Sleep deprivation

By Nathalie Vallerand

For many children, sleep doesn’t come easily. Some become expert bedtime stallers, while others wake up several times a night. What’s more, today’s children sleep slightly less on average than previous generations.

Over the last few decades, sleep duration has declined in both adults and children. Studies have shown that children are sleeping 30 to 60 minutes less a day. That might not sound like much, but it’s enough to affect things like mood, attention span, and memory.

“Children are going to bed later than before, but their wake-up time hasn’t changed, which means they’re sleeping less,” says Dr. Dominique Petit, a research professional at the Center for Advanced Research in Sleep Medicine at the Hôpital du Sacré-Cœur de Montréal. “When bedtime goes past 9 p.m., children take longer to fall asleep and wake up more often during the night.”

Why is bedtime getting later? In many families, both parents work. As a result, dinner and bedtime are pushed back.

“Some parents also feel guilty putting their child to bed instead of spending time with them,” says Dr. Petit. “As a result, they may be less strict about bedtime.” What’s more, evenings are often packed with activities. While these may not directly involve your child, they might be keeping other family members very busy, affecting your little one’s schedule.

“When a child’s meal times and bedtime are irregular, their routine is constantly being disrupted—and routine is very important for their sleep,” explains Dr. Jennifer McGrath, a psychology professor at Concordia University who conducts sleep research.

Plus, when a child does activities in the evening, outside of daylight hours, they’re more exposed to artificial light, which can disrupt their circadian rhythm. Consequently, they may have trouble regulating their sleep schedule.

Light from screens (e.g., computers, tablets, cellphones, TVs) can also affect a child’s circadian rhythm, stimulate their brain, and reduce their sleep time. One American study showed that children aged 3 to 5 who watch TV after 7 p.m. are more likely to have trouble sleeping. “Screen time in the evening pushes back bedtime, delays the child’s sleep, and increases night wakings,” says Dr. McGrath.

Common sleep problems

According to Dr. Evelyn Constantin, a pediatrician and director of the Montreal Children’s Hospital sleep laboratory, 25 percent of children have sleep issues.“The rate can be as high as 90 percent in children with a developmental delay, ADHD, autism, or cerebral palsy,” she says.

Difficulty going to bed

“I’m too hot,” “I’m thirsty,” “I need to pee,” “I want another hug” . . . Some children are very creative when it comes to delaying bedtime! Between the ages of 2 and 5, many children develop what’s known as bedtime resistance.

“It’s normal for your child to try to keep you around for as long as possible,” says Dr. Petit. “But giving in can shorten their sleep time. It’s in everyone’s best interests to set clear boundaries, as insufficient sleep can significantly impact your child’s development.”

Difficulty falling asleep

On average, it takes children 30 minutes to fall asleep. If your child takes longer to drift off, they may not be going to bed at the right time. A child who goes to bed too late may be agitated and have trouble sleeping, especially if they’re overtired. But if they go to bed too early, their body won’t be ready for sleep.

To help your child fall asleep quickly and easily, it’s best to follow a sleep schedule that aligns with their natural circadian rhythm and to have a stable bedtime routine. To ensure that your child’s nap doesn’t affect their night sleep, make sure they have at least four hours of wake time before bed, especially if they’re aged 3 or older.

Difficulty falling back to sleep alone

Children aged 1 to 3 wake up three times a night on average. They’ll usually wake up for a few seconds and then go back to sleep.

However, night wakings can become problematic if the child starts crying, calling for their parents, or getting out of bed every time they wake up. At that point, they’re agitated and won’t be able to fall back to sleep right away. When this kind of waking happens frequently, it can lead to a decrease in nighttime sleep. Often, this situation occurs when a child is used to falling asleep with a parent present.

Éloïm’s parents know this from personal experience! The 2-year-old’s mother used to always lie down with him until he fell asleep. She enjoyed their little ritual—but not the night wakings. “He’d wake up two or three times a night and need his mom to fall back to sleep,” says Étienne, Éloïm’s father.

Helping your child fall asleep at night lets them know that you’re there for them. But over time, they may start to associate your presence with going to sleep. That means they’ll always need your help to fall back to sleep.

One of the main differences between a good sleeper and a bad sleeper is the ability to go back to sleep without help. You and your child will both get more sleep if you teach them how to fall asleep on their own.

That’s what Éloïm’s parents are trying to do. “At bedtime, we read him a story and then tell him we’ll be back to check on him soon,” says Étienne. “Often, he falls asleep before we come back. The best part is, he’s getting better at putting himself back to sleep at night.” To avoid having the same issue with their youngest, 8-month-old Anaël, the couple always puts him in bed awake.

Other sleep issues

Lytycya, age 5, used to snore in her sleep. But when her father, Éric, realized that she would sometimes stop breathing for a few seconds, he got worried. At the hospital, Lytycya was diagnosed with sleep apnea, a condition that affects 1 to 5 percent of children. “If your child snores, breathes through their mouth, or momentarily stops breathing while they sleep, they should be seen by a doctor,” says Dr. Constantin.

Other common sleep disorders include night terrors, teeth grinding, and sleep walking or talking. They’re usually not serious and often resolve on their own. However, if they happen several times a week for several weeks, it’s best to have your child seen by a doctor.

Sleeping to grow

You’ve likely noticed that your child’s mood improves when they’re well rested. But did you know that a good night’s sleep also helps your child learn and contributes to their mental and physical health?

When your child sleeps, their brain is hard at work. It’s busy storing what they learned during the day.

In addition, the neuronal activity that occurs while they sleep helps them gain better control of their emotions and actions and develop their problem-solving, reasoning, and general intellectual abilities. In terms of physical benefits, quality sleep strengthens your child’s immune system. What’s more, during sleep, their body produces the hormones that help them grow.

Conversely, a child who regularly gets too little sleep is at greater risk of experiencing language difficulties. “They may also be more agitated, impulsive, anxious, or depressed, and they may not do as well academically once they start school,” says Dr. Dominique Petit of the Center for Advanced Research in Sleep Medicine at the Hôpital du Sacré-Coeur de Montréal.

Lack of sleep makes it harder for a child to learn. It can result in difficulty concentrating, retaining information, thinking, and finding solutions.

Napping

Naps are also essential and help reinforce learning. According to an American study, missing naptime causes toddlers to become more anxious, less joyful, and less capable of problem-solving.

“A number of other studies have shown that kids who skip their usual nap are more likely to forget what they learned earlier in the day,” says Dr. Petit. Of course, after a certain age, children no longer need to nap in order to learn and function properly. But parents should avoid ditching naptime before their child grows out of it on their own.

Sleep and weight

Children who sleep less run a higher risk of becoming overweight, says Dr. Jennifer McGrath, head of a Concordia University research program called the Healthy Heart Project, which focuses on the link between sleep and childhood obesity.

“Lack of sleep increases our levels of cortisol, a hormone that plays a role in how the body reacts to stress. It’s also linked to obesity,” Dr. McGrath explains. Poor sleep can also affect the hormones associated with appetite and hunger cues. Therefore, children may tend to eat more if they’re not getting enough sleep.

The link between insufficient sleep and obesity appears very early on. A study published by Dr. Petit and his colleagues shows that toddlers who sleep less than 9 hours a night at age 2½ are already more likely to be overweight by age 6.

Dr. McGrath’s work, meanwhile, has demonstrated that quality of sleep also has an impact on the risk of obesity. “Children who sleep less soundly, go to bed too late, and wake up more often during the night are more likely to carry extra pounds.”

Children who need less sleep

All of that being said, how much and how well your child sleeps depends on several factors, including their temperament. Some children sleep a lot, others a little less.

However, children who genuinely require less sleep (i.e., those who sleep one or two hours less than the minimum recommended amount) are relatively few and far between.

“Children in this category show zero fatigue, function perfectly well, and are in a good mood during the day despite sleeping less than other children their age,” says Dr. Petit. “It’s a rare genetic trait that’s often inherited from one of their parents.”

Before concluding that your child has this genetic quirk, check that they aren’t showing any of the following signs of fatigue, which indicate a lack of sleep: difficulty waking up in the morning, trouble concentrating, agitation, aggression, impulsivity, irritability, greater susceptibility to colds or other infections, etc.

Like all children, kids who require less sleep still need to go to bed at the same time every night, have a soothing bedtime routine, and learn to fall asleep on their own in order to get quality sleep.

Obstacles to sleep

Every parent wants their child to sleep soundly, but there are many things that can affect sleep without us even realizing it. Read on to learn the most common sleep disruptors and a few tips to help your little one get a better night’s sleep.

Inconsistent dinner and bed times

Keeping a consistent weeknight routine can be a challenge. If you often work late or someone in your family has frequent evening commitments, your dinner and bedtime schedule may tend to get thrown out the window. Nevertheless, you should do your best to try and maintain a regular schedule.

“Doing so regulates your child’s biological clock and helps them fall asleep more easily,” explains Dr. Jennifer McGrath, a psychology professor at Concordia University. “That’s why it’s also a good idea to stick to the same schedule as much as possible on weekends.”

There’s no quick fix for hectic weekday evenings. However, there are things you can do to control the chaos: plan and prep meals on the weekend, keep evening activities to a minimum, divide household responsibilities between you and your spouse, and so on.

It’s also important to watch for signs that your child is tired so that you can put them to bed when they’re naturally sleepy. “When my daughter needs to sleep, she starts whining, gets impatient for no reason, and plays with her hair,” says Pascal, father of Félix, 5, Manue, 2, and Matéo, 5 months. Other children might rub their eyes, yawn, stare into space, misbehave, or exhibit other behaviours.

No bedtime routine

Experts agree that this is the main cause of sleep issues in young children. If you set a predictable, comforting routine (e.g., bath, pyjamas, brush teeth, story time, cuddles, then sleep), your little one will sleep better and be less fussy about going to bed.

“Children are soothed by rituals because they know what to expect,” says Dr. Dominique Petit of the Center for Advanced Research in Sleep Medicine at the Hôpital du Sacré-Coeur de Montréal. “With bedtime routines, they start to associate each step with winding down for bed.”

As the father of four children between the ages of 5 and 21, Éric knows how much of a difference a bedtime routine can make. “My older kids didn’t have a bedtime routine or a consistent bedtime, so it was always a challenge to get them to sleep,” he says. “With my youngest, Lytycya and Lukas, who are 5 and 6, we do the same things in the same order every night. It signals to them that it’s bedtime, and they sleep much better.”

It’s best to do quiet activities in the hour before bedtime, such as reading, listening to soft music, or drawing.

Too much screen time and not enough physical activity

A number of studies have shown that too much screen time (TV, tablet, cellphone, computer) can disrupt sleep. In fact, it’s best to avoid screens entirely before bedtime. Children shouldn’t have TVs or electronic devices in their rooms, either.

It’s also a good idea to limit screen time during the day in order to make more time for other things, such as physical activity. To sleep well, your child needs to move. Just ask Lukas’s dad: “When my son isn’t active enough during the day, he has trouble falling asleep at night.”

Poor bedtime habits

Dr. Petit’s research has shown that parents often unintentionally develop poor bedtime habits. For example, a well-meaning parent might stay with their child until they fall asleep or bring them back to their own bed if they wake up in the middle of the night. The problem is that the child may become dependent on their parent’s presence to fall asleep and have trouble sleeping on their own.

Conversely, children who are used to falling asleep without help at bedtime have an easier time falling back to sleep on their own if they wake up. They also tend to wake up less often at night and sleep more soundly.

“It’s best to get your baby used to falling asleep on their own as early as possible,” says Dr. Petit. When they’re just a few months old, you can put them to bed before they’re fully asleep. By around 6 months, babies usually no longer need to be fed at night.

If your child wakes up and cries, you should check on them to make sure everything’s okay, but Dr. Petit advises leaving them in their bed. To soothe them, start by stroking their skin and talking softly to them, rather than picking them up right away.

There are different methods to help your child fall asleep on their own from the age of 1 or 2 (link in French only), and just as many opinions on the subject. For example, some parents prefer the “controlled crying” method, while others are not comfortable with this technique. Controlled crying involves letting your baby cry for progressively longer intervals before checking on them (e.g., 5 minutes, then 10 minutes, then 15 minutes). You can also use shorter intervals.

While some studies suggest that this technique is safe and effective, Marie-Hélène Pennestri, a psychologist and associate professor at McGill University, is cautious about drawing conclusions from the results. “It’s very difficult to establish a direct relationship between the use of a sleep training method and a child’s long-term emotional development,” she says. “It’s one factor among many.”

She adds that your choice of a sleep training method will also depend on your family, values, and culture. “If parents don’t feel comfortable with a particular method, we shouldn’t tell them that it’s their only option. There are many other methods to choose from. If a parent uses a specific technique because of social pressure and it doesn’t work, that doesn’t help anyone.”

The way you respond to endless stalling requests at bedtime (another bathroom trip, a glass of water, one last goodnight kiss . . .) can also make a big difference. It’s normal for children to test limits. But, if you say yes to bedtime requests every time or just when you’re in a good mood, your child will likely keep up this behaviour because you’ve shown them that it works. Therefore, to cut down on bedtime stalling, it’s important to set boundaries and stick to them.

Some parents also use rewards to reinforce good behaviour. That’s how Manue’s parents got her to stop leaving her bed multiple times a night. “Every time she stays in bed, she gets a sticker to put on her sticker chart,” explains Pascal. “After three stickers, she gets a little treat.”

Source:Naître et grandir magazine, October 2016 Research and copywriting: Nathalie Vallerand Scientific review: Évelyne Touchette, Ph.D., professor/researcher and sleep expert, Department of Psychoeducation, Université du Québec à Trois-Rivières Updated: July 2023

Photos: iStock.com/Bodler, iStock.com/IPEKATA, iStock.com/Bodler