World Sleep Day: Are Indian children sleep deprived? How many hours do they need?

Teenagers, in particular, bear the brunt of modern lifestyles. They experience a biological shift in their circadian rhythms (day/night clock), where the body expects them to fall asleep later and wake later. Their body now releases melatonin – the sleep hormone – two hours later than most adult bodies. So, teenagers who are difficult to wake in the mornings or who sleep in on the weekends aren’t necessarily just “lazy” or lacking in routine. Their body expects them to sleep late and wake up late. Something that is compounded by the use of gadgets and screens in recent times. Early school start times render it impossible for teens to complete their sleep needs, with devastating effects on their physical and mental health, including academic performance.

The sleep loss begins in infancy itself, with very little information available to parents on how much sleep their children actually need, how normal sleep biology works and how to support their children’s sleep.

Recommended sleep hours:

Newborns (0 to 3 months): 17-18 hours
Babies (4 to 12 months): 14-16 hours
Toddlers (1 to 3 years): 12 to 13.5 hours
Preschoolers (4 to 6 years): 12 hours
Young children (7 to 10 years): 10 to 11 hours
Tweens and teens: 9 to 10 hours

HOW SLEEP IMPACTS CHILDREN

It is worthwhile for parents and society at large to focus on the sleep needs of children as, in truth, “sleep is medicine” and is absolutely critical to a child’s development. Here are some impacts:

1. Growth: Growth hormones are primarily secreted during deep sleep and usually in the hours of sleep before midnight. This is one of the reasons an early bedtime is recommended.

2. The heart: Sleep helps regulate blood glucose as well as the amount of cortisol or stress hormones being produced, hence protecting against vascular damage and diabetes.

3. Obesity: Sleep deprivation impacts the production of the hormone, leptin, which signals to our body that we are full. Without this hormone, we continue to eat. Over time, kids who do not get enough sleep can become obese. Also, tired kids crave high-fat foods and tend to be more sedentary.

4. Immunity: Proteins called cytokines are produced during sleep, which help us fight infection, illness and stress. Poor sleep negatively impacts gut health, which in turn leads to lower immunity as well. Studies of teens have found that reported bouts of illness declined with longer nightly sleep.

5. Attention span: Studies have shown that children who consistently sleep fewer than ten hours a night before the age of three are three times more likely to have hyperactivity and impulsivity problems by age six. For school-age kids, research has shown that adding as little as 27 minutes of extra sleep per night makes it easier for them to manage their moods and impulses so that they can focus on schoolwork.

6. Ability to learn: Children make neural connections and store what they have learnt through the day in their brains while they are sleeping at night. Short-term memory is also converted into long-term memory during sleep. Daytime naps (up to the age of five years) play an extremely important role in learning.

UNDERSTAND SLEEP PARENTING

Mindfulness about sleep begins at birth. However, as any young parent will tell us, babies and toddlers are notoriously difficult sleepers. A commonly asked question is, “Don’t children just sleep when they are tired?” The answer is no. The first step to “sleep parenting” is acknowledging that parents have to support the child to sleep. We help our babies to eat, bathe, play, walk, learn, talk and, yet, somehow we assume that parenting ends when the baby is asleep. Sleep parenting involves:

Ø Observing cues: Babies and toddlers show sleep cues in stages. It is important to understand and observe early sleep cues (like rubbing eyes) and not wait for late cues (like crying). The body produces the stress hormone, cortisol, when overtired, which disrupts sleep.

Ø Age-appropriate routines: The right number of naps and wake times according to the baby’s age, an early bedtime and sufficient night sleep are the key. Good day sleep leads to good night sleep as overtiredness disturbs sleep.

Ø Feeding or rocking to sleep: It is biologically normal for babies and young toddlers to sleep while nursing/bottle feeding or while being walked/rocked in arms up till the age of 3.5 to 4 years. These are not “bad sleep habits” or “bad sleep associations.”

Ø Providing the safety of physical contact: Babies have a biological survival instinct that makes them seek the comfort and security from physical contact. Babies often need to be held in arms for their daytime naps and also sleep better when bed-sharing with their parents day or night.

Ø Helping to go back to sleep: All human beings sleep in “cycles” and wake at the end of cycles, including babies and toddlers. Unlike adults, they usually do not have the ability to start the next sleep cycle on their own and need soothing from us to do so.

Ø Creating the right sleep environment: A dark and quiet room for both daytime naps and night sleep are vital to good sleep as babies are very easily stimulated and jerked out of sleep.

A soothing bedtime routine, age-appropriate early bedtimes and a conducive sleep environment stand older children and teens in good stead as well. As far as possible, young children should not need to be “woken up” in the mornings. Alarm clocks are so ubiquitous in our culture and the belief that children have to be woken up is so commonplace that this idea usually sweeps parents clean off their feet in surprise. In truth, if children have an age-appropriate routine, they do not need to be woken up. Children do not “over sleep”, in fact, and waking up a child is a sure shot sign that the child is not actually being able to complete his or her sleep needs and is probably sleep-deprived.

There is a lot of research ongoing that shows the myriad ways in which sleep affects human beings. After all, young ones spend 12-18 hours sleeping. Adults also spend one third of their day sleeping. If sleep did not have a major biological purpose, this would be a big goof-up on the part of evolution!

(Dalmia is a co-author of Sleeping Like a Baby, published by Penguin)