Sleep and Your Pre-Schooler.

Children aged 3-5 years typically need to sleep for about 11-15 hours in every 24.  Most of this is during the night but a nap in the day isn’t uncommon.  Most over-5s don’t need a nap during the day.

Common problems with preschoolers’ sleeping include finding it difficult to go to sleep, waking in the night and night time fears.  Nightmares and sleep terrors aren’t uncommon at this age too, as the central nervous system, imagination and social interaction continue to grow.  All these problems can cause parents considerable anxiety and we’ll discuss them here.

My child won’t go to sleep.

A child fighting the urge to sleep or wanting to stay awake and to be with the adults in the house is something many parents battle with.

One reason she resists going to sleep is if she is over-tired.  A nap/longer nap during the day (not too near bedtime) may help with this – the National Sleep Foundation says that parents commonly underestimate how much sleep their child needs.

Having a set bedtime and a good bedtime routine where the child chooses her pyjamas, bath toys, music etc will help her learn about her time and adult time in the evenings.  Hopefully you’ve been doing this since she was a tiny baby but even so, growing independence can mean that she’s pushing her boundaries.

Even if she doesn’t settle to sleep right away, she can learn to lie quietly in bed or play quietly there until she does fall asleep.  This way she learns to entertain herself and that she can fall asleep safely and confidently on her own.  A night-light or leaving the door open may help build this confidence.

If she gets out of bed and wants to be with the adults, take her quietly back to her own bed; don’t make conversation, be tempted to play, read stories or get involved with getting endless cups of water etc.  And try not to get too irritated by what can seem like infuriating behaviour – getting her upset won’t help you or her sleep!  Repeat this going-back-to-bed routine as often as you need to.  It can be hard, but not as hard as a persistently wakeful child.

This advice is the same for children who wake in the night and come to your room, either to wake you or get into your bed.  Unless she is wet, soiled, distressed or sick, simply take her by the hand and put her back in her own bed.  Do this as many times as she comes to you.  Keep the lights off or low, don’t play, talk, play music or TV or any other activity that will wake her up any further.

My child has nightmares.

Nightmares and night terrors are often confused.

A nightmare is a dream with a very vivid and disturbing nature.  If you/your child wake from a nightmare you can usually remember very clearly what it was about; your child will respond to comfort but may be reluctant to go back to sleep.

They are common in childhood as well as in adults and occur during REM sleep.  We’ll look at REM and non-REM sleep below.

Nightmares often happen later in the night/early morning.

A night terror or sleep terror is an extreme and more violent nightmare and also usually happens during non-REM sleep.  They’re more common in children aged 4-12 years than in adults but only about 3-8% of children suffer them.

The child seems terrified, can scream, sit up, thrash about, sweat and is inconsolable for a few minutes after she wakes.  She will probably then settle back to sleep when she’s more relaxed.  They can be combined with sleep walking (see below) and usually happen during the early part of the night – 2-3 hours after she’s fallen asleep.

The main difference that you may notice between a nightmare and a night terror is that after a night terror the child has no or only a vague recollection of what happened in the dream and in a nightmare the recollection is often good.

Whether your little one has a nightmare or a night terror, it’s often very disturbing for you and for her.  Here’s more about each and how to deal with them.

Helping a child with nightmares.

No one really knows what causes nightmares.  They are thought, like dreams, to be the way we deal with what’s going on in our waking lives – the emotions, thoughts and feelings we attach to certain events.  Sometimes they occur out of nowhere and sometimes there is an obvious cause, such as change, stress or family tension.  Often the cause is never known but events on the TV or from films or video games can be as upsetting as real life imagined or real events.

Nightmares can’t be prevented but by:

  • Having a regular, relaxing bedtime routine
  • Making sure she’s not watching scary movies, games or TV before bed
  • Having a cosy bedroom that she loves to be in
  • Helping her understand that bad dreams aren’t real

Both you and she can have a better night’s sleep.

If she does have a nightmare:

  • Offer love and reassurance when you console her, so that she feels a calm presence
  • Tell her what’s happened – “you had a bad dream and it’s all over and gone now” – so that she knows it’s finished
  • Use a night-light or turn the hall light on with her bedroom door ajar so that she feels reassured
  • Ask her about the nightmare and listen to what she has to tell you
  • Help her to go back to sleep by asking her to choose a favourite toy or blanket that will help her have sweet dreams.

Nightmares are often just occasional but if they are repeated and interfere with good quality sleep, then speak to your paediatrician.

Helping a child with night terrors.

Night terrors are thought to be caused by over-arousal of a child’s developing central nervous system – that’s the part that controls sleep and waking activity in the brain.

Sometimes this is an inherited tendency, for other children night terrors can happen when she is sick, over tired, stressed, taking medication or sleeping in an environment they are not familiar with.

Like nightmares, night terrors can’t be prevented but:

  • Make sure she doesn’t get over-tired by staying up too late in the evening
  • Have a comforting bedtime routine and stick to it
  • Try to reduce her stress

If she does have a night terror:

  • You’ll feel helpless, but you need to patiently wait out the terror but just make sure she doesn’t hurt herself if she’s thrashing her arms and legs
  • Don’t wake her – attempts to wake her probably won’t work and she will be confused and disorientated and may take longer to settle to sleep again
  • Offer your reassurance and comfort when she wakes and help her settle to sleep again when she’s ready.

When you understand nightmares and night terrors they become less frightening for you and you’re then able to give more confident reassurance.

 REM and Non-REM Sleep.

REM stands for Rapid Eye Movement and Non-Rapid Eye Movement.  If you’ve ever watched someone sleeping you’ll have noticed their eyes flickering under the eye lids.  This is Rapid Eye Movement and sometimes called ‘active sleep’ when the brain is active but the body is immobile and dreaming occurs.

Non REM sleep is ‘quiet sleep’ when the blood to the muscles is increased as restorative hormones are released and pumped round the body.

Elspeth Raisbeck

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