By J. Christopher McGinnis, Ph.D., BCBA-D Director, Behavioral Health Clinic Boys Town South Florida
Good sleep is one of those things we tend to take for granted. When we sleep well, we don’t think much about it. When we don’t sleep well, most of us complain about it but then either don’t address the problem or don’t know how to address the problem. We just hope tonight goes better. As important as sleep is for us, it is even more important for our kids. Good sleep makes life easier. The day just goes better. Learning is easier. Test taking is easier. Friendships are more easily won and maintained. Yet plenty of evidence shows that our kids are not getting good sleep. According to surveys, over two-thirds of parents have concerns about their child’s sleep, and about half of that group report sleep problems on at least three nights per week before their child’s fourth birthday. We also know that a vast majority of adolescents are chronically sleep deprived, getting about two hours less per night than they really need. Academic and social demands are most commonly blamed.
Well, so what? Here’s why good sleep is important: Studies show that poor sleep causes problems with behavior, emotions, learning, memory, and family functioning. It even causes weight gain and mimics ADHD. So what do we do about it? We see poor sleep health for many reasons, among them:
• “I had no idea he needed that much sleep!” Because our culture does not prioritize sleep health, guidelines on how much sleep kids need at different ages are not well known. Your 3 year old needs about 12 hours of sleep (including about 90 minutes of naptime), your 5 year old needs about 11 hours, your 9 year old needs about 10 hours, and your 14 year old needs about 9 hours.
• “We get home so late – there are just not enough hours in the day!” If you say this, your family is overscheduled and some things have to give. As important as they are, sports, karate, dance, scouts, and choir practice in the evening exist because our society does not prioritize sleep and because the planners of such activities don’t understand just how much sleep our kids require. Fortunately, the older our kids get, the less sleep they need and the wider the window of available time for such activities. And don’t forget to also set aside some time each day to just be a family.
• “Bedtime is such a hassle!” Behavioral treatment for bedtime refusal has an extremely high success rate with greater effectiveness the younger the child. We regularly see success in only a few nights. If your child
is afraid of the dark, we treat that first, and that typically takes only a night or two.
• “She complains about not being able to turn her mind off at night.” This is a sleep onset issue with many causes including too much late screen time (e.g., texting), caffeine use, and late exercise and hot baths or showers too close to bedtime. Altering some lifestyle factors and teaching relaxation strategies typically solve this problem.
• “He gets enough sleep but he’s still lethargic during the day.” If indeed your child is getting enough sleep, this complaint may prompt a full physical examination with lab work and perhaps an overnight sleep study to look at whether his sleep is restorative. Of course, it could also be the three hours of after-dark videogaming he’s not telling you about.
Sleep health is so important that solving sleep problems is one of our first-line interventions. It often seems to us that no one is getting enough sleep, and because our society doesn’t value sleep or think about sleep as a contributor to childhood problems we tend to hunt for other explanations and solutions, distracting us from the real culprit. I for one like to keep things simple. When one faces a complex problem, one must simplify. Fundamentals first. Sleep health is one of those fundamentals. If you or your child is experiencing difficulty in life, go there first. And if you are unable to get it under control, seek help. It is available.
Dr. Christopher McGinnis is the director of Boys Town South Florida’s Behavioral Health Clinic in West Palm Beach, Florida. He is a licensed psychologist, Board Certified Behavior Analyst, and a founding member of the Society of Behavioral Sleep Medicine. He may be reached at chris.mcginnis@boystown.org