Other child sleep issues
Nightmares are common and again most children grow out of them. They usually occur later in sleep and cause strong feelings of fear, terror or anxiety, they are often remembered the following morning and can be described. They can be a response to a frightening event such as a scary movie or could be due to longer term anxiety. The first step is to see if there is anything that is worrying them.
Sleep apnoea is when there are pauses in breathing during sleep. In children this may be from obstruction of the upper airway by large tonsils during deep stages of sleep. This is recognised by pauses in breathing followed by load grunts, snorts and groans on arousal. It can be associated with day time sleepiness. If concerned you should see your GP.
Bruxism or teeth grinding is common in childhood and most children will grow out of this as they get older and it usually does not cause damage to the teeth. If you are concerned see your dentist.
Nocturnal enuresis or bed wetting is also related to the sleep cycle and it is not a bladder disorder. As we get older we have changes in our sleep cycles. Infants and toddlers have deep sleep and do not respond to messages of a full bladder. Bed wetting is normal until the age of five, if it is happening after this age you should see your GP, especially if there is day time wetting.
Finding positive sleep routines
For all sleep conditions, good sleep hygiene or positive routines are very important both for the child and the household.
Sleep produces cyclical surges in hormones such as cortisol and growth hormone that are required for growth and immunity, it is important to allow enough time for sleep and to have a regular schedule for sleep to regulate these changes.
Ensure there is a consistent time and routine for sleep. There should be no screens in the room and they should be able to fall asleep by themselves.
Normal sleep time varies as we get older, newborns will sleep for 14 to 17 hours per day. This decreases to about 11-14 hours for toddlers and 9-11 hours for school children. Sleep is required to learn and grow.
We have periods of both deep and quiet sleep during the night and these sleep cycles are important to achieve good quality sleep. At the end of each cycle there is often a period of awakening and this may not result in becoming alert or fully awake if children have a good sleep routine.
Children need a routine for sleep that allows quiet low-key activities prior to sleep with a wind down time to relax. If toddlers can fall asleep by themselves in their own bed most will sleep through without waking their parents.
As we all have awakening periods during the night the sleep routine needs to be able to allow a toddler to fall asleep by themselves or they will require the presence of an adult for all night awakenings. It is important a child can do this without their parents being needed for each sleep onset.
The bedroom needs to be quiet, cool and dark with no blue lights or screens as these activate the brain and prevent sleep. There needs to be a consistent routine: brush teeth, read a book or sing a song and leave the child to fall asleep on their own when they are drowsy.
Don’t give a bottle to fall asleep, ensure it is finished prior to the child going to bed, remember feed, play, sleep. There may be a period of calling or getting up from the bed, check if they need something and redirect them back to bed. If they do wake at night use a dim light and soothe not play. Emphasise the difference between night and day.