Normal Sleep Patterns 0 - 16 Years

Your child needs plenty of sleep to allow their body and mind to rest and to grow and develop. But for many families bedtime can be frustrating and no fun. However most children have the ability to sleep well and understanding what is normal and when to seek help is important.

Newborn sleep

Full-term Babies will sleep 16 to 20 hours per day. They have a 40-minute sleep cycle and cannot differentiate between day and night. They have 3 different sleep states and spend half their time asleep dreaming - called REM sleep (Rapid Eye Movement Sleep) - during which they will suck, grimace, smile and occasionally twitch their fingers and feet. They wake to feed every 3-5 hours. Premature babies may sleep 20-22 hours per day with only very short periods of wakefulness. During REM sleep all newborn babies have a pattern of "brief pauses in breathing" (called Periodic Breathing) where they take a few breaths, pause, take a few breaths, pause and so on-this often for long periods of sleep and can be quite normal

3 to 6 months

Time spent asleep starts to diminish as babies spend more time awake, moving, rolling and learning. Gradually, a baby's sleep becomes more like that of a child and by about 6 months, all of the five sleep states are defined. They still wake for feeding and comfort every 4 to 6 hours and periodic breathing has ceased by 6 to 8 months of age.

Toddlers and Pre-Schoolers

At 2 years of age, 12 out of 24 hours is spent asleep without waking. A nap during the day averages one and a half hours ranging up to about 2.5 hours. By 3 years of age the daytime nap is reducing and then ceases. Dream (REM) sleep continues to decrease while the other stages of sleep lengthen and become more consolidated

School Age Children

During primary school the average child sleeps 10 to 11 hours at night without waking with a gradual decrease into later childhood. By 12 years of age, slow wave (deep) sleep occurs mainly in the first half of the night while dream sleep (REM) decreases to adult levels of about 15-20% of the total time spent asleep. "Night terrors" - where the child appears to wake, is very frightened and inconsolable - are not uncommon from 4 to 8 years of age.

Adolescents

As puberty approaches sleep needs are increasingly unmet. Pressures of schoolwork, social life and peer contact often cause adolescents to go to bed late and sleep in half the day. This practice should be discouraged as it can eventually lead to altered sleep phase where the individual wakes late and is unable to sleep at night. A sensible balance between late night socialising and sleeping needs to be established. Normal young adult sleep should be in place by 16 years. Dream sleep (REM) occurs after 80 to 90 minutes and sleep continues to cycle over 6-8 hours.

Sleep Hygiene

Parents should encourage good sleep practices from an early age. A consistent bedtime in a warm (he ideal temperature is around 21�C), dark, comfortable room with light blankets and a firm mattress; encourages children to feel safe and secure at night.

Many children will wake after one or two cycles of sleep and wander to their parent's bedroom and climb into bed with them. Children should not be punished or scolded for this, as they may not be fully awake at the time. The best remedy is to carry or walk them back to their own bed and settle them back to sleep with the minimum of fuss.

Symptoms that may indicate Abnormal Sleep

• Snoring.
• Sweating.
• Restlessness.
• Morning headaches.
• Daytime sleepiness.
• Bedwetting after 5 or 6 years of age or after a 6-week period of dryness.

If severe may need attention

• Sleep walking and talking.
• Head rocking/banging.

Treatment for sleep problems

• Like all physical and emotional disorders, sleep disorders need to be properly investigated, diagnosed and treated.
• Discuss the problem with your general practitioner and they can refer you and your child on to a Sleep Physician for assessment.

• Every age group has a different pattern of sleep, if you are concerned speak to your GP and seek a referral to a specialist.