Lack of a good night's sleep has been shown to have an adverse effect on children's daytime behaviour, as Harriet Griffey reports. You can help parents with our cut-out guide
Recent research, widely reported in the national press, has shown that tired children do not cope well with life. While this may come as no surprise, what is shocking is the number of children affected. Professor Gregory Stores, head of research into child sleep disorders at Oxford University, has described it as 'an epidemic of sleeplessness that is way above levels usually expected.' An estimated 20 per cent of children aged between one and three, and 10 per cent between four and five, have difficulty either settling or staying asleep.
'Sleep disturbance is very common among young children,' says Professor Stores.
'Their school attainment and performance is affected, as well as their social relationships. It's happening on a large scale and it's likely it's getting worse.'
As a result of poor sleep and the sort of disruptive behaviour that arises from it, many children are also being inappropriately diagnosed as having attention-deficit type disorders, which can result in being prescribed powerful drugs like Ritalin. Over-active behaviour may lead parents to conclude that their child just isn't tired or doesn't need much sleep, whereas in fact this is a symptom of chronic sleep deprivation, and the child enters a vicious circle of being incapable of sleeping well.
A study of Dutch children, published in the Journal of Sleep Research in June, looked at the lifestyles of young children, to see how this might be affecting their sleep. What was discovered was that in many cases hardworking parents wanted to spend more time with their children, which they often did late into the evening. In addition, bedrooms were no longer just places to sleep, but also served as 'entertainment centres' equipped with televisions, video recorders and computer equipment. Interestingly, a well-publicised British study out this month on the demise of bedtime storytelling, by child psychologist Dr Aric Sigman, cites the same reasons.
The author of the Dutch study, Anne Meijer, looked at what effect the lack of sleep has on school performance. Her conclusion was that children who suffered from lack of sleep showed poor performance in both academic achievement and social ability. 'Children who feel better rested display a more positive self-image and more achievement motivation; they have more control over their aggressive behaviour and are less bored and more receptive to their teacher,' she said.
Yvonne Miller, a clinical child psychologist at the Primary Care Child Psychology Service in Islington, London, says, 'Learning good sleep habits is very much to a child's advantage. Our largest referral group is in two-, three- and four-year-olds, and poor sleep habits can be a major factor in behavioural problems. Tired children are irritable, quick-tempered and less able to learn or negotiate their peer relationships.
'Parents have to see that it is in their child's best interests to help them learn good sleep habits, and this ability to be able to separate from others with confidence and go to sleep independently does need to be learned.
Often young children with sleep problems have never been allowed to learn to go to sleep unassisted, and this hinders their ability to learn.'
A parent's guide to sleep routines
Children who sleep well cope better with life. But being able to sleep well doesn't just happen by chance - parents have to help children learn good sleeping habits.
How much sleep do babies and young children of different ages need?
Newborn babies sleep for a large proportion of time over a 24-hour period, while learning to differentiate day from night until, eventually, the longest sleep period happens during the night. By about a year, babies still need between 12 and 14 hours sleep over a 24-hour period, with at least one good nap of between one and two hours during the day. At two years old, you would still expect a toddler to follow a similar routine but during the third and fourth year the daytime nap would reduce in time, gradually phasing out, while the night-time sleep should still average 12 hours.
How do babies learn to sleep through the night?
At birth, babies have no ability to differentiate between day and night. But they quickly learn to do this through the 'clues' they receive - mealtimes and regular bedtimes all help them to learn. If a baby is left to go off to sleep peacefully and alone, rather than being constantly fed or rocked, then when he wakes briefly during the night he can resettle without needing attention. This ability to go to sleep without adult intervention creates the possibility of good sleep habits on which parents can build.
When is it useful to introduce a bedtime routine?
Because introducing a bedtime routine helps a baby to learn that there is a slowing down of the day's activities towards the inevitability of bed, introduce it from around four months. This coincides with the introduction of solids, and by the time night feeds have been stopped, it should be possible for a baby to sleep through the night.
What should a bedtime routine involve?
Where possible, allow a couple of hours for a wind-down towards bed, from the last meal to lights out. If tea is at around 5pm, bathtime at around 6pm, followed by a quiet and peaceful last drink, a story, teeth cleaning, cuddle and then bed at around 7pm, this creates a routine. If you stick to the same pattern of events (make sure other carers of the child do the same) then you can be flexible occasionally without undermining the routine. If you need to delay the evening events, perhaps because you're working, make sure a young child has a good daytime nap to compensate so that the overall amount of sleep is appropriate to his need.
How to deal with a baby who won't settle
Sometimes babies can't settle because they are overtired. Don't be tempted to keep your baby going, or skip a daytime nap, in hopes that it will improve night-time sleeping. What happens is that 'awake' hormones go into overdrive to compensate, and it becomes increasingly difficult for a baby to calm down enough to go to sleep alone. When babies can't settle it's better to bring bedtime forward slightly, so they have the chance to fall peacefully asleep alone.
How to handle an older child who won't settle
Keep the bedtime routine going - a five- year-old should still be going to bed at 7 to 7.30 unless he has a day-time nap - but shift the emphasis off going to sleep straight away. Focus on getting the child to enjoy going to bed, perhaps to look at a book or listen to a story tape alone for a while before settling. But insist he stays in bed. If a child gets up, take him back to bed, and don't 'reward' wakefulness with drinks, or further stories, once it is time for sleep.
When things go wrong
If a poor sleep habit has developed, seek help. Health visitors are a good source of information, and they may know of a local sleep or child development clinic that can help you.
