Sleep information

Getting a good night’s sleep regularly is essential for good health and the ability to perform physical and mental tasks well during the day. Although many children have a natural ability to sleep easily, others, including those with neurodevelopmental problems such as ADHD and autism, may struggle to do so, resulting in loss of sleep together with poor quality sleep.

Common problems reported by parents include not falling asleep quickly at bedtime or frequent waking during the night. These situations can have a negative effect on both the child and family unit, and it sometimes hard to see that improvements are possible. However, research shows that our behaviour connected to sleep is highly important and that following some simple rules around bedtime can make a big difference.

Because babies, children and teenagers grow and develop rapidly they need much more sleep than adults do. The amount of sleep required varies depending on the individual, but the guide below details the number of sleep hours recommended for different age groups:

Babies (0–3 months)
11–13 hours
(Not less than 11 hours or more than 19 hours)

Babies (4-11 months)
12–15 hours
(Not less than 10 hours or more than 18 hours)

Toddlers (1–2 years)
11–14 hours
(Not less than 9 hours or more than 16)

Preschool (3–5 years)
10–13 hours
(Not less than 8 hours not more than 14)

School age (6–13 years)
9–11 hours
(not less than 7 or more than 14)

Teenagers (14–17 years)
8–10 hours
(not less than 7 hours or more than 11 hours)

Young adults (1 –25)
7–9 hours
(not less than 6 hours or more than 11 hours)

Sleep is affected by many things and it is important to consider possible causes of sleep difficulties before using medication as a solution. Once a cause is identified, taking targeted action along with making improvements in routines and environment may be enough to restore balance and improve life for everyone in the family.

Common reasons why children suffer sleep problems:

Stress, worry or anxiety

Children can be very sensitive to the world. They perceive things differently from adults and may be easily frightened or worried by even little things.  Stressors may include something they have seen or heard on television (even briefly), being bullied at school, the arrival of a new sibling or any other change (minor or major).

Bedtime fears

Childhood is a time of active imagination and it is not uncommon for children to feel scared by the prospect of being alone, in the dark or to be frightened by noises from outside the bedroom.  Even when asleep the brain is still active and fears may be expressed through bad dreams or nightmares, which may cause children to try to avoid going to bed.

Trauma

Family life is sometimes difficult and full of tension. Children need to feel safe to sleep well, and problems at home or domestic violence are likely to have a direct impact on their ability to relax and drift off soundly.

No structure at bedtime

Although sleep is a natural biological process we need to do certain things to help it happen easily. Sticking to the same simple routine each evening sends the right messages to the brain and teaches children how to manage their own sleep needs more effectively (see Sleep Hygiene and further Tips).

Overtiredness

Overtired children, unlike adults, may not seem sleepy or sluggish at bedtime but be very lively instead, sometimes showing behaviours similar to those found in ADHD. This can result in stress at bedtime and may delay the onset of sleep.

Poor diet

The brain and the gut play a key role in sleep, both of which need good nutrition to function well.  Evidence shows that diets high in saturated fat and sugar are linked to lighter sleep. Fibre in the form of wholegrains, fruits and vegetables support a healthy microbiome (gut environment) and aid sleep. Children who eat restricted diets or a lot of junk food may be at risk of sleep difficulties.

Caffeine intake

The most common sources of caffeine (a stimulant) are chocolate, coffee, energy drinks and some soft, fizzy drinks. Research shows that this substance blocks sleep-inducing chemicals in the brain and can have a stimulating effect as soon as 15 minutes after it is consumed.  The influence of caffeine (which is also addictive) may last for several hours.

Not enough exercise

Tiring children out with physical activities such as sports, playing in the park and going for walks increases the speed at which they fall asleep. Exercise should ideally be taken in the morning or afternoon to increase exposure to natural light and regulate the body’s internal temperature, both of which control sleep. Children and young people (5–18 years) are encouraged to aim for at least 60 minutes of exercise each day (www.nhschoices.uk).

Medical conditions, disabilities or illness

Studies show that children who have medical conditions such as epilepsy, eczema or asthma are more prone to disturbed sleep, as are those with cerebral palsy. Glue ear, a common childhood condition, may also disrupt sleep.

Note: parents should seek medical advice if their child snores, as this could be related to a potentially serious, although treatable, condition called sleep apnoea. This causes frequent, brief waking at night and can result in daytime sleepiness and concentration problems.

Technology

A study of 4–11 year olds found that increased screen time was associated with increased sleep anxiety, night time waking and overall sleep disturbance. Other studies have shown that watching television in the evenings can result in shorter amounts of the time spent asleep.

Environment

The conditions in which we sleep should make us feel safe, secure and comfortable. Anything from a lumpy mattress, noisy household or sibling disturbance may cause either difficulty in settling and/or night time waking.

Adolescence

During this stage of development, because of changes in the brain, the sleep/wake cycle of the body alters resulting in later falling asleep and waking times. As many teenagers also have irregular routines it is common for them to be sleep deprived and find it hard to get up in the mornings.

Neurodevelopmental difficulties

Sleep problems occur more frequently in children with neurodevelopmental problems, including those with Autistic Spectrum Disorder, ADHD and rarer types of genetic disorders. There are many reasons for this ranging from sensory issues, gastrointestinal (gut) discomfort, finding it hard to switch off, and certain types of medication treatment.

Because lack of sleep is a major problem for individuals, families and society as a whole, finding solutions and creating the right conditions for the best sleep possible is very important. Making changes can sometimes be hard but is worth the effort, especially if it means that the use of medication is avoided.

For guidance and help in making those changes the following information may help:

Sleep Hygiene and Further Tips

Sleep – Resources for parents/Caregivers

Relaxation Exercises and Mindfulness

Eat Right to Sleep Right

Melatonin