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      How to get your kids back into a sleep schedule for the new school year

      From Elementary to High School, sleep problems are widespread. Dr. Puckett, from Complete Family Medicine, stopped by the set of Good Morning Heartland to talk about the importance of sleep and how we can help our kids get back into a good sleep routine.

      Question: How common are sleep problems amongst school age children?

      Answer: You may be surprised to learn how prevalent sleep problems are. In studies of elementary school-age children, nearly 40% showed some kind of sleep problem, and 10% had daytime sleepiness. In adolescence, the rates even increase further. With increasing freedom from parental control, social activities and academic challenges, sleep is not exactly a high priority for adolescents, and the sleep time most teenagers get is insufficient: the average is under 7 1/2 hours, with only 15% sleeping 8 1/2 hours or more on school nights and more than 25% typically sleeping 6 1/2 hours or less. Up to half of adolescents reported at least occasional difficulty falling or staying asleep, with up to 13% experiencing chronic and severe insomnia.

      Question: The problem goes beyond just making them tired, Right?

      Answer: Late to Bed, Early to Rise, Makes Us Cranky, Moody and Cry. Sleepless adolescents are not just tired teenagers. They are at increased risk for negative moods, impaired memory, motivation and ability to think and make good judgments. Drowsy driving together with "micro sleeps" (i.e., unintended sleep episodes) adds up to increased automobile accidents, of which teens are heavily represented.

      Question: So what can heartland parents do to help improve their sleep time and schedule?

      Answer: The first day of school often initiates a cycle of poor sleep and problematic behaviors that may be difficult to break. It goes something like this: Late Bedtimes, Early Start Times: Late summertime bedtimes collide with early school start times; so kids start the new school year being sleep-deprived. Sleep Debt Builds: Each day they lose more sleep, building up a "sleep debt" that, like all debts, must be paid-off. Weekend Catch-up - There's a Catch: Now comes the weekend, and we feel good that our child sleeps late, catching-up on all that sleep. But wait just a minute - there's a catch to that catching-up: it is actually a big red flag that your child is not getting enough sleep, and late weekend sleeping actually perpetuates the whole dysfunctional sleep pattern. Interestingly, a study in which school start times were moved from 7:15 a.m. to 8:40 a.m. resulted in children getting an hour more sleep each night and improved attendance. Late-night-type, rebellious adolescents are predisposed to this pattern and often complain that it is very hard to fall asleep, easier to fall asleep if bedtimes are later, hard to wake in the morning, late to school and sleep late on weekends.

      Question: So what can we look for as red flags that should prompt us to take action?

      Answer: Given the prevalence and enormous impact of sleep problems on daytime functioning, we should all regularly look at our own children to see if they are getting the sound sleep they deserve. For some it may be obvious, but for most of us it requires some education, investigation, and a keen, watchful eye. This is because few of us really know what normal, healthy sleep should be, plus there is a great deal of individual variation among children and at different ages. Sleep deprivation is also difficult to detect because sleep problems are masters of disguise, often masquerading in myriad manifestations. Consider that: Children rarely complain about sleep problems. A study of adolescents showed that very few sought help for their sleep, even though some considered their problems to be very severe. Another found that almost 90% of adolescents say that they need more sleep, but how many parents have heard their child say, "You know, I think I am going to go to bed early tonight." Adolescent sleepiness is so prevalent that it almost seems normal. Though bedtimes get later and later, the biological need for sleep in adolescents does not decease with age. Parents may overestimate the amount of sleep their child gets, because we may be unaware of when our child actually falls asleep, as well as night awakenings. Research has shown that medical conditions may cause or contribute to sleep problems even when overt medical symptoms seem well controlled. For example, asymptomatic children with asthma and gastro esophageal reflux may have poor sleep and daytime fatigue. Allergies may cause respiratory distress when sleeping. In one study, almost 1/3 of the children in elementary school reported significant body pains during the night, of which parents were largely unaware. Enlarged tonsils can cause intermittent breathing problems by physically blocking the airway. One study showed an increase in grades in children with sleep disturbed breathing after tonsillectomies. Sleep deprivation may present itself in many ways other than daytime sleepiness -- inattention, poor concentration, moodiness, behavioral problems, and poor academic performance and social skills, to name a few. Interestingly, poor sleepers were found not to be consistently more tired than good sleepers, and they were actually least tired in the evenings, when most good sleepers were tired.

      Question: So what can we do?

      Answer: Talk with your child. Just taking the time to ask some of the right questions can go a long way. If there is a problem, discuss it and make a plan agreeable to all. Include detailed targeted behavior changes and rewards. With your child in school during the day and with after-school activities and part-time jobs for many, it is critical to talk with teachers, coaches, bosses, etc. to see if your child is exhibiting any signs of sleep deprivation. This may involve you taking some time to educate the educators. Teach your child good sleep habits, also known as "sleep hygiene". Establish sleep-healthy bedtimes, bedtime routines, habits, and diets. If late bedtimes are an issue, try ticking back bedtimes in 15 minute increments every night or other night until you get to a bedtime where your child wakes up easily and refreshed. Identify and reduce as much daytime stress as possible. Limit TV and other "screen time" (computers, video games), especially at bedtime, and do not put a TV in your child's bedroom: children with a TV in their room tend to go to bed later and get less sleep than those without, and those kids who get less sleep are more likely to spend 2 or more hours watching TV.

      Question: How much time should we shoot for to sleep?


      1-4 Weeks Old: 15 - 16 hours per day

      1-4 Months Old: 14 - 15 hours per day

      4-12 Months Old: 14 - 15 hours per day

      1-3 Years Old: 12 - 14 hours per day

      3-6 Years Old: 10 - 12 hours per day

      7-12 Years Old: 10 - 11 hours per day

      12-18 Years Old: 8 - 9 hours per day

      Complete Family Medicine1611 S. Baltimore Street.

      Kirksville, MO. 63501