Sleep Much?

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Back-to-school means routines and earlier bedtimes, but that’s not always as easy as it sounds. Sarah Flora, M.D., with St. Elizabeth Physicians in Alexandria, offers tips for common sleep woes and tells how to establish a solid sleep routine.

What gives elementary school-aged kids sleep trouble?

Nightmares and night terrors:
These are very common in the preschool and elementary school age groups. Nightmares are just bad dreams. When a child wakes up from a bad dream they are often consoled fairly easily and remember what happened. Night terrors are often scary, a child may seem awake, sit up and scream, they may be inconsolable for up to 30 minutes but they do not remember it afterwards. Both are exacerbated by stress. Providing reassurance and avoiding overly stressful environments are usually the only necessary interventions for both of these problems. If night terrors occur nightly at a certain time, waking the child before they occur can be helpful.

Growing pains:
Growing pains affect 10 to 20 percent of children and most often affect children between 4 and 8 years old. These pains occur intermittently and usually affect the thighs and calves. They do not affect joints such as knees or ankles. Massage and pain medicine such as Tylenol or ibuprofen are effective in soothing growing pains.

Bed-wetting:
At 5 years of age, seven percent of boys and three percent of girls wet the bed. By 10 years old, the percentages are three percent and two percent, respectively. Each successive year about 15 percent of children who wet the bed in the prior year will outgrow it. Some good ideas for prevention of bed-wetting include limiting evening fluid intake and emptying the bladder before bed. Some success can be had with alarms and other training programs. Medications may be prescribed but are not always successful and do have risks of side effects. Time and patience are often the best treatments.

Sleepwalking:
15 to 40 percent of children sleepwalk on at least one occasion and up to 17 percent do it regularly. The most important consideration when dealing with a sleepwalking child is to keep them safe. If a child sleepwalks regularly, gates and alarms can be installed and doors and windows should be locked to keep kids safe. Most children outgrow sleepwalking.

Sleep apnea:
This is an important sleep disorder to detect because it can be particularly troublesome for a child’s health and often can be cured. Symptoms may include snoring, difficulty breathing during sleep, and pauses in breathing. Long-term complications may cause problems with brain development, poor growth and hypertension. The problem often is caused by large tonsils and adenoids and may be fixed by removing them. It is important to discuss this with your child’s doctor if you think your child may have sleep apnea.

What are the effects of sleep deprivation in children?
Often children act just like adults do when tired. They act sleepy and are not as alert. However, some children show signs of sleep deprivation in ways we might not expect. They may be moody, irritable, angry, get headaches, and have trouble with behavior. This may include difficulty with memory, attention and hyperactivity.  It has also been shown that sleep deprived children are more likely to become overweight than non-sleep deprived children.

How many hours a night should children in this age group sleep?
Nine to 11 hours is the recommended amount of sleep for this age group.

What are tips to help get children on a healthy sleep schedule for the school year?
Be consistent. Set a bedtime and stick to it. There shouldn’t be more than an hour difference in bedtimes and wake up times from one day to the next. For the last hour before bed avoid stimulating activities such as TV or video games. A small snack before bedtime can be helpful but avoid heavy meals. Avoid caffeine-containing food and drinks in the evenings. Make sure kids are getting lots of exercise during the day.

~ Sarah Flora, M.D.

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