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Clinical Psych Ph.D. student, Sammy Dhaliwal, contributes to article on sleep with mentor, Dr. Daniel Lewin and colleagues at Children's National Medical Center.

6 Ways to Promote Healthy Sleep Routines for Your Family This Summer

Catch a slow wave to sleep.

By Daniel Lewin, ContributorJune 14, 2018, at 6:00 a.m.
U.S. News & World Report

Promoting Healthy Summer Sleep Routines

When kids and teens have a calming routine like unplugging from electronics and reading before bed, it helps them to transition more easily to sleep.(GETTY IMAGES)

SLEEP IS A LOT LIKE surfing: It takes preparation and practice to learn how to catch and ride the wave. But it’s worth the effort, since healthy sleep patterns during childhood and adolescence are linked to improved health outcomes, academic achievement and physical safety, among many other benefits.

As parents, know that every night won’t bring perfect conditions, but helping children improve their sleep quality, attitudes and rituals sets them up favorably to catch the big wave and establish healthy sleep routines.

It’s important to know that sleep habits, attitudes, rituals and routines satisfy deep human instincts to be safe at times when we are most vulnerable, such as letting down vigilance for the night. This drive is present not only across the lifespan, but in all species. Even for the best sleepers, environmental conditions and undercurrents of emotions (particularly fear and sadness) as well as medical illness and injuries can erode sleep quality and, in some cases, lead to chronic insomnia (defined as difficulty falling asleep, staying asleep and poor sleep quality). For humans, and children in particular, routine translates to predictability – which translates to comfort and feeling safe.

Here are six key recommendations for developing healthy sleep routines:

1. Establish a bedtime routine. A brief bedtime routine with clear limits may at first feel like tough love, or may conflict with working parents’ desire for open-ended together time. However, children, and even teens, feel safest when they know what to expect. Parents can help to create a routine that includes soothing activities before bedtime. An example of a bedtime routine might include having a child brush teeth, put on pajamas and engage in quiet reading or cuddle time, with a final prayer, meditation or ritual that is special to your family. The specific order isn’t important. Moving toward a calm, quiet and positive social routine is what matters.

To support this calm environment, put all sleep antagonists, like electronics, away 30 to 60 minutes prior to bedtime. Don't engage in conversations that may cause excitement or spur negotiations (like pleas for more online time) during this time. Ditch any long and complicated routines. Simple, calm routines promote an easy transition to peaceful slumber.

2. Be prepared for the “burst zone.” This is the natural biologically based burst of energy or vigilance that occurs for most individuals shortly before their optimal biological sleep time. This can create choppy waters for children near bedtime. While this “burst zone” can lead to challenging interactions between parents and children, it’s an important and useful cue that a child is about 15 minutes away from their optimal bedtime. Once it is recognized, some solo time with a few specific tasks can avoid activating supercharged or emotional interactions in children. (“Go and brush your teeth, and when you are done, I’ll be right there.”) For anxious children, or when anxiety occurs during this period of time, listening to a not-so-exciting audiobook, practicing mindfulness, stretching or doing yoga can settle both your child’s body and mind and prepare them for bedtime.

3. Maintain regular sleep-wake schedules. Big shifts in the timing of sleep, particularly on weekends, has the same effect as jet lag (now called social jet lag) and daylight saving time. While some sleeping in on weekends (more than one to two hours later than weekdays) feels great, and feels like we are catching up on lost sleep, big shifts – particularly for adolescents – result in the negative effects of jet lag on Monday mornings. Going to bed at times that are not biologically optimal for teens leads to frustration and sometimes chronic sleep problems. Aim for fairly consistent summer sleep patterns, just as you would for sleep patterns during the school year. Talk to children and teens about why this matters, and have them test it out for a week. They will feel the benefits almost immediately.

4. Create a sleep sanctuary. A bedroom should be a soothing and comfortable place designed for sleep – an environment that helps you transition to sleep. Yet, for some children with sleep problems, the bedroom may have some negative associations. Younger children might associate the bedroom with the fear of being alone or have difficulty controlling fears. Older children might use the bed for all activities (homework, social media, napping or thinking) through their day. To help children restructure their sanctuary, parents can work together with their kids to shift these associations.

If your child is scared of monsters under the bed, stay with her while she checks, and discuss bedtime worries. Do a download of her day in the late afternoon or early evening, but not right before bed. For older children, getting them out of bed when awake and frustrated, and having them engage in a pleasant, but calming activity – such as reading something that is neither too activating nor completely uninteresting – and having them return to bed when they are calm and tired, creates a new and more positive association with their bed.

The top bedroom priorities are to use the bed for sleep and only sleep; and avoid the temptation to look at alarm clocks. Night lights and calming sounds can facilitate sleep for some children. By improving the sleep environment and shifting any negative associations, children will learn that the bed comes to symbolize comfort, calm and sleep.

5. Treat nighttime awakenings as the regular occurrences they are.

Brief awakenings occur a dozen times per night in addition to a longer awakening three to four hours after falling asleep. Helping your child treat awakenings as normal occurrences can help them quickly return to sleep without worry.

6. Know the recommended sleep ranges.

As children grow, the amount of time they sleep each night decreases and their bedtime drifts later. Parents want their children to have a good and restful sleep.

Here are my age-appropriate recommendations for sleep, based on guidelines from the American Academy of Sleep Medicine that are endorsed by the American Academy of Pediatrics:

0-2 12-16 Day and night
3-6 11-13 Night and one nap
6:30 p.m. to 6:30 a.m.
7-11 10.5-11.5 7 p.m. to 7 a.m.
12-15 9.5-10.5 9 p.m. to 8:30 a.m.
16-18 8.5-9.5 10:30 p.m. to 9 a.m.
19-22 7.5-8.5 10:30 p.m. to 8:30 a.m.

In order to ensure that children get adequate rest each night, parents can encourage specific healthy daytime habits that protect quality sleep. Limit naps and caffeine use, and make sure your family eats a healthy diet and exercises.

As a parent, you are like a surf coach. You can teach and model for your children how to catch that smooth ride on the wave of sleep. To do that, keep these recommendations in mind: Maintain a regular schedule between weekdays and weekends, remember that nighttime awakenings are normal, and establish a consistent bedtime routine to prepare your child for a smooth transition to the restorative sleep that enables everyone to wake up feeling refreshed and ready to take on the day.

Sammy Dhaliwal, Amysue Hansen and Wendy Pinder contributed to this post.

Rachel Tache's paper, "Temperament Profiles Predict Community Violence Exposure and Adjustment Problems" was selected as an Abstract of Distinction at the 2018 Society for Prevention Research (SPR) annual meeting in Washington, DC. Rachel is a rising 4th year clinical psychology Ph.D. student working with Dr. Sharon Lambert.

Great job, Rachel!

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