschooler sleep: in a nutshell

By Raising Children Network

 

 

A preschooler's rapidly expanding imagination can sometimes get in the way of a good night's sleep. By listening to her fears and helping her overcome them, you can keep the bedtime monsters away.

If you like your information 'in a nutshell', download our Preschoolers book which includes this and other essentials on children aged 3-5 years.Go to Make a Book

 

Children aged from three to five need around 11-13 hours of sleep a night. Some may also have a day nap of about an hour. Sleep is important for their health, growth and development. If your child sleeps well, she will be more settled and happy during the day. Getting the right amount of sleep also strengthens her immune system and reduces the risk of infection and illness.

Night terrors and nightmares

As your preschooler's imagination takes flight, she may start having nightmares  or night terrors. Night terrors tend to happen in the first few hours of sleep when your child is sleeping deeply; nightmares usually happen between midnight and 4 am.

Here are some tips for dealing with nightmares:

• Explain that she had a bad dream and reassure her. A kiss and a cuddle might help her settle again. If she wants to come into your bed, that's fine. Once she is comforted, you may want to return her to her own bed so that she does not get into the habit of sleeping with you.

• If she has dreamed about monsters, you could try explaining that monsters are only make-believe and can't really hurt her.

• If you notice a recurrent nightmare, explore what may be causing it. Gently ask her about encounters with other children, television shows or other daytime experiences. If you find the culprit, you can reduce her exposure to it.

Bedtime routine

Some children fall deeply asleep very quickly. Others sleep lightly, fidgeting and muttering for up to 20 minutes, before getting into deep sleep. As your preschooler becomes more aware of the world, she may find it harder to settle to sleep. A bedtime routine can help. Most preschoolers are ready for bed around 7 pm, especially if they've had a big day at preschool.

A bedtime routine might look something like this:

Time	Activity
6.30 pm	Brush teeth, go to toilet, night nappy if needed
6.45 pm	Quiet time (read a book or tell a story)
7  pm	Into bed and kiss goodnight

Some preschoolers can demand more and more bedtime stories as a delaying tactic. You may want to establish a three-book rule for bedtime, with the promise to read more during the day.

If your child takes a dummy to bed, you may consider losing it (literally) when she is about three, if you think she is ready. Read about how you can help her let go of the dummy.

Night-time pull-ups

Even if your child uses the toilet or potty during the day, it's not time to throw away the nappies just yet. Often, children are between three and four years of age before they are dry at night. Some children don't have dry nights until six or seven.

Putting a night-light on and a potty in her room may prompt her to wee there during the night. Let her know that you will help her if she needs it. If not, there's no worry. Most children grow out of night wetting all by themselves.

Getting up after bedtime

Your preschooler may go through a stage of calling out from her bed or getting up after you have said goodnight. Try these tips:

• Avoid boisterous play before bedtime, as it may make it harder for her to settle.

• Establish a consistent, calming bedtime routine.

• Make sure her room is cool, quiet and dark.

• Before leaving the room, check your child has everything she needs and remind her to stay quietly in bed.

• Try not to respond to her calls after you have turned the light out. If you respond, she may try the same thing again next bedtime.

• If she gets out of bed, calmly ask her to go back to bed and remind her that you are just in the other room. Repeat this firmly and quietly over and over until she doesn't get up again.

Your child may actually need something if she is calling out. If she is scared of a monster under her bed, a quick check by you (with the light off) can confirm the room is monster-free and your preschooler may then settle. If she is scared of the dark, think about using a night-light.

Calling out and getting out of bed

By Raising Children Network

 

 

Calling out and getting out of bed after being put to bed are two common problems with young children. A nightly routine can cut down on bedtime battles.

Calling out and getting up are just two of the delaying tactics that can turn bedtime into a real battlefield. Here's what to do if your older toddler or preschooler's habit of stalling is causing conflict and making nights unpleasant.

Of course, calling out or getting out of bed is not always a problem. Your child might genuinely need something. Go to her if you think she needs your help or something is wrong.

What causes delaying tactics?

Delaying and stalling tactics can begin as a way of keeping you around. From around nine months, children can begin to develop separation anxiety, and not want to leave you at bedtime.

Spending a little time together and creating a positive, predictable routine before lights out will make saying goodnight easier.

Being warm, clear and firm, and not letting delaying tactics pay off at this stage will also help prevent longer-term bedtime struggles from setting in. If your toddler is under two years of age, you might find our Guide to solving sleep problems helpful.

If bedtime struggles suddenly appear following a significant change or loss in your child's life, then it may be a sign your child is experiencing some stress or anxiety. In this instance, you also need to work on relieving the stress in her life if you can. Spending a little more time with your child before lights out and the use of positive pre-bed routines will also help. You may also wish to discuss the issue with a health professional before implementing a new bedtime plan. Similarly, it may be helpful to speak to a professional if your child is experiencing a high level of anxiety or fear about night-time or separating from you.

Set up a bedtime routine

This is the most important part of any effort to help young children go to bed and settle. Doing the same things each night before bed will help prepare your child for sleep. Loud or boisterous play before bedtime will make it harder for her to settle.

Sometimes children and adults get their second wind late in the day. This surge in alertness is also referred to as the 'forbidden zone'. In some children it can bring intense activity and alertness that lead to resistance to going to bed.

When you start your bedtime routine is important. If your child is taking a long time to fall asleep, you may be putting her to bed too early. Try making bedtime later so that she is sleepier when you put her to bed. This way you maximise your chance of success in helping your child settle for sleep. If this new time is too late, bring it forward 5-10 minutes each week until you get to your child's ideal bedtime.

Do a quick check before you say goodnight

Before turning out the light, check that your child has done all the things she might call out about later. Has she had a drink? Been to the toilet? Brushed her teeth?

Turn on a night-light if this makes your child feel more comfortable.

Remind her of what you expect

Tell her before you leave her room that you want her to stay quietly in bed until she falls asleep. Explain that you will not be answering if she calls out. Say `Goodnight' or `I love you, sleep tight' (or whatever you usually say when she goes to bed) and walk out.

If your child calls out

As hard as this may be, do not respond. Ignore all further requests. Your child may come up with all sorts of reasons you should come to her, but if you want this technique to work you'll have to stay firm and ignore the calling out. That means no extra drink of water, no extra bedtime story, no extra kiss and no straightening her blankets if she has got herself untucked. Don't go to her at all.

If you respond because your child gets louder or more demanding, she'll learn that protesting long enough and loudly enough will get your attention. In future, she'll be more likely to keep protesting until you come.

If your child gets out of bed

There are two strategies that can work. Choose the strategy you feel suits you and your child the best, and stick with it.

Strategy 1: Return your child to bed

1. Say once, `Dominique, do not come out again. Please stay in your bed,' and return her immediately to bed without further discussion or argument.

2. Return her gently and calmly to bed, without talking, making eye contact or reprimanding her in any way. Do this as many times as it takes until she stays there. 

3. It may take many returns before she stays in bed. If you use this option, you'll have to be very patient. This may not be the best option for you if returning your child to bed is likely to make you very angry or upset.

Strategy 2: Restrict your child to her bedroom

1. Say once, `Dominique, do not come out again. Please stay in your bed'. Return her immediately to bed without further discussion or argument.

2. If she comes out of bed again, say, `Dominique, you have not stayed in bed, so now I will close the door (or the gate). I will open it again when you are staying in bed'. Return her to bed, and shut the door.

3. Ignore any further calling out.

There are a number of ways you can keep your child in her room:

• Erect a child gate; she will still be able to get out of bed, but won't be able to come out of her room.

• Close the door until your child is back in bed and stays there (if your child can open the door, you could consider holding the door shut until she stops trying to get out; the advantage of holding the door is that you are still nearby to ensure her safety).

If you are concerned that your child might be afraid of the dark, install a night-light.

Restricting a child to her room can be a better option if tempers are likely to be frayed and there is a risk that you might lash out at your child through frustration and anger. However, this may not be your preferred option if you are uncomfortable with closing the door.

You need to stay firm for either of these strategies to work. If you give your child what she wants after repeatedly leaving her room or protesting loudly you are simply teaching her to be more persistent.

What if your child vomits?

Sometimes children will cry to the point of vomiting. If she vomits, come in and clean her up with minimal attention and fuss. Reprimanding or punishing won't help. Best to try not to talk much at all, avoid eye contact and do not kiss or cuddle her. As soon as she is clean and back in bed, say goodnight and walk out again.

Praise your child if she was quiet

If your child goes to sleep without calling out, make a point of praising or rewarding her the next morning for staying quietly in bed. You might consider celebrating with a special breakfast surprise or a phone call to a special person. If your child is three or older, she might benefit from and enjoy a star chart.

Don't mention it if there was calling out

Try to start the next day in a positive way even if there was calling out the night before. You won't change your child's behaviour by talking about the problem at this point.

Night terrors

By Raising Children Network

 

 

One minute your child is sleeping like an angel, the next she's screaming and thrashing about in seeming panic. Night terrors can be scary for you, but they don't hurt or scare your child.

What is a night terror?

A night terror is when your child suddenly becomes very agitated while in a state of deep sleep. She may sit or stand up, shake, move about, and cry or scream loudly. Your child may look like she is in extreme panic.

During a night terror, your child's eyes may be open - but despite all the activity and movement, she is in fact still in a state of deep sleep. A child having a night terror is inconsolable and will not respond to attempts to soothe or comfort her. A night terror can last from a few minutes up to 40 minutes.

Night terrors are less common than nightmares - only around 1-6% of children will experience night terrors. Generally they are seen in children more than 18 months old and should disappear by six years of age. Night terrors can run in families, suggesting that there is a genetic component to whether children will experience them.

Night terrors seem scary to you but they don't hurt or scare your child. Children do not remember the event in the morning, and are not conscious of having had a bad dream or a fright. If wakened during a night terror, they will typically be confused and disorientated.

You do not need to be concerned about night terrors. They do not mean there is anything wrong with your child. Night terrors are natural events associated with the normal development of sleep in children. They disappear as children develop more mature forms of deep sleep.

Night terrors are different from nightmares. Night terrors happen during the first few hours of sleep when your child is sleeping very deeply (nightmares tend to happen in the second half of the night during phases of REM sleep). Managing nightmares is quite different because children have woken and might remember and feel upset by the dream.

What to do

The good news is that night terrors will not harm your child.

Avoid waking her during a night terror. She will only be confused and disorientated, and may take longer to settle.

Instead, wait for her thrashing around to subside. Guide her back to bed, and tuck her back in. She will settle back to sleep quickly. If you think she might hurt herself, stay close to guide her away from hitting or bumping into the sides of her cot or other obstacles.

When to get help

If you remain concerned, or the night terrors seem prolonged or violent, seek professional advice. If night terrors are occurring along with other sleeping difficulties, or breathing problems such as snoring, your child may also benefit from an ear, nose and throat assessment.

Nightmares

By Raising Children Network

 

 

Nightmares are very common. Comfort and reassurance is in order when your child wakes from a nightmare.

What are nightmares?

Nightmares are bad dreams that can cause children to wake in fear and distress. Your child may have nightmares about a realistic danger, such as aggressive dogs, sharks or spiders, or she may dream about imaginary fears, such as monsters. A vivid imagination can contribute lots of content for nightmares.

Nightmares occur in 25-50% of children aged 3-6 years. They happen during active sleep (or REM sleep - see About sleep), most commonly in the second half of the night. Unlike night terrors, children often wake, tearful and upset following a nightmare and will seek comfort from a parent. Depending on their language ability, they can often recall the content of their bad dream in detail. Some younger children may find it difficult to get back to sleep following a nightmare.

As your child grows older, she will get better at understanding that a dream is just a dream. By the age of seven, she may be able to deal with her nightmares without calling you to comfort her.

What to do about it

The occasional nightmare is not a sign of emotional disturbance and need not be cause for concern. However, if your child is dreaming about the same or similar things over and over again (a recurrent nightmare), or the content of the dream is particularly disturbing, she may be experiencing some kind of stress during the day.

Trauma can also cause nightmares. If your child has experienced some type of trauma, she may have nightmares about it for several weeks or months afterwards.

Tips for dealing with nightmares

• If your child wakes up because of or during a nightmare, explain that she had a bad dream and reassure her that she is safe. A kiss and a cuddle might help her settle again.

• If your preschool-aged child has dreamed about monsters, you could try explaining that monsters are only make-believe. Explain to her that made-up things, although scary, can't really hurt her. Avoid making fun of the nightmare or telling her that she is silly for worrying - nightmares can seem very real for little children.

• If you notice a recurrent nightmare, explore sources of stress or fright in your child's day. You might gently ask her about encounters with other children, television shows or other daytime experiences. If you locate a basis for the nightmares, you can then take measures to eliminate or reduce her exposure to the disturbing events.

Getting help

It can be a good idea to seek professional advice if your child is experiencing nightmares coupled with high levels of anxiety during the day. Or if nightmares are part of her response to a traumatic event.

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