According to World Health Organisation, sleep is one of the essential conditions for a healthy lifestyle. It is a vital human function to restore depleted energy, to reload the body. It is a proven fact that sleep is vital. In this article, together with Evelina Pajėdiene, a neurologist, sleep specialist, member of the World Sleep Society, author of the blog www.meskosmiegas.lt, we will explore the peculiarities of children's sleep and will try to find the answer to an unsettling parenting question: why kids do not want to go to sleep as if it was the biggest punishment of the day?  

It is a fact that children need more sleep than adults. Is it possible to briefly scientifically substantiate why?

The need for sleep and the natural length of sleep time needed usually depend on your age. Newborns can (but it is not a must) sleep most of the day, when a five-year-old may need about 12 hours of sleep a day in total, a teenager - about 10 hours, and a middle-aged adult about 8 hours.

A brain of a child, as well as the structures that regulate sleep, are actively developing, which makes both the internal structure of sleep itself and the need for sleep different from those in adults. Not only the nervous system is actively developing, but all other body systems are consuming a lot of energy, which also requires more sleep to recover.

However, infants and children often wake up very early, with the first sunrays, because their circadian or biological clock is sensitive to one of the most important guides of the rhythm of sleep and wakefulness - the pulse of light. In adulthood, the rhythm of sleep and wakefulness is often changed by the regime dictated by modern civilization - late work, evening activities using artificial light sources, and a desire to wake up later in the morning.

I have read, that children who are uneasy sleepers during their childhood, later as adults have higher IQs, greater empathy, and become wiser personalities. Is that true?

Most research suggests quite the opposite, shorter duration sleep and poor-quality sleep are associated with lower cognitive abilities and poorer learning capabilities. However, we must keep in mind that the mental and emotional intelligence of a growing person is shaped not only by the peculiarities of sleep, but also by many other factors, such as relationships with parents, other close people, life experiences, nutrition, physical activity, and so on.

Why is it that sleeping for adults is one of the greatest pleasures, while for children bedtime seems to be the punishment?

Children often are incapable of comprehending and expressing their emotions and feelings, such as being tired and need for sleep. Same with describing pain or anxiety. When children are tired, they become easily irritated, unable to listen or focus. Games, fun, and new experiences are difficult to abandon and suddenly go to sleep. In addition, babies and toddlers are often stubborn and tend to object when told what to do or how to behave.

How to develop the pleasure of sleep for a child?

Sleep can become a pleasant activity if we create some kind of routine bedtime rituals such as dimming the lights, creating a quiet or a soft music environment, giving a warm bath, a glass of herbal tea or a glass of warm milk, reading a fairy tale, a discussing the experiences of the day. It is also important to explain to children why they need to sleep – during sleep, the body grows and becomes stronger and the brain becomes smarter. Sleep protects us from various illnesses and it gives us the most interesting dreams.

What helps children to fall asleep easier and sleep better?

To get quality sleep, both the child and the whole family need to follow certain rules of sleep hygiene. First, at least a few hours before bedtime, it is advisable to avoid anything that stimulates brain activity: being close to screens, computer games, foods and drinks high in sugar and caffeine, bright blue and white spectrum light, noisy environment.

Second, the aforementioned sleep rituals and the creation of a safe, soothing sleep environment are extremely important. When getting ready for bed, the child should not feel anxious or afraid. If necessary, you should talk about the emotions of the day, the worries and fears associated with night sleep, such as darkness or nightmares. A dim light bulb, sleeping toys, and a soft blanket can help create a safer environment.

The third very important aspect is - the regularity of sleep and wake rhythms. If a child goes to sleep and gets up at the same time, it will be easier for him/her to fall asleep and get better rest. That way his/her biological clock will know when to get the body sleeping and when to wake it up. Surely, very important to spend as much time as possible in the fresh air, in natural light, and to eat and exercise regularly to maintain your biological rhythm intact.

Of course, certain rules for improving sleep need to be adapted to the specific age of the child, as it is normal for babies to wake up several times a night and have a few naps a day, whereas adolescents normally have a physiologically later sleep rhythm.

There are many different views on the topic, in your opinion what is it better for a small child - to sleep with the parents or alone?

I do not have a strong opinion, because I believe that each family should find the right balance between the physiological needs regarding sleep and the psychological principles of parenting. According to one scientific study that used objective methods to assess sleep, infants sleeping with their parents woke up more often than those sleeping alone, and their mothers complained more often about sleep disorders. In another study, babies and their mothers were observed every three months from child’s birth to one year. Mothers of children sleeping in the same bed complained much more often about their own and the baby's night sleep distractions and worsening relationships with their spouse. In both studies, babies sleeping separately slept in their cribs in the same room.

In addition, both, sleeping in the same bed and a separate room increases the risk of sudden infant death syndrome. There are many cases when parents and children feel a great need for closeness and attachment, so sleeping together in the same bed is a better choice for both parties. However, sometimes sleeping together for too long can make it difficult to move a child to a separate crib or another room because the child may lack the skills to calm down and fall asleep.

Could it be that poor sleep may be caused by inherited disorders or illnesses?

Sometimes poor sleep can be a symptom of certain illnesses, such as frequent limb twitching. Changes in body position during a night’s sleep can be related to vitamin D or iron deficiency. Poor sleep quality and morning fatigue can be caused by snoring or sleep apnea. A child's level of sensitivity, a poor emotional state during the day, problems at school or in relationships with others could also affect sleep.

Astrocytes are the cells responsible for sleep. Are there ways to stimulate them to get better sleep?

When we sleep astrocytes clear toxic metabolic products from our brain that we accumulate during the day. This function takes place during deep or slow-wave sleep, which lasts for a certain portion of the night’s sleep. Other stages of sleep such as slow sleep and rapid-eye-movement sleep also have their functions. It is important to ensure regular sleep and wake rhythms and, if necessary, treat the causes of sleep disturbances such as snoring, sleep apnea, or leg movements during sleep. It is important to maintain a sufficient number of sleep cycles and an adequate number of all sleep stages.

You mentioned the pleasure of dreaming: what do dreams mean in the science of sleep? What impact do they have on a person’s physical health?

Dream scientists are actively studying this field, but we still do not know much about the purpose of dreams. It is very difficult to perform experiments related to dreaming. Dreams are inconsistent, as well as people with their experiences and interpretations are all different. It is difficult to accurately capture the state of a dream and then the changes during it. There are several assumptions about the purpose of dreams: they regulate emotions, organize memory processes, "destroy" unwanted memories, and perhaps prepare for unplanned life situations. Newborns, infants, and young children dream much more than older children or adults. Sleep patterns change with age, the dreamy rapid-eye-movement stage decreases, and the slow-wave sleep stage increases.

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Here are some reasons why a child's (adult's) sleep may be poor:

- Not enough natural sunlight. The pulse of light through the retinal receptors reaches the pineal gland in our brain, or the biological clock, where the sleep hormone melatonin is synthesized. Its production is most active at dusk, and during the day it produces the opposite stress hormone, cortisol. So, to sleep better at night, we need to spend as much time as possible in natural light, especially in the morning, and in the evening, we should avoid artificial light, various screens.

- During the day, experiences such as too much excitement, worries, problems, anxiety also lead to sleep disorders. Tension, fatigue activates the nervous system, the brain sends information to the adrenal glands, which stimulate adrenaline production, the person may feel energized and may have a hard time falling asleep or sleeping poorly. Positive experiences can also cause anxiety and stress - so it is a myth that a tired child sleeps well.

- What also can interfere with your night's sleep is the excess of sleep-promoting substances accumulated during the day. When you are awake adenosine accumulates in the brain, which determines sleep time and sleep-wake balance. This so-called "fatigue" chemical accumulates throughout the day and in the evening it determines the time of your falling asleep. The amount of adenosine that accumulates depends on the duration of wakefulness. Studies have shown that the intensity of sleep depends on the length of the previous day and activities during the day - the more tired you get, the deeper your sleep will be. However, excessive fatigue interferes with sleep.

- The child's sleep may be disturbed due to illness, pain, unpleasant physical sensations: teething, various abdominal pains, sudden growth, pain in the leg muscles.

- Due to the sleep cycle differences between adults and children, parents may feel that their child is not sleeping or is constantly waking up. The sleep cycle for adults lasts 80-120 minutes, while for newborns - 60 minutes. 50% of infants' sleep consists of the rapid-eye-movements stage, whereas for adults it is 20-25% (this is the stage of sleep in which the brain works intensively; it is thought that at this stage a person dreams). So parents often confuse their child’s supposed awakenings with the sleep at the rapid-eye-movement stage and they awaken the baby through their reaction or actions.

- Children may wake up when they feel unsafe or when their basic needs are not met. The safer the child feels, the better the sleep.

- The sleep of the little ones can be disturbed by parasomnia - fear of darkness, nightmares, sleepwalking, of which in the morning they have no memory. It is important to take appropriate measures when such episodes become frequent, a child gets up in the mornings tired and irritated. It is very important to have a safe bedroom environment (so that your baby cannot open a window or door during sleep, and reach for sharp tools). Usually, children grow out of parasomnia.

- Change of time in the spring and autumn, can disturb the quality of sleep, as the human biological clock is accustomed to falling asleep and waking up at a certain time. Sleep scientists have a negative opinion about such clock rotation and seek to prove that it is harmful to human health. The facts show that in the spring when people lose an hour of sleep due to clock rotation, the number of car accidents and heart problems increases.

- The quality of sleep is determined by a balanced diet and physical activity. It is best to exercise and have dinner 2-3 hours before bedtime. Before sleep time it is important to avoid high-sugar products that give your body a quick excess of energy. Fatty, spicy foods and fast absorption of carbohydrates also interfere with sleep. Digestion is an intense body activity, during which heat is released, body temperature rises, and it becomes harder to fall asleep.

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