Download When it comes to bedtime, most children try their best to avoid

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W
hen it comes to bedtime, most
children try their best to avoid
it, preferring to continue playing
their games or watching their television
programmes rather than hitting the hay.
Even if you were to manage to convince
them to get into bed with their teeth brushed
and snuggled under their blankets, children
don’t fall sleep quickly.
However sleep is an essentiality for
children, with the recommended amount of
sleep for those in preschool to be between
11-13 hours of sleep per 24 hour period and
school-aged children to be between 10 -11
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hours of sleep for 24 hours, shares Associate
Professor Daniel Goh, head of department of
Paediatrics at the National University
of Singapore.
Why they need sleep
For young, still-growing bodies, sleep is
needed as with a day full of activities, their
minds and physical bodies require rest in
order to be replenished for the next day,
while their brains also get some time to rest.
Lack of sleep has also been linked to
weight gain as too little sleep alters levels
of hormones that regulate satiety and
solving
their sleep
issues
Proper sleep is important for young
child. Find out what disturbs them at
night to help them have sweet dreams.
BY KAItLYN ANG
learnt during the day comes together in a
coherent manner and the knowledge can
be accessed in the future. Thus sleeping
well improves their memory of what they
learnt during the day, causing them to do
better in school as well as from day to day.
Problems that they face
The most common sleep problems related
to bedtime are night wakings. These
children have difficulty getting to sleep
and wake up repeatedly through the night,
frequently having much difficulty getting
back to sleep after they awaken, says
Professor Goh. Here are some of the other
common disorders that get in the way of a
child’s good night rest.
Obstructive Sleep Apnea Syndrome
hunger, potentially leading to overeating
and obesity. Insufficient sleep has also been
associated with more common occurrences
of behavioural issues such as attention
deficit hyperactivity disorder and impaired
cognitive function.
Sleep is an integral part of health, and
sleep deprivation can result in significant
complications such as poor growth,
cognitive impairment, hypertension,
bedwetting and even increasing the risk of
diabetes, says Professor Goh.
Memory consolidation also occurs when
children are deep in sleep, where what is
Obstructive Sleep Apnea Syndrome (OSAS)
is one of the more serious sleep problems
that occur in childhood, says Professor
Goh, elaborating that it is associated with
abnormality in breathing during sleep.
“This can be complicated by many long
term health issues such as hypertension,
poor growth and even cognitive
impairment,” he adds.
Thus children with OSAS often snore
on most or all nights and may have
increased effort in breathing during sleep.
Many children with OSAS also have poor
growth related to poor sleep quality, with
early detection and treatment the key to
the prevention of long-term complications.
This can occur from two to eight-yearsold, when the adenoid and tonsillar
enlargement are at its peak, shares
Professor Goh.
How to help Address the issue as soon as
it is suspected, as there is a chance surgery
may be required. If there is prolonged nontreatment, this can lead to academic and
behavioural problems, and have a negative
impact on the child’s health and function.
Having sleep disturbed in the long term
can also lead to neuro-cognitive and
behvioural problems, with most children
improving on these areas once the problem
is identified and tackled.
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grow
Sleepwalking
If your child sleep walks, you may find him out
from bed wandering about with a dazed look
on his face. However, ask him about it the next
day and you probably won’t be able to get any
memory of it from him.
Sleepwalking can be caused by lack of sleep,
irregular sleep schedules, illness, medications and
stress. They may look awake with the eyes open
as they move about, but they don’t respond when
spoken to.
How to help Most children grow out of
sleepwalking as they become older. However
they may get hurt when they sleepwalk as
they are not aware of what they are doing. To
prevent them from getting injured, do keep all
dangerous objects out of their way, including
locking the doors and windows in the house. If
you see him sleepwalking, don’t wake him up as
you may scare him but instead try to guide him
back to bed.
Night Terrors
This is a sleep disruption that that is often
confused with nightmares as children will wake
up out of fear. However, with night terrors, they
are often inconsolable, possibly sitting up in the
middle of the night to shout in distress or thrash
around, acting upset or scared. After a few
minutes, they calm down and go back to sleep,
having no recollection of the event the next day.
Night terrors usually occur during the
first two to three hours of sleep, as opposed to
nightmares which happen in the later part of the
sleep cycle, with total recall of the event the next
day. Children who awake from night terrors also
do not respond to efforts made to comfort them,
unlike children who have nightmares and
would want their parents’ reassurance
before returning to sleep.
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Night terrors occur less often than
nightmares and happen more for children who
are fatigued and stressed or are sleeping in a new
environment away from home.
How to help It can be upsetting for you as you
are unable to help or comfort your child when he
looks to be fearful, but the best thing you can do
is to be patient and watch him to make sure that
he does not accidentally hurt himself as they will
usually settle down after a few minutes. Waking
them up usually does not help and they may take
a longer period of time to settle down and go
back to sleep.
Prevent it by ensuring that your child is not
overly stressed and making sure that your little
one gets enough rest everyday. This can be best
accomplished by setting up and adhering to a
fixed bedtime routine every night.
Teeth grinding
A common occurrence in children, the cause
of teeth grinding has yet to be determined
but has been associated with factors such as
emotional or physical stress, sleep positioning,
irregularities in the teeth, or their alignment,
genes and allergies, says Dr Betty Mok,
senior consultant, discipline of Orthodontics
and Paediatric Dentistry at the National
University Hospital.
Though children do outgrow the habit
without any treatment, the problem is usually
managed through reassurance and observation.
However if the habit is severe and persistent,
problems such as the wearing out of teeth,
broken fillings, pain the jaw, headache and sore
facial muscles in the morning. Additionally,
teeth may become sensitive and loosen.
How to help Dr Mok shares that simply
reducing the stress levels, in particular
just before bedtime would help reduce the
occurrence of teeth grinding. Thus you can
choose to do something relaxing as opposed to
stimulating as the last activity before heading to
bed. Remember also to avoid stopping him midactivity to head off to bed.
If you catch him grinding his teeth during
his sleep, do not wake him up as this may
cause additional him stress. Instead, just
reposition him and this usually does the trick.
Keys to getting a good night’s rest
As a good night’s sleep is always good to have, here are tips to make sure that they hit the
hay every night.
Establish a routine
Young children respond best to having a fixed
schedule and this is no different even for sleep at
night. Once you find a timing that fits the schedule of
your family, bearing in mind how much sleep a day
they require, do your best to ensure that your little
one is tucked under the sheets every night.
The routine should start about half an hour before
the actual bedtime and should include calming
activities such as taking a warm bath or reading
books together. Over time, your child will know to
take these as cues to calm down before bedtime.
Involve them physically in the day
If your child is not sleepy when bedtime rolls around,
it could be simply because he may not have exerted
himself enough during the day. It is recommended
that a child gets at least one hour of physical activity
daily, and this also helps keep him healthy and allows
him to expend his energy to be ready for sleep when
the night rolls around.
Avoid patting or rocking them to sleep
Patting or rocking them increases their
dependence on parental intervention, and can
prevent them from learning to self soothe when
they wake up in the middle of the night. Instead
establish that they sleep in their beds and they
will learn to prepare their mind as long as they
are tucked into bed.
Use a white noise machine
If your household is noisy, a white noise
machine may be a good way to mask the
sounds that can keep them awake. Other
alternatives include using a humidifier or a
stereo that is turned to static.
It is advisable to see a doctor if your child has a
severe case of teeth grinding as this can at times
be linked to underlying psychological problems
that might be troubling the child.
How to help As most bedwetting children
Bedwetting
Affecting 15-25% of healthy five-year-olds,
bedwetting is uncontrollable wetting in a child
who has not yet achieved bladder control
during sleep. However as only 1-3% still wet
their beds by the time they reach adolescence,
most children generally outgrow this problem
of bedwetting at night with time, says Dr
Perry Lau, consultant, division of Paediatric
Nephrology, Dialysis and Renal Transplantation
at the National University Hospital.
However if your child still wets the bed at
night when he is six years or older, you may
want to bring him to see the doctor. The child
may still be healthy, but there can be a profound
psychological effect of the child, especially if
he has started schooling, and is found to still
be wetting his bed. On the other hand, if your
child experiences urine leakage when awake
in the daytime or has recurrent urinary tract
infections, do consult a doctor to ensure that it
are deep sleepers, they are not easily
awoken, not even by the sensation of
having a full bladder or having wet the bed.
You can start by reducing the amount
of urine that they produce at night, firstly
through restricting their fluid intake two
hours before bedtime and ensuring that
they empty their bladders completely
before bed.
You should also wake them up two to
three hours after they sleep and get them
to empty their bladders again. Give them
extra motivation by developing a reward
system if they manage to get up during the
night to use the toilet or do not wet the bed
at time. Over time, the best help you can
give your child is by staying positive and
taking steps to work through the problem
together. Remember not to use negative
reinforcement by punishing the child for
bedwetting, but instead, remain patient and
be encouraging towards your child.
is not a rare disorder of the bladder that
your child may be suffering from.
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