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A good night's sleep

Last Updated 08 January 2016, 18:37 IST

Getting your child to sleep might be a Herculean task. But if your little one isn’t getting his share of rest, it may hamper his development, says Dr Atul Mittal.

People who say they sleep like a baby, are usually not babies, neither are they parents of one! Any parent worth their grit and salt remembers the luxuriousness of uninterrupted sleep like a distant forlorn memory. It miraculously gets taken over by the kids’ cries, fights and the general dilly-dallying for having to go to bed. Kids and bedtime! Little hands rub their eyes, lids droop, intermingled with yawns and protests that they are not ready to get to sleep.

Newborns typically sleep a lot, 16 to 17 hours a day. They do it in maddeningly short bursts around the clock. Baby sleep cycles are far shorter than those of adults, and they spend more time in REM sleep (Rapid Eye Movement), which is thought to be necessary for the extraordinary development happening in their brain. REM sleep is lighter than non-REM sleep, and more easily disrupted. Somewhere between four and six months, experts say, most babies are capable of sleeping at a stretch of 8 to 12 hours.

It’s hard to believe, but by the time a child turns two, he will have spent more time asleep than awake. On an average, toddlers sleep 12 to 14 hours a day, including naps. As children outgrow naps and lullabies, they gain an important skill:
reasoning. At this time, parents have less control over making older children sleep, so it comes down to teaching them the importance of getting a good night’s rest. After all, children aged five  to 12 still need 10 to 11 hours of sleep a night.

Every night and at every nap, sleep recharges the brain and keeps the mind alert and calm. Quality sleep is uninterrupted sleep that allows your child to move through all the different and necessary stages of sleep, playing its essential role in the development of the nervous system. Sleep disruptions make a child less mentally alert, inattentive, unable to concentrate and easily distracted. They also make him more physically impulsive, lazy, or hyperactive .

Watch out
Sleep is one of those areas where the line between normal and abnormal can blur; there can be short sleepers and long sleepers. It may be more useful to look for changes in the sleep pattern of an individual child: if they are waking more at night, there’s a sudden change in how long they sleep, or physical signs such as poor growth — that would be a sign of something to seek advice about.

Like adults, children too can have medical conditions that interfere with their sleep. Up to 12 per cent of kids snore habitually and two per cent have sleep apnea, a disorder in which the airway becomes partially blocked, reducing airflow and rousing the child from a deep sleep. Although many children will outgrow the problem, a doctor’s advice should be taken if your child snores heavily or is excessively sleepy during the day.

Airway obstruction is a blockage in the airway. It may partially or totally prevent air from getting into your lungs. Upper Airway Obstruction (UAO) is a common cause of pediatric emergency. It occurs in the area from the nose and lips to the larynx. Also, Lower Airway Obstruction (LAO) can occur between your larynx and the narrow passageways of your lungs. The airway can become narrowed or blocked due to various reasons including:

Allergic reactions(in which the trachea or throat swell) to a bee sting, certain foods, medications, or pollen.

Fire or burns from breathing in smoke.

Foreign bodies such as peanuts and other breathed-in foods, pieces of
balloon, buttons, coins and small toys.

Infections or injury in the upper or lower airway area.

Epiglottitis (infection of the structure separating the trachea from the esophagus).
Tonsillitis (inflammation of the tonsils).

Bronchitis (inflammation of the bronchial tubes — airways that carry air to your lungs).
Enlarged adenoids that make it hard to breathe and cause ear problems.

Collection of pus in the tissues at the back of the throat during or soon after a throat infection.

Asthma.
It is important to resolve sleep issues because sleep is vitally important, particularly for children. Not only do we consolidate memory and learning when we sleep, but poor sleep adversely impacts areas like growth, immunity and blood pressure. If our sleep is fragmented, or we get too little, it drives our appetite for carbohydrate-rich foods. And we are seeing an explosion in numbers of severely obese children.

Establishing healthy habits
Stick to a consistent and soothing bedtime routine. A bath, bedtime story, quiet game can be incorporated while tucking your child in.

Make an effort to keep your child’s daily schedule consistent and she’ll be much more likely to fall asleep without a struggle.

If you want your child to learn to sleep independently, let her practice falling asleep on her own when she is relaxed and drowsy.

Create a good sleep environment — a room that’s not only cool, but also dark and quiet.

A consistent wake-up routine is just as important as a regular bedtime. Children should get up at roughly the same time every day (give or take 30 minutes). Fight the urge to let them sleep in on weekends.

Staying up too late is a common pitfall for grade-schoolers. Parents often contribute to the problem because they want to spend more time with their kids at the end of the day.
n Discourage homework before bed. Schedule a regular work time or build it in the child’s routine of playing, relaxing after school and other activities.

Restrict usage of TV, computers, mobile phones, tablets etc., close to bedtime. They interfere with the body’s natural triggers that allow us to sleep.

Making sure your child gets good sleep ensures that s/he will have a sound
foundation for proper mind and body development.

(The author is director, Fortis Memorial Research Institute, Gurgaon)

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(Published 08 January 2016, 15:52 IST)

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