How to help children get enough sleep, especially during the COVID-19 pandemic
Published Wednesday, March 3, 2021 8:11AM EST
Getting enough sleep was tough even before the pandemic. With disrupted routines, extra screen time and the incredible amount of stress most people face now, sleep routines seem to have gone quickly but quietly downhill. And from what I'm seeing in my child psychiatry practice — kids are suffering especially hard.
Consider the work our brains do all day — thinking, feeling, decision-making and worrying about our family, friends and even our own safety. Sleep is the one time our brains get to rest.
To get enough of that rest, the American Academy of Sleep Medicine recommends 10 to 13 hours of nightly sleep for kids ages 3 to 5 years old; 9 to 12 hours for kids ages 6 to 12; and 8 to 10 hours for teens. According to the U.S. Centers for Disease Control and Prevention, however, only 4 in 10 middle schoolers and 3 in 10 high schoolers are getting enough sleep.
The lack of adequate sleep does not come without a steep cost. Insufficient sleep can cause problems in the short and long term, including not just impaired cognition, irritability and lack of patience but also diabetes and heart disease, studies have shown.
Much of our emotional health is tied to sleep as well, and lack of sleep can create a downward spiral: Issues with mood or anxiety can worsen sleep, and lack of sleep worsens mood or anxiety. Our best bet is to break the cycle as soon as we can.
I know that's easier said than done, especially with homework, hormones and college pressures looming over kids and teens — not to mention their social lives, or lack thereof right now. Implementing good sleep hygiene practices as a family is key — for both parents and kids.
START WITH A CONSISTENT BEDTIME ROUTINE
Remote learning, work from home, lack of child care and financial difficulties are some of the reasons our routines look different these days. A good bedtime routine is one of the most critical parts of sleep hygiene.
The more consistent the bedtime routine, the more your children's body clocks stay on course, and the more their brains start to associate the routine with getting sleepy. Having a consistent internal clock helps regulate mood as well, which in turn further improves sleep.
This means trying to keep weekend sleep and wake routines as close to the weekdays as possible. This is hard, especially for teens whose body clocks are naturally shifted later in a way that doesn't always line up with the school day. But the more consistent the routine on the weekends, the easier it will be to fall asleep and wake up on weekdays, when it's typically the toughest.
STARTING WINDING DOWN AT LEAST AN HOUR BEFORE BEDTIME
Do relaxing, wind-down activities at least an hour before bedtime that stay away from screens. Try reading together, doing a puzzle or even telling stories for younger kids. Older kids can try journaling or creating a bedtime ritual like writing down things they're grateful for from the day. These activities typically stop our minds from racing in different directions from the day.
KEEP SCREENS OUT OF THE BEDTIME ROUTINE — AND THE BEDROOM
The blue light that screens emit can tell your brain that it's time to be awake — the exact opposite of what we want before bed. Not only should kids stop using their phones or screens an hour or so before bedtime, it's best to keep them out of the room in order to reduce temptation to use them, but also to reduce the emitted light that keeps the room from being fully dark. That means laptops, tablets, gaming systems and yes, cellphones.
In my experience, although putting phones away can be a disappointment at first, many older kids find they feel liberated, more mindful and get much better sleep when their phones are left in buckets on the dining table and they don't pick them up until after breakfast.
CREATE AN ENVIRONMENT THAT'S CONDUCIVE TO SLEEP
In addition to eliminating devices, setting up the room just right can play a big role in the quality of the sleep you get. You want it to be cozy, inviting and safe. Try keeping your child's favourite stuffed animals, toys or a symbol of something soothing nearest to their bedside. The room should be as dark as possible (blackout curtains work) and the temperature on the cooler side.
TRY NOT TO EAT OR DRINK AN HOUR BEFORE BED
Your body does a lot of work to digest food, pull out all of its nutrients and turn those nutrients into energy. You want to keep that process from happening too late at night because not only can certain foods, like sugars, give you a burst of energy right before bed — if you haven't waited long enough to go to sleep, it could be a recipe for reflux and stomach discomfort.
For the older members of the household, avoid caffeine as much as you can, and not just before bed. Caffeine any time of day, even late morning, can affect your sleep. If you want better quality, deeper sleep, cut the tea, coffee or caffeinated sodas from the day.
TRY MEDITATION FOR SLEEP WHILE IN BED
If your child is awake in bed, have them try meditating. It can reduce stress and boost chemicals that make you feel relaxed and sleepy. One that's easy to do is a body scan.
With your eyes closed and your body still, start with the very tip of your forehead and, moving downward, relax each and every muscle in your face. Continue moving downward through your body to draw your focus on different body parts, relaxing your muscles as you "scan" that area in your mind. Many kids I've worked with tell me they barely make it to their arms before falling asleep.
KEEP THE BED ONLY FOR SLEEP
It's also helpful for kids to stay out of bed for nonsleep activities, including homework or even listening to music while texting their friends. You want your brain to associate the bed with sleep, and that physical separation can help.
If meditation, counting or other activities don't work and your child can't fall asleep after 20 to 30 minutes, they should get out of bed and try a relaxing activity until they are feeling sleepy enough to try sleeping again. This helps your brain continue to connect the bed with being sleepy, not awake.
MODEL GOOD SLEEP HYGIENE FOR YOUR KIDS
As with most things parenting-related, practicing what you preach not only reinforces the message, it shows your kids what to do. By implementing the same techniques that you expect of them, it becomes a family activity. Choose some nightly rituals as a family, like screen-free reading time after dinner, or playing a guided meditation and following it together.
STAY ON THE LOOKOUT FOR SIGNS THAT YOUR CHILD IS STRUGGLING
If your child is newly not sleeping and is having a hard time in other areas as well, like a low appetite, trouble with motivation or withdrawn or irritable mood — it might be time to see your pediatrician, therapist or psychiatrist to see if something else is going on, like depression or anxiety.
The brain is one of our most precious assets, and as with any precious asset, there are ways to take care of it and nurture it so that it can do its job best. And, it all starts — and ends — with sleep.
Editor's note: Dr. Neha Chaudhary is a double board-certified child, adolescent and adult psychiatrist at Massachusetts General Hospital and Harvard Medical School and cofounder of Brainstorm, Stanford's Lab for Mental Health Innovation.