ZZZ’s are important for ABC’s

Healthy child - November, 2004


Alyna Chien


If you think it’s tough to get your child to sleep, you are not alone. In fact, you’re in the majority. About 80 percent of preschool and school-aged children resist bedtime, according to a recent “Sleep in America” poll from the National Sleep Foundation.

In addition, more than half of parents report they would like to change their child’s sleep habits. The good news is healthy sleep habits are possible. It is never too late to start and children respond well to established bedtime routines and environmental cues.

Numerous studies show there may be no way to borrow from sleep without paying for it. Our brains are not merely idle when we sleep, instead they actively process and consolidate information. Less sleep means we are less able to organize our thoughts, remember facts and perform tasks. A nightly loss of just 30 minutes can lead to sleep debt, which diminishes our ability to function.

Sleep is not only important for children’s minds but for their bodies as well. Sleep-deprived children can become paradoxically overactive and have difficulty falling and staying asleep. Ultimately, sleep deprivation can manifest itself in moodiness, poor school performance, temper tantrums or even poor growth. Adequate and regularly scheduled sleep should be one of the most important things your child does.

Healthy sleep routines The amount of sleep a child needs and what the mind does while a child is asleep differs according to age. I have some guidelines for parents to give you an idea of how much sleep your child needs. (See table.)

But another way to judge whether a child is getting enough sleep is how he or she behaves. A child who wakes on his or her own at the proper time and moves through the morning routine with ease is probably getting enough sleep. One who requires a tow truck to get out of bed and then slogs through the morning routine, complaining all the time, probably is not.

Time spent asleep is just one part of the equation. There’s also the time spent on the bedtime routine and the time it takes a child to actually fall asleep once he or she has been tucked in and the lights turned off.

A well-paced bedtime routine takes about 30 minutes and most children need about 15 minutes to fall asleep. Allocating less time may mean your child won’t unwind properly; allocate much more and the bedtime routine loses momentum.

Most families notice great improvement after they have instituted a strong bedtime routine—children concentrate better, are more relaxed and are better able to take problems in stride. 

Successful bedtime habits  To teach good sleep habits, consider the following: • Choose a regular start time. Once you have determined the best bedtime for your child and family, stick to it. Infants and toddlers need only small incentives to start the nightly ritual. The promise of a story or a song, or time spent cuddling with a favorite doll or blanket is usually enough for most children—as long as they understand that once the story or song is over, it’s time for sleep.

Older children may require some explanation before a change in their routine. For example, you may need to help them understand good sleep habits help them have fun tomorrow, run faster on the playground and better remember things for a test.

If this is a new step for your family, expect your child to whine, beg or even throw a tantrum. Calmly hold your ground and provide your child with both positive and negative consequences. Offer to read together if a child is in bed on time, and take away television for the next day if the child is not. Children will stall, but if you consistently enforce the bedtime routine, you will have less protesting.  

• Use environmental cues. Darkness and quiet are potent ways to let your child know it is time for their bodies to slow down and relax.

Signal the beginning of a bedtime routine by shutting off all light- and sound-generating activities—the television, stereo, even the telephone. Keep the lights lowered in the bathroom and bedroom. (If you plan to be up past your children, turn up the volume on the stereo or television only after you’re sure they are asleep. Better yet, go to bed early yourself. Children learn best by the example you set.)

• Be part of the bedtime routine. Supervise teeth brushing and toileting, then spend time cuddling or comforting your child with a story, song, back scratch or tummy rub. Reading is one of the best things to include in a bedtime routine. A 1-year-old may be interested in only turning pages, and a toddler may look only at pictures, but these activities relax both the child’s and the parent’s heart rate and blood pressure, according to studies. (Television watching, on the other hand, is associated with delayed sleep onset, less overall sleep and fragmented sleep. Television sets should be removed from bedrooms altogether.)

If you have tried these sleep basics and still have trouble with your child, ask your pediatrician for more suggestions. While your children may never thank you for putting them to bed earlier, their teacher or daycare provider may. And you will see a difference in their attitude and abilities.


Alyna Chien is the mother of two, a pediatrician and a Robert Wood Johnson Clinical Scholar at the University of Chicago’s Department of Pediatrics.

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