Children have more difficulty initiating sleep than maintaining sleep

Oct 2 2007

Further, parents tend to underestimate their children's sleep problems. This highlights the importance of having treatment options available to help a child overcome a sleep disorder, according to a study published in the October 1 issue of the journal SLEEP.

The study, authored by Leonie Fricke-Oerkermann, PhD, of the University of Cologne in Germany, centered on 832 children and their parents, who were surveyed using questionnaires three times on an annual basis. The average age of the children was 9.4, 10.7 and 11.7 years at the three assessments.

According to the results, in child and parental reports, about 30 to 40 percent of the children had problems falling asleep at the first assessment. One year later, the child and parental reports indicated that about 60 percent of those children continued to have difficulties initiating sleep.

One of the striking results of the study, notes Dr. Fricke-Oerkermann, is the difference between the children and their parents in the assessment of the children's sleep problems. Children described significantly more difficulties initiating and maintaining sleep than what their parents reported on their behalf. For example, in the parental reports, four to six percent of the children “often” had difficulties initiating sleep, whereas up to five to 10 percent of the children reported difficulties initiating sleep. About 40 percent of the children reported difficulties initiating sleep which occur “sometimes”, compared to 25 to 30 percent of what the parents reported for their children. Sleep onset problems in all surveys were present in 13.5 percent of the children according to their parents and 24 percent of the children according to the children's ratings.

These findings are supported by other studies, and imply that in epidemiological studies and in practical work, the inclusion of children's and adolescent's self-reports is necessary. It might be that parents are not informed about the sleep problems by their child, Dr. Fricke-Oerkermann speculates. On the other hand, it might be that children in this age range have difficulties estimating the severity of their sleep problems.

Difficulties maintaining sleep are less common, with three percent (parent-reported) versus six percent (child-reported). These results indicate that children of this age group have a higher risk of developing difficulties initiating sleep than difficulties maintaining sleep after one year, adds Dr. Fricke-Oerkermann.

“Sleep problems in childhood and adolescence are a frequent phenomenon,” says Dr. Fricke-Oerkermann. “Sleep problems decrease only marginally with age. Sleep problems might become chronic, requiring medical treatment.”

It is recommended that children in pre-school sleep between 11-13 hours a night, school-aged children between 10-11 hours of sleep a night, and adolescents about nine hours a night.

The American Academy of Sleep Medicine (AASM) offers some tips to help your child sleep better:

• Follow a consistent bedtime routine. Set aside 10 to 30 minutes to get your child ready to go to sleep each night.
• Establish a relaxing setting at bedtime.
• Interact with your child at bedtime. Don't let the TV, computer or video games take your place.
• Keep your children from TV programs, movies, and video games that are not right for their age.
• Do not let your child fall asleep while being held, rocked, fed a bottle, or while nursing.
• At bedtime, do not allow your child to have foods or drinks that contain caffeine. This includes chocolate and sodas. Try not to give him or her any medicine that has a stimulant at bedtime. This includes cough medicines and decongestants.

Children are encouraged to inform their parents of any sleep problems they may have. Parents who suspect that their child might be suffering from a sleep disorder are encouraged to consult with their child's pediatrician or a sleep specialist.