Q: My 12-year-old son gets eight hours of sleep every night but he still seems tired in the morning. Is there something wrong?
A: The following recommendations for total hours of sleep per age group (including naps) are made by the American Academy of Pediatrics and the American Academy of Sleep Medicine: 0 to 3 months, no set recommendation but may be up to 90% of the day; 4 to 12 months need 12 to 16 hours; 1 to 2 years need 11 to 14 hours; 3 to 5 years need 10 to 13 hours; 6 to 12 years need nine to 12 hours; and 13 to 18 years need eight to 10 hours.
Your child could need one hour more or less than this range as well. Getting enough sleep is important for physical and mental health.
Signs that your son is not getting enough sleep can present as suffering from poor concentration and irritability, and can contribute to headaches, depression, high blood pressure and obesity. Getting adequate sleep supports memory and improved school performance, a healthier immune system, and better behavior and mental health.
Helping your child get enough sleep can be a challenge because of bedtime resistance or difficulty falling asleep. A child who is displaying bedtime resistance will often dilly-dally in getting ready for bed, finding many excuses to get out of or not get into bed. It is important to try and maintain a consistent bedtime routine that does not go beyond 30 minutes. Rewarding sticking to the routine with something special the following day can help reinforce good bedtime behavior.
Some kids and teens have difficulty falling asleep for a variety of reasons but there are a number of strategies you can employ to help them. Make sure there is ample time for physical activity during the day, as being physically active can help with sleep onset and maintenance of sleep.
A healthy sleep environment is also very important. For younger kids this may include a nightlight, having some water available at the bedside, and one or two chosen stuffed animals. For teens, try to keep them out of their beds except for sleep and keep the bed uncluttered. Not consuming caffeine after the morning time, or avoiding it altogether, can also be beneficial.
Meditation is a helpful way to “turn off the brain” and help the mind and body relax into sleep. The New Mexico Medical Home Portal (nm.medicalhomeportal.org) has a great list of websites and apps for meditation for all ages, as well as many resources to help with sleep issues. For young kids to teens, avoid screen time 30 to 60 minutes before bedtime, as the backlit screens can stimulate the brain and impair the ability to relax and fall asleep.
Nighttime awakenings negatively impact sleep and can be caused by sleep apnea, growing pains, and nightmares or night terrors. A child with sleep apnea may snore, have restless sleep and have daytime sleepiness. This is definitely something to discuss with your child’s health care provider as it can cause heart damage if left untreated.
Growing pains are often more noticeable at night, particularly after an active day. These are usually present in both legs (although the pain may alternate sides), mainly in the thighs, behind the knees or in the shins. Massaging the legs usually helps resolve the pain and occasionally use of pain medication, such as acetaminophen or ibuprofen is necessary for comfort.
Finally, nightmares or night terrors can disrupt sleep for both a child and the family. A child having a nightmare is consolable and will often remember what they were dreaming about. Avoiding scary shows or movies and talking about what was scary can help families resolve the cause.
During a night terror, kids are not actually awake and will not remember having had one. Don’t try to awaken them, make sure they are safe and most episodes will pass fairly quickly. Talk to your pediatrician if they become more frequent or become longer in duration.
As we head into the time of year that is often very busy with school, work and social obligations, it is important to recognize the impact of inadequate sleep and driving safety. Teens and adults should be especially cautious to avoid drowsy driving, as it is a significant cause of fatal car crashes.
In the wise words of Thomas Dekker, “Sleep is the golden chain that binds health and our bodies together.”
Melissa Mason is a general pediatrician with Journey Pediatrics in Albuquerque. Please send your questions to firstname.lastname@example.org.