Understanding Your Child’s Sleep: Bedtime Tips for Parents

Sunny Im-Wang, Psy.D.

To follow up from previous two posts, here are tips to help ensure that your child gets a good night’s sleep:

• Stick to a regular bedtime.
• Develop a calming routine each night to help your child relax. This may include a warm bath or a relaxing bedtime story.
• Don’t keep a TV in your child’s room. Also, don’t allow him to watch intense or scary movies or shows late in the evening.
• Make the bed for sleep only, rather than activities like texting or phoning friends, reading, or doing schoolwork. This will help your child to associate his bed with sleeping.
• Don’t let him exercise late in the evening, as this can disrupt his sleep.
• Don’t allow your child to eat or drink anything that contains caffeine late in the evening.
• Limit beverages two hours before bedtime so your child won’t need to go to the bathroom in the middle of the night.
• Keep the room at a comfortable temperature and as dark and quiet as possible.
• Teach your child about reasons why we may awaken sometimes, such as when needing to go to the bathroom.

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© 2011 Sunny Im-Wang, Psy.D.  All rights reserved.

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Understanding Your Child’s Sleep: Nightmares and Night Terrors

Sunny Im-Wang, Psy.D.

It is important to know the difference between night terrors and nightmares. Since their origins are different, the ways in which you approach them will be very different. Night terrors in children usually occur during the early part of the night, as they transition from stage 3 to stage 4. Night terrors are not dreams; rather, they are a highly aroused state in which the child is very frightened[2]. It is almost as if the child’s body is awake, but his mind is not. Nightmares, on the other hand, are bad dreams that may be quite vivid. They are more likely to occur in the wee hours of the morning, during REM sleep. A child usually won’t remember having a night terror, whereas he may remember a nightmare.

With nightmares, you can gently awaken your child to comfort and reassure him. But with night terrors, it’s best not to try to awaken your child. If you do, not only will he be very confused and disoriented, but he may also have a harder time getting back to sleep. He will not be responsive to reasoning or consoling. Typically, even your presence might frighten him, as he may mistake you for a figure who is trying to harm him. Remember, your child may look awake, but he is not. If you are concerned that he might hurt himself while crying and moving too harshly, stay with him until the night terror passes. Since your child may thrash or try to get out of bed during a night terror, you may need to use gentle restraint to prevent him from injury.

Understanding Your Child’s Sleep

Sunny Im-Wang, Psy.D.

Getting restful, adequate sleep is crucial to good health—both physical and mental. We spend approximately one-third of our life sleeping, yet experts still don’t know exactly what happens when we sleep. But we do know that we can’t function well without it.
If you have children, you know that they need much more sleep than adults do. In fact, on average, a newborn baby needs between 12 to 18 hours of sleep per day. Toddlers require between 12 and 14 hours of sleep, and older children require an average of 10 to 11 hours per night[1].  Most adults need only 7.5 to 9 hours of sleep for optimal health and functioning.

Sleep Stages

As you sleep, you go through five different stages. These stages are dictated by your brain. Understanding the stages of sleep will help you better understand the effects on your child if he or she is awakened during a particular stage.

• Stage 1 – Thisis a transitional stage between being fully awake and asleep. The heart rate and body temperature begin to decrease, and the muscles start to relax. During Stage 1 sleep, which lasts only a few minutes, the brain is producing very slow waves known as theta waves[1].  If something were to awaken your child, he would probably say he had never gone to sleep.

• Stage 2 – This stage of sleep is very light and lasts for about 20 minutes. Your child can still be easily awakened, so if a dog barks or someone honks a car horn, he’ll likely wake up. Heart rate and body temperature continue to slow down slightly. Quick bursts of rhythmic waves, called sleep spindles[1] , are being produced by the brain during this stage.

• Stage 3 – Stage 3 is another transitional stage, taking the body from a light sleep to a very deep sleep. This stage is also known as the slow-wave sleep because the brain begins to produce slow, deep waves known as delta waves[1]. During this phase of sleep, blood pressure begins to drop. It will be much more difficult to wake your child during this stage. Some children (as well as adults) talk or walk in their sleep during this stage.

• Stage 4 – Like Stage 3, this stage is also regarded as slow-wave sleep, as the brain continues to produce delta waves[1]. It is the deepest stage of sleep and lasts for about a half hour. You’ll find that it is very difficult to awaken your child during this stage. If you do, expect him to be quite groggy for the first few minutes. Sleepwalking and talking often occur as people transition from this stage to a lighter sleep stage. If your child is prone to wet the bed, it will typically happen toward the end of this stage.

• Stage 5 – This unique, active stage of sleep is known as REM sleep because it is when rapid eye movement occurs[1].  Breathing is often irregular, and the heart rate is faster. This is the stage of sleep when dreaming takes place. Your child is most likely to remember a dream if he is awakened during this stage. The brain is very active during REM sleep, but the muscles in the arms and legs are essentially paralyzed.

The Sleep Cycle 

Everyone repeats stages 2 through 5 several times throughout the night. Each cycle lasts about 90 minutes, so on any given night, your child will repeat this cycle several times until he wakes up[2]. Although the length of the cycles is the same, the majority of deep sleep takes place during the first part of the night, whereas the REM stages are longer during the latter part of the night.

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© 2011 Sunny Im-Wang, Psy.D.  All rights reserved.

Reference:

1. Epstein & Mardon, 2006. The ABCs of Zs: What Happens During Sleep? The Harvard Medical School Guide to a Good Night’s Sleep. Ch 2.
   
2. Nicholi, 1988. The New Harvard Guide to Psychiatry

Traveling with kids?

Sunny Im-Wang, Psy.D.

Vacations are fun…for most people. For those who have young children, it can be a bit stressful to think about how to prepare and what to do while traveling with your little ones. Just explaining the situation won’t work with young children. Kids at this developmental stage are in the middle of toilet training or at the tail end of it, have a strong desire to be independent, and have an abundance of curiosity and a desire to explore. None of these qualities are bad if you’re in your typical surroundings. However, add in the security line, “random” searches, being strapped in seat belts, changes in air pressure, and limited access to bathrooms, and it can turn ugly. Just imagine a child not wanting to separate from her “blankie” being told it has to be put into a container and scanned by a security camera.

With children at this age, it is not only helpful, but crucial, to share a simple overview of what is going to happen during the day. Since it is not a typical day, it helps them to have a sense of what to expect. Here are some tips to help with the process:

• Use children’s natural tendency to want to be in charge and be independent. Make your child your traveling helper. (You can even make him or her a little badge out of one of those “My name is” stickers or a blank label.) Explain some of the rules beforehand, such as needing to take off jackets and shoes. You’ll find that kids at this age LOVE knowing the rules and especially telling others that they’re not following the rules.

• Remember that kids, like adults, function best when their physical needs are met, including their needs for food, sleep, and bathroom. Gauge and assess what your child might need physically. If there is a physical need, try to fill it for him or her. If you’re unable to provide it, however, such as when sleep is interrupted due to a delayed flight, try to soothe your child by sitting and helping your child to calm his or her body down. When children are extremely tired, their bodies go into overdrive, and instead of sleeping, they might appear to have lots of energy. Do not wait for them to crash. Although there is a widespread belief that kids will crash if you let them work out their overactiveness, it is actually more helpful to assist them in calming their body down. Sit with your child and perhaps sing his or her favorite lullaby softly. This will calm your child’s senses, which his or her body needs when in overdrive.

• Roughly plan out your child’s elimination needs. Whenever you think he or she needs to go, you go, too. Tell your child that it’s potty time for everyone.

• Have a little emergency food bag with your carry-on so you’re prepared for possible travel delays.

• Create a story or use a storybook to help you during your trip. Books such as Fly with Kai offer kids knowledge and models to know about in-flight experience.

With some preparation and planning ahead, the process of traveling doesn’t have to be so stressful.

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© 2011 Sunny Im-Wang, Psy.D.  All rights reserved.