Sleep and Children: What's Normal?

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KEY POINTS

• Sleep patterns vary, based on the age of the child. Generally newborns sleep about 16 hours per day, while the average for teens is 9 to 10 hours per day.
• Every child is different, and some need more sleep than others. If your child seems tired during the day, moody, or "overactive," she may not be getting enough sleep.
• Most sleep problems in children and teens are not serious and will go away on their own. If you are concerned about your child's sleep, talk to your child's healthcare provider.

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While children may seem anything but sleepy at bedtime, they may not be getting enough sleep. Sleep patterns vary, based on the age of the child. Children need to get enough sleep to help their mood, memory, and thinking. Sleep also helps the body be healthy, such as helping to recover from an illness.

What are normal sleep patterns?

Infants (up to 1 year of age)

• Newborns sleep about 16 hours per day, divided into 3 or 4 hour naps between feedings. They may not sleep at the same times every day.
• By the first birthday, infants usually sleep 13 to 14 hours per day. However, about 1 in 5 infants still do not sleep through the night by the first birthday. They may sleep only about 6 hours at a time without waking.
• A good portion of infant's sleep is active sleep in which she makes faces and makes small movements.

Toddlers (ages 1 to 2)

• Toddlers sleep 11 to 13 hours per day, including a morning nap and an afternoon nap. Around 18 to 21 months of age, toddlers may give up the morning nap and nap only once a day.
• Toddlers often feel scared to go to sleep or wake up in the dark. Bedtime rituals (regular bedtimes, baths, quiet activity, bedtime reading, a favorite stuffed animal or blanket) may help relax your toddler.

Preschoolers (ages 3 to 5)

• Preschoolers usually sleep 10 to 12 hours per day, including a midday nap and nighttime sleep.
• Even if they stop napping, children this age may be less fussy in the evening if they have a quiet time for rest in the afternoon.
• Even after being toilet trained, many children (especially boys) continue to wet the bed at night. Drinking plenty of fluids throughout the day and then stopping fluids 2 to 3 hours before bedtime may help stop bedwetting.
• Preschoolers have vivid imaginations and may have nightmares once or twice per week. Your child may dream about being abandoned or about scary animals or monsters. This is most likely to happen after active days, going to bed late, or watching a scary movie. Mild comforting and a night light may help them overcome their fears.
• Many children up through the middle elementary school years ask to sleep with their parents. The American Academy of Pediatric recommends that children sleep near you, but not in the same bed with you. If your child sleeps in your bed, she may take longer to fall asleep and wake up more often. It may be best to calmly send your child back to her own bed. She may cry or fuss for several nights before being OK with this.

School-aged children (ages 6 to 12)

• Elementary school age children usually sleep 9 to 11 hours per night. It commonly takes 15 to 30 minutes before they fall asleep.
• Nightmares a few times per month are common and often include scary things from real life or movies. Common fears at night are darkness, strange noises, and intruders.
• Until age 7 or 8, children may continue to wet the bed.

Teens (ages 13 to 17)

• Teens need 9 to 10 hours of sleep per night. Lack of sleep can cause moodiness as well as problems with attention and memory. It also puts them at risk for falling asleep while driving.
• Teenagers get sleepy later than preteens and often have trouble falling asleep. They may take 20 to 30 minutes before falling asleep. They often complain of being tired after school, and like to sleep-in on the weekends. Puberty brings changes to their sleep-wake cycle. Many teens like staying up late and waking up late and then trying to catch up with sleep on the weekends.

What can I do to help my child?

To help your child sleep:

• Make sure that your child gets regular exercise and time outside in the sunlight every day.
• Set a bedtime for your child and stick to it. Changing bedtimes can cause problems such as trouble getting to sleep and waking up in the morning.
• Whether you have a young child or a teen, plan a quiet time of at least half an hour before bedtime. This means no TV, computer, electronic games, or phone for 30 minutes before bed. For preschool and elementary school children, have a predictable pre-bedtime routine such as a bath and reading time. Tuck in your child and talk with her.
• Accept that your child may lie in bed up to 30 minutes before falling asleep. Do not tell your child to "go to sleep" since saying this often increases how long it takes to fall asleep.
• Help your child feel more secure by allowing her to have a night light or a special toy in bed with her
• If your child gets up or calls out after going to bed, stay calm. Getting angry with your child will not help her get back to sleep.
• If your child has a nightmare, calmly reassure her that the dream is not real. Help her understand that everyone has bad dreams sometimes. Talk with your child during the daytime about nightmares she has had. Reassure your child that she is OK and it was just a dream.
• Do not let your child or teen have drinks with caffeine, such as a cola or sports drink, for 5 hours before bedtime.

Every child is different, and some need more sleep than others. If your child seems tired during the day, moody, or "overactive," she may not be getting enough sleep.

Most sleep problems in children and teens are not serious and will go away on their own. Some sleep problems, however, may need treatment by a healthcare provider. If you are concerned about your child's sleep, talk to your child's healthcare provider.