3 to 5 -year-old Sleep Problems

My four-year-old has deciding to start fighting us when he goes to sleep. I saw this headline and thought it might be of some help. However, he doesn't watch television much during the summer, there is no t.v. in his room and he doesn't watch violent programming. So, I don't think this is a fit for me, but I thought it might help out other parents.

FROM NBC: If you have trouble getting your kids to sleep, there may be an easy solution. It turns out that television and other media sources could be keeping the sandman away. Previous studies have shown that exposure to electronic media can keep kids from a good night's sleep.

Now a report in the journal "Pediatrics" focuses on when and what children are watching. Looking at over 600 three-to-five year olds, the authors found that the youngsters were exposed to an average of 73 minutes of media time every day. Those who had televisions in their bedrooms got an additional forty minutes daily.

The report finds viewing violent content during the day is linked with sleeping problems-- while non-violent daytime exposure has no effect. But any media exposure -- violent or not-- after 7:00 p.m. was associated with difficulty sleeping, including trouble falling asleep and daytime tiredness. The authors recommend that parents reduce kids' evening media access and violent content in general. And they advise removing televisions and other media devices from childrens' bedrooms.

-NewsAnchorMom Jen

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Childhood Insomnia

When does your child go from having sleep problems to having childhood insomnia? Pediatric sleep specialist Dr. Sarah Zallek says she's not convinced insomnia is a cause for not sleeping. She says it is usually a symptom of another problem: like sleep apnea, breathing obstruction, or anxiety. "Childhood Insomnia isn't necessarily a condition on it's own. It's a behavioral thing most of the time. Childhood insomnia can also be caused by medications like the ones used to treat asthma, ADHD and others," said Dr. Zallek.

Causes of Childhood Insomnia:

1. Limit Setting

Dr. Zallek: There are some kids who are developmental abnormal and have insomnia. That's a different story. For most kids, behavioral insomnia in childhood can be related to limit setting. Keep the child within limits, put them in bed, don't give in when they ask for another drink, etc. It turns into a not sleeping thing because they get attention for getting up. She advises her parents to say, "Go to bed and stay in bed." If the child gets up, don't let them snuggle in bed with you, watch T.V. or anything else. Don't get them into that habit.

Dr. Zallek: I would go back to the sticker chart, a series of squares to put stickers in. Three nights of good behavior gets a little toy. For an older child, it would be a week of good sleeper gets a toy. You reward what you want them to do. Punishment almost never works.

Jen: I can attest to that last statement. We have tried punishment for bad sleeper. Completely pointless in my house!

2. Bedtime Fears

Dr. Zallek: Bedtime fears can cause childhood insomnia. Sometimes they will be totally good sleepers, then they will start saying there's a monster in the closet. There are shadows or something. The best way is to make sure and tell them the monster doesn't exist in the first place. Don't invent monster spray. No checking under the bed for alligators. Rationally explain to the child those things don't exist. Reassure them they are loved and protected.

3. Caffeine

Dr. Zallek: It is also outstanding to me how many kids get caffeine. Even one caffeinated beverage early in the day can effect their sleep. That little bit of caffeine gets in more than people realize. It's not just Coke and Pepsi. It's Sunkist Orange all those energy drinks. I found a Mango smoothy that included caffeine. It had the equivalent of three cups of coffee. Even if it looks like a natural drink, make sure you read labels.

Dr. Zallek: Chocolate gets a bad rap. It really doesn't have that much caffeine in it. A & W cream soda has caffeine in it. And not all products label caffeine in terms of milligrams, so you really have to be careful and read the ingredients part of the packaging.

About.com gives these causes of childhood insomnia:

If you set a realistic bedtime and your child is still not getting a good night's sleep, then common causes of insomnia can include:

• poor sleep habits
• caffeine
• stress
• obstructive sleep apnea (snoring)
• side effects of medications, including stimulants used to treat ADHD, antidepressants, corticosteroids, and anticonvulsants
• asthma (coughing)

• eczema (itching)

• depression

• anxiety

• restless legs syndrome
• neurodevelopmental disorders, such as autism, mental retardation, and Asperger's syndrome

There are several medications used to treat childhood insomnia and also some non-medical approaches. Doctors seem to agree that treating childhood insomnia is no easy feet. Here's an interesting perspective published in Psychiatric News.

Here are the others blog posts on getting our kids to sleep through the night:

Breastfeeding babies and sleep
Sleep ApneaHow many hours of sleep do kids need?
"The Sleep Fairy" Book for toddlersOlder kids losing sleep when new baby arrives

-NewsAnchorMom Jen

How many hours of sleep do kids need?

Each Thursday we are answering questions from readers like you about getting your kids to sleep through the night.

Here's this week's question:

"I have older kids (not babies) but I still have questions. How much sleep does an early teen (ages 13-14) need? (I think they still need 9-10 hours but bedtime is getting harder to control as they get older). My son is a mouth breather, does that effect sleep?" ~Jennifer

Dr. Zallek says you are right about the number of hours a 13-14 year-old needs to sleep. She also mentioned parents have a tough time setting limits with kids this age. She thinks you are one step ahead because you realize your child may not be getting enough sleep. Dr. Zallek said, "Most parents don't recognize those are the sleep needs of their children. They expect their kids to sleep less and feel fully refreshed. " The main thing to keep in mind is to be adamant about making them go to bed on time. (Now you have back-up because a specialist is telling you to do this!)

Here's the breakdown on how many hours of sleep kids need:

Babies: 16-18 hours

Pre-school age children: 11-13 hours

School-aged children: 10-11 hours

10 year-olds: 10 hours

14 year-olds: About 9 hours, but some need a little more and some a little less

The American Academy of Sleep Medicine (AASM) offers some tips to help your child sleep better:

• Follow a consistent bedtime routine. Set aside 10 to 30 minutes to get your child ready to go to sleep each night.
• Establish a relaxing setting at bedtime.
• Interact with your child at bedtime. Don’t let the TV, computer or video games take your place.
• Keep your children from TV programs, movies, and video games that are not right for their age.
• Do not let your child fall asleep while being held, rocked, fed a bottle, or while nursing.
• At bedtime, do not allow your child to have foods or drinks that contain caffeine. This includes chocolate and sodas.
• Try not to give him or her any medicine that has a stimulant at bedtime. This includes cough medicines and decongestants.

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Jennifer also mentioned her son is a mouth breather. Dr. Zallek said, "Mouth breathing can be a sign of a tendency of sleep apnea because of upper airway narrowing."

I will post all the information you need to know about childhood sleep apnea next Thursday.

Here are the links to the other sleep topics we have already covered:

"The Sleep Fairy" book for toddlers

The new baby can lead to sleep problems in older kids

-NewsAnchorMom Jen