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MWMG Pediatrics

Family Values

April 2009
Elaine Stone

Spring has sprung; the dormant and sleeping are now coming to life. Bears have left their dens, leaves have begun to sprout, and grass is becoming green. Sunshine, daylight, newness, and growth resonate all around. Just as winter hibernation/dormancy is nature’s preparation for spring, it is the hours before dawn that rejuvenate the body and supply energy for the day. Sleep is vital to human existence. In fact, sleep is innate to all living creatures.

Rest fixes, heals, and strengthens all living things for the next day of life. At night, bodies are not simply still. According to the American Sleep Research Institute, “While a person sleeps, the body is rejuvenated. Cells are repaired, the immune system is strengthened and mental functions are sharpened.” (, accessed Feb. 2009) Different amounts of sleep are required for different ages, but according to the Centers of Disease Control and Prevention, an estimated 50 to 70 million Americans suffer from constant sleep loss or sleep disorders. (, accessed Feb. 2009) Sadly enough, children are not excluded from those numbers or the health concerns that follow. So, as life “springs” forth each morning, what should parents know about sleep and their children?

“Sleep is the primary activity of the brain during early development. Circadian rhythms, or the sleep-wake cycle, are regulated by light and dark and these rhythms take time to develop, resulting in the irregular sleep schedules of newborns. The rhythms begin to develop at about six weeks, and by three to six months most infants have a regular sleep-wake cycle. By the age of two, most children have spent more time asleep than awake and overall, a child will spend 40 percent of their childhood asleep. Sleep is especially important for children as it directly impacts mental and physical development.” (, accessed Feb. 2009)

There are two states of sleep which alternate through the night. Both are distinguished by the physical symptoms they exhibit; Non-Rapid Eye Movement (NREM) or “quiet” sleep and Rapid Eye Movement (REM) or “active” sleep. Both states are equally important to physical health and each accomplishes different physical purposes. Non-REM sleep is when the human body reaches its deepest level of sleep. During this stage, blood supply to the muscles in increased, energy is restored, tissue growth and repair occur, and hormones are released for growth and development. During REM sleep, brains are active and dreaming occurs. Bodies become immobile, breathing and heart rates are irregular. Infants spend about 50 percent of their sleep in each stage, with cycles occurring about every 50 minutes. By the time age two is reached, about 30 percent of sleep is comprised of REM sleep and 70 percent NREM sleep with cycles lasting 90 minutes.

“Judith Owens, MD, MPH commenting on the National Sleep Foundation's poll examining children's sleep habits states, one of the most striking findings is that sleep problems appear to be more prevalent in children than previously expected. The poll shows about 70% of parents and caregivers report their child have some type of sleep problem. Additionally, it appears as though children in all age groups are not meeting the expert recommendations of sleep amounts, even toddlers and preschoolers, according to poll results. It looks like the sleep deprivation that we know exists for adults and for adolescents is now trickling down into the younger age group. We know that younger children, in particular, require an extraordinary amount of sleep; newborns sleep for about 16 to 20 hours in a 24-hour day. We conclude from that, that sleep is vitally important to brain development and although we don't know what the exact mechanisms are, we do think that sleep has very important impact on the development of memory. We also know that sleep is very important for attention, creativity and higher level organizational functioning. So there are all sorts of cognitive problems that could result from inadequate sleep in young children.” (, accessed Feb. 2009)

Health Day News reports, “Getting enough sleep is important for adults, but for children, it’s critical. Those who don’t get the recommended hours regularly are at higher risk for accidents and could even be mistakenly thought to have attention-deficit hyperactivity disorder (ADHD), according to government studies. The symptoms of sleep deprivation closely mirror those of ADHD. This is not a small problem, says Dr. Carl Hunt, a sleep research expert with the U.S. government’s National Center on Sleep Disorders. And the problem isn’t always evident. The sleepiest children often don't seem sleepy at all. A major problem with children, if they are sleep-deprived, is that once they get up and get going, they don't act sleepy during the day and early evening. Instead, the sleep deprivation may have the opposite effect, and they may be overactive," he says. "Because they don't act sleepy, parents don't appreciate that the cause of their hyperactivity is sleep deprivation, but there is a clear association between lack of sleep and overactivity." (, accessed Feb. 2009)

As one can imagine by the time children are school age, sleep or the lack of it, will definitely show up in a child’s academic performance. Paying attention, moods, coping skills, and cognitive learning will all hinge on adequate sleep. To make matters worse, after-school and evening activities have become so prevalent and dominant that children are not able to go to bed in sufficient time to receive the proper hours of sleep. Hectic family schedules leave little room for evening routines which support healthy sleep; decreasing activity in the evening, regular bedtime, a relaxing routine (warm bath or reading a story), avoiding large meals close to bedtime, and no caffeine within six hours of sleep. As children become teens the pace heightens and lengthens. Late evening activities are routine and parents expectations for highly functioning/accomplishing children increases. It is normal for high school athletics and academic clubs to compete after 10 pm; after which, teens return home to homework, dinner, and family responsibilities with no time for relaxation or decompressing. A huge deficient can be gauged between proper hours of sleep necessary and actual hours of sleep available. And so the cycle of deprivation continues.

A major study, done by Dr. Jean E. Rhodes, psychologist at the University of Massachusetts, Boston, tracked middle school student as they moved through the middle school years. She found a strong link between sleep patterns and moods. On average, the students' total time spent sleeping fell in the three years, but the pattern was more pronounced among girls. "Elevated levels of depression and drops in self-esteem are seen as inevitable hallmarks of adolescence," Dr. Rhodes says. "Yet these results suggest that such changes are partially linked to a variable -- sleep -- that is largely under individual, parental and even school control. Attempts to improve the health, quality of life and academic careers of adolescents should consider the importance of a good night's sleep. (, accessed Feb. 2009)

Parents need to wake-up and give priority to sleep matters. It may appear a luxury, but it is, by far, a necessity needing tending. Lack of sleep leads to sleep problems which cascade into multiple health, behavioral, and emotional problems. Spend some time reading sleep requirements and healthy sleep habits and then be diligent in putting them into practice. Spring into action, sluggishness may have dire consequences.

Elaine Stone, mother of three, lives in Spotsylvania. Write: This email address is being protected from spambots. You need JavaScript enabled to view it.

How Much Sleep Should My Child Get?

Age - Hours Of Sleep

0 - 2 months - 10.5 - 18

2 - 12 months - 14 - 15

1 - 3 years - 12 - 14

3 - 5 years - 11 - 13

5 - 12 years - 10 - 11

Preteen - College - 9 or more

(, accessed Feb. 2009)

How do I teach my child good sleep habits?

Make bedtime a special time. A time for you to interact with your child in a way that is secure and loving, yet firm. Spend some special time with your child and go through a bedtime routine. Then, lights go off and it is time to fall asleep.

Put some thought into finding your child’s ideal bedtime. Look for the time when your child really is starting to slow down and getting physically tired. That's the time that they should be going to sleep, so get their bedtime routine done and get them into bed before that time. If you wait beyond that time, then your child tends to get a second wind. At that point they will become more difficult to handle, and will have a harder time falling asleep.

Keep to a regular daily routine—the same waking time, meal times, nap time and play times will help your children to feel secure and comfortable, and help with a smooth bedtime. Babies and children like to know what to expect.

Use a simple, regular bedtime routine. It should not last too long and should take place primarily in the room where the child will sleep. It may include a few simple, quiet activities, such as a light snack, bath, cuddling, saying goodnight, and a story or lullaby. The kinds of activities in the routine will depend on the child’s age.

Make sure the sleep routines you use can be used anywhere, so you can help your baby get to sleep wherever you may be.

Some babies are soothed by the sound of a vaporizer or fan running. This "white noise" not only blocks out the distraction of other sounds, it also simulates the sounds babies hear in the womb. Small, portable white noise machines with a variety of different sounds are now available.

Make sure your kids have interesting and varied activities during the day, including physical activity and fresh air.

Use light to your advantage. Keep lights dim in the evening as bedtime approaches. In the morning, get your child into bright light, and, if possible, take them outside. Light helps signal the brain into the right sleep-wake cycle.

(, accessed Feb. 2009)

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Pouches' Community Corner

Pouches Visits the Past


If Pouches' experience at History Camp is any indication, your son or daughter will enjoy joining Washington Heritage Museums and the George Washington Foundation for History Camp in Fredericksburg. The week-long day camp will be held June 25-29, from 9:00 a.m. to noon each day.

Young historians discover American history with hands-on experiences as they walk in the footsteps where the history of Fredericksburg, and a budding America, was created. The camp complements the history taught in classrooms with activities such as soap making, code breaking, colonial crafts, penmanship and much more.