Does your child have trouble falling or staying asleep?
About 25 to 30 percent of infants and children have sleep problems, due to medical issues, emotional issues or poor bedtime routines.
Sleep problems disrupt the rest of both children and their parents, and can leave everyone in a household exhausted.
If your child has issues with sleep, or they use too many electronics before bed and can't fall asleep, listen in to SMG radio’s interview with pediatrician Dr. Dahlia Hall.
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Does Your Child Have Sleep Issues?
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Learn more about Dr. Hall
Dahlia Hall, MD
Dr. Hall is an expert in pediatrics and adolescent medicine. She has taught medical students and residents at New York University School of Medicine and Lenox Hill Hospital.Learn more about Dr. Hall
Transcription:
Does Your Child Have Sleep Issues?
Melanie Cole (Host): Does your child have trouble falling asleep or staying asleep? About 25-30% of infants and children have sleep problems due to medical issues, emotional issues or poor bedtime routines. Sleep problems disrupt the rest of children and their parents. The whole family can be left exhausted. My guest today is Dr. Dahlia Hall. She is a pediatrician with Summit Medical Group. Welcome to the show, Dr. Hall. Speak about sleep issues in children. I’d like to start by asking you first, when can we start sleep training babies and getting them on a schedule.
Dr. Dahlia Hall (Guest): Oh, that’s a great question. Usually with babies we can start training them about three months of age because, remember in the newborn period, usually sleep and wakefulness is about equally distributed throughout the day. Oftentimes, I have parents having unrealistic expectations in terms of when babies should start going to sleep and sleeping for longer chunks of time or having more consolidated sleep, like sleeping for longer stretches. Usually, that starts about 2-3 months. That’s when you’ll find that they will sleep 3-4 hours, wake up, feed and go right back to sleep. The best thing is to put the baby down a little drowsy, not completely awake, but just a little drowsy so they get used to learning how to self-soothe and putting themselves back to sleep.
Melanie: That’s so important that the baby learns to self-soothe. What about some of the different ways that people do sleep training? Some people don’t want to let the baby cry. Some people sleep with the baby right near them. Tell us about sleep training and your best advice--what you tell your patients.
Dr. Hall: In terms of sleep training, again, each child is a little different. It all depends on when the brain is mature enough to go to sleep. That’s why we say at usually about 3-4 months, they start sleeping in bigger blocks. You want to make sure, first of all, that the baby is sleeping in the crib, not with you. That’s the safest place for the baby to sleep – in the crib, on their back. You want to have a routine in terms of how you put the baby to sleep because if the baby starts waking up in the night, you have to be able to use that same technique to put the baby back to sleep. I usually discourage things like rocking because as they get heavier, it gets harder and you’re more tired and they get bigger. I usually just recommend, in terms of sleep training, that you might read a story, you might play music and you might just have some quiet time. But really just try to unwind and get the baby to sleep. Again, it all depends. You have to make sure the baby is not hungry, is well fed. I discourage things like pacifiers for sleeping once they get a little older because if they wake up in the middle of the night, they need to find the pacifier to go back to sleep.
Melanie: That’s a nightmare, having to run in and find those pacifiers unless you put like 40 of them in their crib.
Dr. Hall: Right. Exactly. So, you want to get them to self-soothe--to learn how to calm themselves down. Most babies are able to do that. You just have to give them the opportunity to do so.
Melanie: It certainly is a process and sleep training is so important. Now, they become toddlers and they have regressed a little bit. They’re fighting bedtimes. They’re waking up. They’re coming to mommy in the middle of the night. They’re little walkers and they get up out of bed and walk around. So, what do we do to get toddlers on a good sleep routine?
Dr. Hall: The important thing with toddlers is to keep in mind that usually they are sleeping about thirteen and a half hours a day because remember, they nap usually a couple of times during the day up until age two and a half to three years. With toddlers, again, the routine becomes most important. Consistency, I tell parents, equals security. You know what to expect and that equals good behavior. In this situation, being going to bed. One of the important things is to make sure the room they are sleeping in is safe. Some kids do better with a very dim night light. You want to make sure it’s safe in the sense that on all the windows there are window guards so there is nothing for them to climb on that they can get to the windows. I also believe in a gate. Because, again, you want them to be able to be safe in the room and if anything you go to the room, but don’t have them come to you. Unfortunately, if you are unable to have a gate and if they come to you, you want to make sure to take them back to their room. There are different techniques used. Most people often quote the Ferber Method which is basically gradually desensitizing the child in terms of coming to you and waking you up. Because, remember, if your toddler isn’t sleeping then neither is the parent. Remember, many of the sleep problems that are created are usually created during this period of time because the parents will often do something for short-term gain not realizing that they are creating a problem for later on. For example, if a child starts crying and one parent can’t take it anymore and goes in. Then, what you’ve taught the child is “if you cry long enough, I’ll come in and take care of the issue and take you out of your bed and bring you into mine.” Unfortunately, once you start that cycle, it gets more challenging. Again, what you want to do is make sure you have a procedure to go to bed whether it’s reading a story or being calm. What is also important is to not have any T.V. or videos--that’s the cell phone; that’s the iPad--at least an hour before bed. To help them wind down so they will be able to go to sleep. When they wake up, I always say you treat that as a business meeting. That is not a time to play. That is not a time for a lot of interaction. You take them, if they need a hug, you give them a hug and put them to bed and try to calm them down that way but definitely keep them in their room. Take them back to their room. That’s the best recommendation.
Melanie: That’s great advice and so important because sleep is so important. As they start to get older, Dr. Hall, then, as you mentioned, some of these distractions come in. As we move into the tween and teen years, boy, they could stay up all night playing video games on their laptops and on their tablets. Just doing things electronic and mostly their phones which they sit next to their bed and they wake up every time it buzzes for a text or something. What do you want to tell us about some really important information for sleep hygiene as our children get older?
Dr. Hall: Once they hit the adolescence age group and teen years, then their sleep requirements actually decrease a lot from the toddler who’s getting like 13 hours a day. Then, they’re getting about eight and half to nine hours. That’s what they need. However, in the adolescent period it is not unusual for their biological clock is set a little differently. It’s normal for them to want to stay up late and wake up later. Unfortunately, because of how our society is set up, school starts early and they have sports afterward and then there is social interaction, then they have homework. It’s not set up to suit their normal biological rhythm. We usually call this “delayed sleep stage syndrome” where, because of the release of melatonin where a lot of people sometimes take, but we don’t recommend that anyone give children any medication for sleep--because their natural production of melatonin has changed, they tend to want to sleep a little later and wake up a little later. For teens, the first thing I say is get rid of the electronics an hour before bed. That’s a rule that should last a lifetime, even for us. What happens is, that stimulates the brain instead of allowing you to unwind. With cellphones, iPads and things like that, what we want to do is have rules for the home. “Okay. At this time all phones are plugged in and placed in the living room, or wherever to be charged overnight. No cell phones, no iPads, no T.V.’s in the bedroom.” That is good sleep habits. You want them to go to bed at a regular time. Ideally, you want them to be more consistent in terms of what time you start bedtime and what time you wake up. One of the habits that often occurs is that parents allow them to sleep until two o’clock in the afternoon on Saturday or Sunday. That’s the worst thing you can do. You really don’t want to vary your sleep time and your sleep wake up by more than an hour or two because then you have trouble getting the rest you need and feeling well rested. We know that when children don’t get enough sleep, then they can have behavioral issues, mood issues, and inattention. They make more bad decisions because they are tired. We already know that’s the period of time when their moods tend to be quite labile, so sleep definitely helps in that regard.
Melanie: It’s so true. I’m such an early bedtime person in my household. As a result, my children still go to bed early at 13 and 15 because this is just what they’re used to. In just the last few minutes, Dr. Hall--and it’s such great information--really give your best advice about the importance of sleep; the benefits of a good night’s sleep and how it can help our children.
Dr. Hall: As I touched upon previously, the most important thing with getting enough sleep is that you feel well rested. When you feel well rested, you’re in a better mood and, again, you can learn. At this age kids, are going to school and they need to learn and they need to be well rested and be able to participate in activities. Exercise should be part of their natural routine in some respects and that also helps us to sleep better by getting regular exercise. You want to make sure that they are in a nice, comfortable environment for sleeping. It’s routine. Consistency, I tell all my parents, equals security, equals good behavior. The more consistent we can be in terms of sleep times and sleep wake up times, the better off the child will be and will be able to learn when he or she goes to school the following day.
Melanie: It’s great information. Thank you so much, Dr. Hall. You’re listening to SMG Radio. For more information you can go to SummitMedicalGroup.com. That’s SummitMedicalGroup.com. This is Melanie Cole. Thanks so much for listening.
Does Your Child Have Sleep Issues?
Melanie Cole (Host): Does your child have trouble falling asleep or staying asleep? About 25-30% of infants and children have sleep problems due to medical issues, emotional issues or poor bedtime routines. Sleep problems disrupt the rest of children and their parents. The whole family can be left exhausted. My guest today is Dr. Dahlia Hall. She is a pediatrician with Summit Medical Group. Welcome to the show, Dr. Hall. Speak about sleep issues in children. I’d like to start by asking you first, when can we start sleep training babies and getting them on a schedule.
Dr. Dahlia Hall (Guest): Oh, that’s a great question. Usually with babies we can start training them about three months of age because, remember in the newborn period, usually sleep and wakefulness is about equally distributed throughout the day. Oftentimes, I have parents having unrealistic expectations in terms of when babies should start going to sleep and sleeping for longer chunks of time or having more consolidated sleep, like sleeping for longer stretches. Usually, that starts about 2-3 months. That’s when you’ll find that they will sleep 3-4 hours, wake up, feed and go right back to sleep. The best thing is to put the baby down a little drowsy, not completely awake, but just a little drowsy so they get used to learning how to self-soothe and putting themselves back to sleep.
Melanie: That’s so important that the baby learns to self-soothe. What about some of the different ways that people do sleep training? Some people don’t want to let the baby cry. Some people sleep with the baby right near them. Tell us about sleep training and your best advice--what you tell your patients.
Dr. Hall: In terms of sleep training, again, each child is a little different. It all depends on when the brain is mature enough to go to sleep. That’s why we say at usually about 3-4 months, they start sleeping in bigger blocks. You want to make sure, first of all, that the baby is sleeping in the crib, not with you. That’s the safest place for the baby to sleep – in the crib, on their back. You want to have a routine in terms of how you put the baby to sleep because if the baby starts waking up in the night, you have to be able to use that same technique to put the baby back to sleep. I usually discourage things like rocking because as they get heavier, it gets harder and you’re more tired and they get bigger. I usually just recommend, in terms of sleep training, that you might read a story, you might play music and you might just have some quiet time. But really just try to unwind and get the baby to sleep. Again, it all depends. You have to make sure the baby is not hungry, is well fed. I discourage things like pacifiers for sleeping once they get a little older because if they wake up in the middle of the night, they need to find the pacifier to go back to sleep.
Melanie: That’s a nightmare, having to run in and find those pacifiers unless you put like 40 of them in their crib.
Dr. Hall: Right. Exactly. So, you want to get them to self-soothe--to learn how to calm themselves down. Most babies are able to do that. You just have to give them the opportunity to do so.
Melanie: It certainly is a process and sleep training is so important. Now, they become toddlers and they have regressed a little bit. They’re fighting bedtimes. They’re waking up. They’re coming to mommy in the middle of the night. They’re little walkers and they get up out of bed and walk around. So, what do we do to get toddlers on a good sleep routine?
Dr. Hall: The important thing with toddlers is to keep in mind that usually they are sleeping about thirteen and a half hours a day because remember, they nap usually a couple of times during the day up until age two and a half to three years. With toddlers, again, the routine becomes most important. Consistency, I tell parents, equals security. You know what to expect and that equals good behavior. In this situation, being going to bed. One of the important things is to make sure the room they are sleeping in is safe. Some kids do better with a very dim night light. You want to make sure it’s safe in the sense that on all the windows there are window guards so there is nothing for them to climb on that they can get to the windows. I also believe in a gate. Because, again, you want them to be able to be safe in the room and if anything you go to the room, but don’t have them come to you. Unfortunately, if you are unable to have a gate and if they come to you, you want to make sure to take them back to their room. There are different techniques used. Most people often quote the Ferber Method which is basically gradually desensitizing the child in terms of coming to you and waking you up. Because, remember, if your toddler isn’t sleeping then neither is the parent. Remember, many of the sleep problems that are created are usually created during this period of time because the parents will often do something for short-term gain not realizing that they are creating a problem for later on. For example, if a child starts crying and one parent can’t take it anymore and goes in. Then, what you’ve taught the child is “if you cry long enough, I’ll come in and take care of the issue and take you out of your bed and bring you into mine.” Unfortunately, once you start that cycle, it gets more challenging. Again, what you want to do is make sure you have a procedure to go to bed whether it’s reading a story or being calm. What is also important is to not have any T.V. or videos--that’s the cell phone; that’s the iPad--at least an hour before bed. To help them wind down so they will be able to go to sleep. When they wake up, I always say you treat that as a business meeting. That is not a time to play. That is not a time for a lot of interaction. You take them, if they need a hug, you give them a hug and put them to bed and try to calm them down that way but definitely keep them in their room. Take them back to their room. That’s the best recommendation.
Melanie: That’s great advice and so important because sleep is so important. As they start to get older, Dr. Hall, then, as you mentioned, some of these distractions come in. As we move into the tween and teen years, boy, they could stay up all night playing video games on their laptops and on their tablets. Just doing things electronic and mostly their phones which they sit next to their bed and they wake up every time it buzzes for a text or something. What do you want to tell us about some really important information for sleep hygiene as our children get older?
Dr. Hall: Once they hit the adolescence age group and teen years, then their sleep requirements actually decrease a lot from the toddler who’s getting like 13 hours a day. Then, they’re getting about eight and half to nine hours. That’s what they need. However, in the adolescent period it is not unusual for their biological clock is set a little differently. It’s normal for them to want to stay up late and wake up later. Unfortunately, because of how our society is set up, school starts early and they have sports afterward and then there is social interaction, then they have homework. It’s not set up to suit their normal biological rhythm. We usually call this “delayed sleep stage syndrome” where, because of the release of melatonin where a lot of people sometimes take, but we don’t recommend that anyone give children any medication for sleep--because their natural production of melatonin has changed, they tend to want to sleep a little later and wake up a little later. For teens, the first thing I say is get rid of the electronics an hour before bed. That’s a rule that should last a lifetime, even for us. What happens is, that stimulates the brain instead of allowing you to unwind. With cellphones, iPads and things like that, what we want to do is have rules for the home. “Okay. At this time all phones are plugged in and placed in the living room, or wherever to be charged overnight. No cell phones, no iPads, no T.V.’s in the bedroom.” That is good sleep habits. You want them to go to bed at a regular time. Ideally, you want them to be more consistent in terms of what time you start bedtime and what time you wake up. One of the habits that often occurs is that parents allow them to sleep until two o’clock in the afternoon on Saturday or Sunday. That’s the worst thing you can do. You really don’t want to vary your sleep time and your sleep wake up by more than an hour or two because then you have trouble getting the rest you need and feeling well rested. We know that when children don’t get enough sleep, then they can have behavioral issues, mood issues, and inattention. They make more bad decisions because they are tired. We already know that’s the period of time when their moods tend to be quite labile, so sleep definitely helps in that regard.
Melanie: It’s so true. I’m such an early bedtime person in my household. As a result, my children still go to bed early at 13 and 15 because this is just what they’re used to. In just the last few minutes, Dr. Hall--and it’s such great information--really give your best advice about the importance of sleep; the benefits of a good night’s sleep and how it can help our children.
Dr. Hall: As I touched upon previously, the most important thing with getting enough sleep is that you feel well rested. When you feel well rested, you’re in a better mood and, again, you can learn. At this age kids, are going to school and they need to learn and they need to be well rested and be able to participate in activities. Exercise should be part of their natural routine in some respects and that also helps us to sleep better by getting regular exercise. You want to make sure that they are in a nice, comfortable environment for sleeping. It’s routine. Consistency, I tell all my parents, equals security, equals good behavior. The more consistent we can be in terms of sleep times and sleep wake up times, the better off the child will be and will be able to learn when he or she goes to school the following day.
Melanie: It’s great information. Thank you so much, Dr. Hall. You’re listening to SMG Radio. For more information you can go to SummitMedicalGroup.com. That’s SummitMedicalGroup.com. This is Melanie Cole. Thanks so much for listening.