Amanda Wilde (Host): This is Children's Health Checkup, where we answer parents' most common questions about raising healthy and happy kids.

I'm Amanda Wilde. And joining me is primary care provider, Dr. Nicole Brown, as we talk about how to reset your child's schedule for school, including everything from shifting sleep and cutting back screen time to reestablishing daily routines so kids can head into the school year rested, ready, and resilient. Dr. Brown, thank you so much for being here.

Nicole Brown, MD: Thank you for having me.

Host: When a child's schedule has drifted, as it inevitably does over the summer, where do we even start in how we help children reset to a school sleep schedule?

Nicole Brown, MD: I typically talk to my parents about the why before we start talking about the how. It's important that we first talk about why it matters that our kids get sleep and good quality sleep. So, this is basically where I get the buy-in from my parents and patients.

So, I have a little slogan that I've recently used saying, "Sleep is our superpower. It's our secret weapon." So, good quality sleep is connected to, like, a healthy mind and body. So basically, good quality sleep means you're getting sleep that is long enough and restful enough.

So on other hand, when we have children who aren't getting enough sleep, it really starts to show in a lot of ways. So, you might notice that they're having a harder time focusing at school, remembering, you know, what they've learned or managing their emotions. And over time, not getting enough sleep can also increase the risk of, like, anxiety and depression. It can also affect their physical health as well.

So, you know, some things, like, we don't think about that poor sleep can be connected to, like, a weakened immune system, and therefore making them more sick than they need to be. And also, poor sleep quality can be related to obesity, heart disease, and other long-term health problems. So, ensuring our children are getting good sleep is probably the most important things we can do to support our children's overall health and well-being, and that's why I say sleep is our superpower.

During the summer months, we know that parents and the schedules are just all over the place, and that's okay, in all fairness. So, you know, I would say, parents, give yourself grace. Most of my parents and patients admit that their teens sleep about five to six hours a night during the summertime, but this typically shifts around eight hours during a school year.

So when we talk about how to start re-establishing a sleep schedule, I would say start at least one to two weeks or two to three weeks prior to the first day of school. I've noticed that over the past maybe four or five years, the summer schedules are getting shorter and shorter. And so, a lot of our kids are going to be starting school in early August. So around mid, late July is when they should start actually transitioning over to a more ideal schedule for school. So, parents can adjust bedtimes and wake-up times gradually, maybe about fifteen to twenty minutes per day or every two days. But be reminded that every child is different. So, just remember, just be flexible with keeping the end goal in mind.

Host: Can you elaborate on how much sleep children need during the school year? You just mentioned teenagers. What about younger kids as well?



Nicole Brown, MD: When you talk about time schedules, the American Academy of Pediatrics recommend that most preschoolers, this is the age three to five, they need about 10 to 13 hours of sleep per 24-hour period. So, that's including daytime naps and nighttime sleep. Elementary school, ages six to 11, they need about nine to 12 hours of sleep. And then, when you talk about middle schoolers, ages 11 to 13, they typically need about 9 to 12 hours of sleep. And then around 13, something shifts where they only need about 8 to 10 hours. And then, when you talk about high schoolers, this is your 14 to 17 or 18 years old, they go through like a second wave of brain maturation and physical growth spurts, and therefore they need at least eight to 10 hours of sleep. So, most adults need about seven to nine hours, but high schoolers, they still need a significant amount of sleep.

Host: Now, when we talk about readjusting to a school sleep schedule, are we talking about kids getting to bed earlier and waking up earlier? Do we adjust on both ends? How do we gently acclimate kids to a new sleep schedule?

Nicole Brown, MD: One, I always say show yourself some grace. It's not going to be the same for every child. But recommending them to start going to bed earlier and also waking up earlier. So, you can create a scenario that if my kid has to be at school at 8:30 in the morning, what does that look like to make sure they're getting restful sleep the night before? And what is the game plan in the morning time? Practice setting alarm clocks so they can be responsible and know that, "Okay, it's 6:00 in the morning. If I need 15 more minutes, we can get another snooze for like 15 minutes, but after that, we need to start getting up and getting ready for school."

Host: That's good kids take the responsibility for setting the alarm and using the alarm. How can parents help kids adjust to earlier bedtimes? Can they create sort of a wind-down routine that makes it easier for kids to fall asleep earlier?

Nicole Brown, MD: So, I would say for most kids just trying to build what does that look like for your bedtime routine, whether it's a bedtime, bath time at a certain time of night, whether it's reading a book, whether it's saying a prayer, whether it's getting their clothes together for the next day, their lunch ready for the next day. Those are the things I would say will be important to helping them create a good schedule.

Host: And just make that the routine.

Nicole Brown, MD: And make that the routine. And, you know, schedules are fluid, right? Anything can happen that can kind of shift things for your normal schedule. So, adjust appropriately. But we should be mindful that consistency is key. Children thrive on consistency. That's for them to be able to predict what's going to happen for them the following day.

Host: Besides lack of consistency, are there common mistakes you see that we should be aware of when trying to get kids back on a school schedule for sleep?

Nicole Brown, MD: Yes. So, parents, I think we don't talk about this enough. We need to model good sleeping habits. You know, I come from an age where my parents would say, "Do as I say and not as I do." So as a result, our children may inadvertently mimic our behavior. Adults, we still need about seven to nine hours of sleep. So, taking good care of ourselves and the people we love, we need to be well-rested, focused, and able to show up to be our best selves. So, that's one, parents not taking ownership of their role in creating good sleep habits.

The second is starting too late adjusting their children to a school schedule. Some parents may say, "I don't think my kid needs two weeks or three weeks to adjust," and may start the same week. I think you're setting yourself up and your child for failure. Not communicating or organizing family schedules. Sometimes my family struggles with this. But my husband, who's the tech genius in our home, he remains diligent in keeping our activities, our meetings, our doctor's appointments on our shared family calendar.

Another mistake that I see is some parents may ignore the apprehensions that are communicated by their child about starting school, transitioning to another grade. But it's our job, as I remind my parents, we need to listen, have a listening ear for our children, and also offer some strategies on how to deal with their anxiety and offer encouragement.

Host: Yeah, that's so important. Tools and strategies that we can hand to our kids, being consistent in routines, and I like how you point out we have to be consistent in our own sleep habits as well. Screen time often creeps up in the summer. How can families realistically cut back on screen time before school starts? What's the best way to approach that one?

Nicole Brown, MD: That is the question of the hour, right? It's such a hard subject to kind of tackle, especially when your child has been on summertime.

So, I would say, one, if they have been spending that much time on their device, then they need to cut it back an hour a day. So if the desired time for that non-academic related screen time, it should be no more than about two to three hours, right? So if they're spending eight hours a day right now during the summer, we need to gradually cut that down, shave those hours off, starting now really. Because if you start late and then if you start abruptly, you're going to kind of butt heads, and there's going to be a battle there. So in an ideal scenario, I would encourage keeping the same screen time during the summer months as the school year.

Make sure that when school starts, they're not allowed to be on tech for at least two to three hours prior to bedtime, and no tech of any kind in the rooms. And I found a lot of my patients, especially my teens and preteens, sleep with their phones in their rooms. And as a result, they have sleep disturbances. So, have them turn their phones off, have them to turn their devices in and keep them in a central location. Some of my parents are tech-savvy. They turn the Wi-Fi off on their child's device at a certain time. You know, I think that's very important for the well-being of our children going into this next school year as well

You know, when we reduce the hour of time that they're on the screens, what do we do? We let them be bored, because creativity happens in boredom. They can read more, they can journal, they can go outside and do what? Play. But there are some moments where you may have to be on an aggressive digital detox if you have a kid who can't function without gaming and social media. And this can be evidenced by the fact that they're not eating, sleeping, they're neglecting their hygiene, they're doing poorly in school, they're living in isolation, they're depressed, and they're angry.

So, those are the things that I hope that answers the question. But a gradual wean and then reminding yourself that it's a work in progress if a kid has been on device for a significant period of time throughout the summer months.

Host: So, you can really see signs of too much screen time, but what signs might tell a parent their child is having trouble adjusting to a new schedule more than expected?

Nicole Brown, MD: Well, if they are not waking up rested, like if you know that they are in the bed, in the bedroom, off their devices, if they're not waking up fully rested, if they're having a hard time adjusting to the new schedule, those are signs that may need to have them, you know, evaluated by their pediatrician.

If they are dealing with depression, sometimes insomnia can be an issue with kids dealing with depression. And I discovered that during the COVID season, that kids who normally were academically sound children who slept well, all of a sudden, "I can't sleep," or, "I'm sleeping too long." Those are the things that can be a subtle sign of depression.

Another sign that they're waking up not rested, they could be dealing with some evidence of obstructive sleep apnea. So, that's something that causes poor quality of sleep as well.

If there's been some changes in their home environment, a recent move, a death of a loved one or a pet or a friend, that can actually be a reason why children are having problems sleeping. So, there's a myriad of things, but those are the ones I see most commonly

Host: So when do these issues cross the line into something a parent should call their pediatrician about?

Nicole Brown, MD: If it is affecting their overall wellbeing. If you're noticing a child who was once bright and bushy-eyed now is this kind of dark, isolated individual who's struggling with everyday life, that they didn't typically struggle with, then that would be a concern that I think you need to bring them in.

Host: Well, Dr. Brown, beyond sleep, what daily routines should parents focus on reestablishing before school starts, like mornings or meals or homework?

Nicole Brown, MD: So one, and I can go with just based on experience, planning your week ahead, and doing that on the weekends. So, what clothes do you need for the week? And I can speak on experience, my children are responsible for having their clothes ready on Sunday, Saturday or Sunday for the whole week.

As far as lunch preparation, what are you going to eat for the week? If your child does not eat at school, what does that look like for the week? What does dinner plans look like for the week? Are we going to have activities where we can actually be at home, or do we need to consider getting food on the go?

So, we got clothes, we have meals, and we have dinner time as well as, you know, activities. What do you need to prepare for your soccer games, for your volleyball games? You know, making sure that we're communicating the needs before they actually need them. So, that creates some type of synergy within the family.

Host: These are great practical tips and insights, Dr. Brown. Thanks so much for helping us think about effective ways to navigate the back-to-school transition



Nicole Brown, MD: Thank you.

Host: For more back-to-school tips, visit childrens.com/backtoschool. And if you’re in North Texas, Children’s Health Pediatric Primary Care offers trusted care close to home, from newborn checkups to care for common illnesses and more. Find a location near you at childrens.com/primarycare. Thank you for listening to Children's Health Checkup. If you found this podcast helpful, please rate and review and share the episode, and please follow Children's Health on your social channels.