Children and Sleep
Adequate sleep is essential for healthy growth and development in children. The amount of sleep a child needs will change as they grow older, peaking when they are newborns and gradually decreasing through childhood and adolescence. Parents can foster good sleep habits by helping their children adopt a consistent bedtime routine.
Unfortunately, sleep problems are common for children of all ages. Surveys show up to 50% of preschoolers and 40% of adolescents experience some sort of sleep-related issue. Children are also susceptible to sleep disorders such as sleep apnea and restless legs syndrome. Sleep disorders usually require medical intervention, so you should make an appointment with your doctor if you are concerned about your child’s sleep.
Why Sleep Is Important for Children
Healthy sleep and a consistent bedtime routine contribute to a child’s overall happiness. Sleep has also been linked to numerous aspects of growth and development, including:
- Attention and concentration
- Cognitive development and academic performance
- Language skills and vocabulary growth
- Memory consolidation
- Mood and behavioral development
- Motor skills and learning
Not getting the right amount of sleep can also have an adverse effect on your child’s health and increase their risk of certain medical conditions. Inadequate sleep for children can lead to behavioral issues, attention problems, and learning difficulties. Researchers have also established a link between insufficient sleep and a greater risk of high blood pressure, obesity, diabetes, and mental health problems like depression. The same trends have been observed in children who sleep too much.
How Much Sleep Do Children Need?
Understanding how much sleep your child needs at different stages of their life can help ensure they grow and develop properly. Sleep guidelines for children have evolved over the years. The following recommendations are based on the latest research pertaining to children and sleep.
Recommended Amount of Daily Sleep
0 to 3 months
14 to 17 hours
4 to 11 months
12 to 15 hours
1 to 2 years
11 to 14 months
3 to 5 years
10 to 13 hours
6 to 13 years
9 to 11 hours
14 to 17 years
8 to 10 hours
Newborns and Sleep
Most newborns up to 3 months old sleep between 10 and 18 hours per day. They follow a 24-hour cycle of waking to feed for one to three hours, then sleeping the rest of the time. Babies begin to follow light-based circadian rhythms while still in the womb, but circadian cycles are not fully established until about four or five months after they are born. Parents can help their newborn establish a circadian pattern by exposing them to natural sunlight during the day and keeping the lights dim in the evening.
Newborns may express they need sleep by becoming fussy, crying, or rubbing their eyes. Parents should put their baby to bed when they are tired, rather than when they are already asleep. This helps them learn to fall asleep on their own. If your newborn wakes up hungry in the middle of the night, keep the lights dim or off when feeding them.
Infants and Sleep
Once their circadian rhythms are fully established, infants between 4 and 6 months old may sleep up to eight hours at a time – but since they need 12 to 15 hours of sleep every 24-hour period, they will sleep during the day and at night. Most infants take one to four naps per day, each one lasting anywhere from half an hour to two hours.
By the time they reach 9 months of age, infants may sleep up to 12 hours at a time and won’t need to feed during the night. Rocking them, walking around the house, or cuddling can help them relax and prepare for sleep.
Separation anxiety is common for infants at bedtime. They may cry or become upset when you turn off their lights and close their door. You can assuage their anxiety by speaking to them in a calm, quiet voice or gently rubbing their head, but you should avoid removing them from their bed. Over time, your infant will learn you are in the next room and they will be able to fall asleep more easily.
Toddlers and Sleep
Toddlers need 11 to 14 hours of sleep for every 24-hour period. They will receive most of their sleep at night and only require one or two naps during the day. This is a good time to begin establishing a nightly bedtime routine that incorporates the following:
- Nutrition: Healthy snacks before bedtime should take priority over heavy meals.
- Hygiene: Bathing, brushing teeth, and other hygienic practices are helpful for establishing a nightly routine.
- Communication: Reading to your child or singing them a lullaby can have a soothing, sleep-inducing effect.
- Physical contact: Try rocking your child, cuddling with them, or gently massaging them if they have trouble getting ready for bed.
You should also set some ground rules for your child to follow at bedtime. Establish how long the bedtime routine should take, and tell the child when they need to turn off their lights. Make it clear they are not to leave the bedroom after lights-out – but if they break this rule, keep calm and return them to the bedroom.
Preschoolers and Sleep
Preschoolers between the ages of 3 and 5 need 10 to 13 hours of daily sleep. They primarily sleep at night, but some continue to nap during the day – often while they are at preschool. Studies have shown napping can strengthen learning and memory skills for preschoolers. Preschooler naps gradually become shorter up to age 4, and most children stop napping during the day by the time they reach 5 years of age.
Preschoolers often experience parasomnias, a category of sleep disorders defined as unusual behaviors that disrupt sleep. Nightmares are particularly common for this age group, affecting as many as 50% of children between 3 and 5 years. Other common parasomnias for preschoolers include somnambulism, or sleepwalking, and night terrors. Additionally, bed-wetting is most common for 5-year-olds.
Bed-wetting and parasomnias usually resolve on their own without medical intervention, but you should talk to your doctor if you are concerned about your child’s sleep patterns.
School-Age Children and Sleep
School-age children between 6 and 13 years need roughly 9 to 11 hours of daily sleep. Most – if not all – of this sleep occurs at night. School start times help synchronize their sleep schedule, entraining them to wake up early in the morning and go to bed in the late evening. Parents should monitor their child’s sleep habits, as external factors like homework and social commitments can interfere with them getting enough sleep.
Sleep hygiene is a catchall term for habits and behaviors that influence sleep. Proper sleep hygiene becomes increasingly important as a child’s sleep patterns evolve toward those of teens and adults. Guidelines for healthy sleep hygiene include:
- Going to bed and waking up at the same times every day, including on the weekends and during school breaks
- Abstaining from caffeinated foods and beverages in the afternoon and evening
- Avoiding naps after 3 p.m.
- Reading, listening to music, or engaging in other relaxing activities before bedtime
Another way for children to ensure they sleep well is to limit their exposure to smartphones, tablets, televisions, and computers in the evening. These devices feature screens that emit blue light, which is believed to suppress the production of melatonin, a hormone that promotes feelings of sleepiness and relaxation. Melatonin levels increase when darkness falls in the evening as part of a healthy circadian cycle. Some screen time may be necessary for homework, but each hour of blue light exposure can negatively impact sleep.
Teenagers and Sleep
Teenagers between the ages of 14 to 17 should get 8 to 10 hours of sleep – though meeting this benchmark can be difficult. School schedules, homework demands, extracurricular activities, and increased exposure to blue-light-emitting devices can all contribute to unhealthy sleep patterns for teens. Recent polls show roughly two-thirds of teens sleep less than 7 hours per day.
Working can compound sleep problems for teens. Studies have linked teens with jobs to earlier wake-up times, shorter sleep durations at night, and increased feelings of sleepiness during the day. Not getting enough sleep can negatively affect cognitive and academic performance for teens. Sleep-deprived teens are also at greater risk for depression and anxiety, as well as suicidal thoughts.
One way teens can improve their sleep is to abstain from nicotine and alcohol. Cigarettes and other products with nicotine can make it more difficult to fall asleep, lead to sleep fragmentation, and cause teens to feel sleepy during the day. These trends have been observed both after consumption and during the withdrawal period after people quit using nicotine products. Alcohol helps many people fall asleep, but it interferes with the natural sleep cycle during the second half of the night and can cause teens to feel tired the next day.
Common Childhood Sleep Problems
Children and teens, like adults, are susceptible to a wide range of sleep problems and disorders. That said, some sleep-related issues are significantly more common for people younger than 18. These include:
- Obstructive sleep apnea: Up to 5% of children have obstructive sleep apnea (OSA), a disorder that occurs due to a physical blockage that restricts airflow through the breathing passages. Many children experience OSA due to enlarged tonsils or adenoids. Obesity can also increase a child’s risk of developing OSA.
- Behavioral insomnia of children: Insomnia is a sleep disorder defined by difficulty falling or staying asleep. Many children have trouble falling or remaining asleep when their bedtime routine is disrupted, such as after moving or the birth of a sibling. Others refuse to follow bedtime routines. Up to 30% of children exhibit one or both of these behavioral insomnia of children symptoms. Parents can help mitigate this problem by setting firm bedtime boundaries, promoting healthy sleep hygiene in the evenings, and ignoring the child when they throw tantrums after going to bed.
- Restless legs syndrome: Restless legs syndrome (RLS) is defined by painful or uncomfortable sensations in the legs when the body is at rest. People with RLS experience the unsuppressable urge to constantly move their legs while lying in bed. Roughly 2% of children show symptoms of RLS. The condition is particularly common in girls, children with attention-deficit/hyperactivity disorder, and those with low iron levels. Medical treatment may be needed.
- Delayed sleep phase syndrome: People with this sleep disorder struggle to fall asleep and wake up at “socially acceptable” times. Delayed sleep phase syndrome can be particularly problematic for children and teens during their school years. As many as 16% of adolescents have this disorder. Committing to a consistent sleep-wake schedule and avoiding bright light exposure in the evening can help rectify delayed sleep phase issues.
Childhood sleep problems are common and many children won’t need medical intervention. However, parents should closely monitor their child’s sleep habits and patterns beginning at infancy to ensure they are getting enough rest each day. Talk to your doctor if you suspect your child has a sleep disorder, or if you are concerned about them not getting enough sleep.
- Bhargava, S. (2011). Diagnosis and management of common sleep problems in children. Pediatrics in Review, 32(3), 91–98. https://pubmed.ncbi.nlm.nih.gov/21364012/
- Mindell, J. A., & Williamson, A. A. (2018). Benefits of a bedtime routine in young children: Sleep, development, and beyond. Sleep Medicine Reviews, 40, 93–108. https://pubmed.ncbi.nlm.nih.gov/29195725/
- Carter, K. A., Hathaway, N. E., & Lettieri, C. F. (2014). Common sleep disorders in children. American Family Physician, 89(5), 368–377. https://pubmed.ncbi.nlm.nih.gov/24695508/
- Waldon, J., Vriend, J., Davidson, F., & Corkum, P. (2018). Sleep and attention in children with ADHD and typically developing peers. Journal of Attention Disorders, 22(10), 933–941. https://pubmed.ncbi.nlm.nih.gov/25762537/
- Paavonen, E. J., Räikkönen, K., Pesonen, A. K., Lahti, J., Komsi, N., Heinonen, K., Järvenpää, A.L., Strandberg, T., Kajantie, E., Porkka-Heiskanen, T. (2010). Sleep quality and cognitive performance in 8-year-old children. Sleep Medicine, 11(4), 386–392. https://pubmed.ncbi.nlm.nih.gov/20202902/
- Dewald, J. F., Meijer, A. M., Oort, F. J., Kerkhof, G.A. & Bögels, S.M. (2010). The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review. Sleep Medicine Reviews, 14(3), 179–189. https://pubmed.ncbi.nlm.nih.gov/20093054/
- Horvath, K., & Plunkett, K. (2016). Frequent daytime naps predict vocabulary growth in early childhood. Journal of Child Psychology and Psychiatry, 57(9), 1008–1017. https://pubmed.ncbi.nlm.nih.gov/27322102/
- Kurdziel, L., Duclos, K., & Spencer, R. M. C. (2013). Sleep spindles in midday naps enhance learning in preschool children. Proceedings of the National Academy of Sciences of the United States of America, 110(43), 17267–17272. https://pubmed.ncbi.nlm.nih.gov/24062429/
- Maasalo, K., Fontell, T., Wessman, J., & Aronen, E. T. (2016). Sleep and behavioural problems associate with low mood in Finnish children aged 4–12 years: an epidemiological study. Child and Adolescent Psychiatry and Mental Health, 10, 37. https://pubmed.ncbi.nlm.nih.gov/27713765/
- Desrochers, P. C., Kurdziel, L. B. F., & Spencer, R. M. C. (2016). Delayed benefit of naps on motor learning in preschool children. Experimental Brain Research, 234(3), 763–772. https://pubmed.ncbi.nlm.nih.gov/26645305/
- American Academy of Sleep Medicine. (2014). The International Classification of Sleep Disorders – Third Edition (ICSD-3). Darien, IL. https://aasm.org/
- Hirshkowitz, M., Whiton, K., Albert, S.M., Alessi, C., Bruni, O., DonCarlos, L., Hazen, N., Herman, J., Katz, E.S., Kheirandish-Gozal, L., Neubauer, D.N., O’Donnell, A.E., Ohayon, M., Peever, J., Rawding, R., Sachdeva, R.C., Setters, B., Vitiello, M.V., Ware, J.C., Adams Hillard, P.J. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. (2015). Sleep Health, 1(1), 40–43. https://pubmed.ncbi.nlm.nih.gov/29073412/
- MedlinePlus: National Library of Medicine (US). (2022, April 1). Bedtime habits for infants and children. Retrieved April 19, 2022, from https://medlineplus.gov/ency/article/002392.htm
- Rivkees, S. A. (2003). Developing circadian rhythmicity in infants. Pediatrics, 112(2), 373–381. https://pubmed.ncbi.nlm.nih.gov/12897290/
- Wein, H. (2013, September 30). Naps Can Help Preschool Children Learn. National Institutes of Health. Retrieved April 19, 2022, from https://www.nih.gov/news-events/nih-research-matters/naps-can-help-preschool-children-learn
- Iglowstein, I., Jenni, O. K., Molinari, L., & Largo, R. H. (2003). Sleep duration from infancy to adolescence: reference values and generational trends. Pediatrics, 111(2), 302–307. https://pubmed.ncbi.nlm.nih.gov/12563055/
- Schwab, R. J. (2020, June). Parasomnias. Merck Manual: Consumer Version. Retrieved April 19, 2022, from https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/sleep-disorders/parasomnias
- Butler, R. J., & Heron, J. (2008). The prevalence of infrequent bedwetting and nocturnal enuresis in childhood. A large British cohort. Scandinavian Journal of Urology, 42(3), 257–264. https://pubmed.ncbi.nlm.nih.gov/18432533/
- Chaput, J. P., Dutil, C., & Sampasa-Kanyinga, H. (2018). Sleeping hours: what is the ideal number and how does age impact this? Nature and Science of Sleep, 10, 421–430. https://pubmed.ncbi.nlm.nih.gov/30568521/
- MedlinePlus: National Library of Medicine (US). (2017, April 26). Healthy sleep Retrieved April 19, 2022, from https://medlineplus.gov/healthysleep.html
- Lee, S. I., Matsumori, K., Nishimura, K., Nishimura, Y., Ikeda, Y., Eto, T., Higuchi, S. (2018). Melatonin suppression and sleepiness in children exposed to blue-enriched white LED lighting at night. Physiological Reports, 6(24). https://pubmed.ncbi.nlm.nih.gov/30556352/
- Tarokh, L., Saletin, J. M., & Carskadon, M. A. (2016). Sleep in adolescence: Physiology, cognition and mental health. Neuroscience & Biobehavioral Reviews, 70, 182–188. https://pubmed.ncbi.nlm.nih.gov/27531236/
- Teixeira, L. R., Fischer, F. M., & Lowden, A. (2006). Sleep deprivation of working adolescents–a hidden work hazard. Scandinavian Journal of Work, Environment & Health, 32(4), 328–330. https://pubmed.ncbi.nlm.nih.gov/16932831/
- Curcio, G., Ferrara, M., & Gennaro, L. D. (2006). Sleep loss, learning capacity and academic performance. Sleep Medicine Reviews, 10(5), 323–327. https://pubmed.ncbi.nlm.nih.gov/16564189/
- Jaehne, A., Loessl, B., & Bárkai, Z. (2009). Effects of nicotine on sleep during consumption, withdrawal and replacement therapy. Sleep Medicine Reviews, 13(5), 363–377. https://pubmed.ncbi.nlm.nih.gov/19345124/
- Thakkar, M. M., Sharma, R., & Sahota, P. (2015). Alcohol disrupts sleep homeostasis. Alcohol, 49(4), 299–310. https://pubmed.ncbi.nlm.nih.gov/25499829/