Chapter One: How Can I Tell If My Child Is Well Rested?Step One: Suspect the Diagnosis
If your child is old enough to articulate her feelings, she may simply tell you that she is tired. However, most parents aren't this fortunate. Many five-year-olds with a thousand-word vocabulary will deny with their last waking breath that they need to go to bed, and then collapse into a deep sleep on the couch.
You may be able to tell when your child is tired by her behavior, but unfortunately many parents don't realize that their children are seriously fatigued. They may search for another explanation for a child's behavior when in reality sleep is the solution. Here are some ways to tell if your child is well-rested.Let's Check the Numbers
Dr. Richard Ferber, clinical director of the Center for Pediatric Sleep Disorders at Children's Hospital in Boston, has kindly allowed me to reprint a chart from his classic book, Solve Your Child's Sleep Problems
(Fireside Press). It clearly displays the relationship between age and sleep requirement.FIGURE 1 Typical Sleep Requirements in Childhood
Like many other parents, you may be shocked to see how poorly your child's sleep patterns compare to Dr. Ferber's bar graph. You may be tempted to defend the situation by uttering the phrase I hear in my office on a daily basis: "My daughter [or son] just doesn't seem to need as much sleep as other children." You are probably wrong.
Yes, it is true that the sleep needs of individual children can vary widely, and Dr. Ferber's table should be used only as a rough guideline. However, in my experience most parents seriously underestimate their children's sleep needs. There are several reasons for this unfortunate miscalculation. One is the temptation to accept as normal certain fatigue-related phenomena such as falling asleep in the car or having to be awakened in the morning. Another is the failure of parents to recognize symptoms such as crankiness, temper tantrums, hyperactivity, headaches, and leg pains as manifestations of sleep deprivation. Instead these behaviors and complaints may be blamed on dietary deficiencies or some inherent personality flaw.
Carried by waves of technological change, our society has drifted from a lifestyle that was once dictated by sunrise and sunset. We have come to accept an abbreviated night's sleep as the norm. I continue to be troubled by how many parents believe that nine o'clock is an acceptable bedtime for a five-year-old who must be awake by seven to get ready for kindergarten. They wrongly assume that because their friends' children go to bed that late or later it must be normal.
There is a phenomenon scientists call "biologic variation." In simplest terms it means that we are all a little bit different. Your child may become tearful and clingy when she gets overtired. Mine may become belligerent and hyperactive. Your neighbor's six-year-old may appear to function perfectly well on ten hours of sleep each day, and your six-year-old may wake with fatigue-related leg pains if she gets anything less than twelve hours. It just happens.
I doubt that I will live long enough to see all of these differences and vulnerabilities explained, but I am sure that eventually scientists will be able to identify some of the minor variations in brain structure and chemistry that are to blame for these inequalities that at times seem terribly unfair. Don't wait for science to catch up with your own observations. Learn how your child's body and behavior respond to sleep deprivation and learn how much sleep your child needs. You can use Dr. Ferber's chart as a place to start, but your child's requirement may be slightly more than his table suggests is optimal. Don't compare your child's sleep patterns to her playmate's or her cousin's. You may be unaware of the problems their parents are experiencing. Each child has her own limits and peculiar ways of responding when those limits are exceeded. Yes, there are patterns, but treat your child as the special and unique individual that she is.Here Are Some Clues That Your Child Is Sleep-Deprived:Your Child May Not Be Getting Enough Sleep/Rest If...
- When compared to Dr. Ferber's table, her sleep deficit is more than an hour.
- She must be awakened in the morning.
- When allowed to sleep in the morning she sleeps more than a half hour longer.
- She falls asleep as soon as she begins an automobile ride.
- She is frequently cranky and whiny.
- She has numerous temper tantrums.
- It is hard to describe her as a happy child.
- She wants to carry a special stuffed toy or blanket all of the time.
- You frequently find her sucking her thumb.
- She often wakes at night with leg or foot pains.
- She frequently has what appear to be nightmares.
- She has severe afternoon or evening headaches that may be accompanied by vomiting.
- She seems distractible or hyperactive at times, usually in late morning or late afternoon.
- Despite doing well in grade school her grades begin to fall in middle or high school.
- She frequently says she is tired.
This is only a partial list. There are numerous other symptoms and behaviors that can be attributed to fatigue. If you can honestly describe your child as happy and content 95 percent of the time, your child is probably getting enough sleep and rest. However, if your child frequently seems unhappy or angry, and/or you aren't enjoying being a parent, it is time for the sleep solution.
Copyright © 2000 by William Wilkoff, M.D