As children enter the school years, we start to see a reduction in some of the behavioral sleep disorders. For many children, there are great surges in the ability to regulate emotions and self-soothe.
Sleep in this age group becomes more distinct and the pattern of sleep is much more reflective of adult sleep- the sleep stages that they go through are much the same in children and adults.
To me, the deep, slow wave sleep that can be observed in children looks like a symphony.
As children move into adolescence, it drops some of the amplitude (see picture), and will remain consistently similar throughout the lifespan until it changes again with old age.
The reason why I like to share these pictures is because I feel that they show the intense amount of activity that is occurring in the actively growing and developing brain of the school-age child.
It is so easy to start to see them as smaller versions of ourselves when they start to utilize mature patterns of speech and activity, but we need to give their brains every possibility to sleep well.
Inconsistent Sleep, Timing, and Behavioral Interference
The biggest challenges that we see in this age group are problems with inconsistent sleep timing, behavioral interference in sleep continuity, and parasomnias. It can be tempting to start to anticipate that your child can take responsibility for their sleep timing, but it is essential to maintain stable sleep periods in this age group.
In particular, wake times should be consistent throughout the week, and sleeping in on weekends should be avoided. When a child sleeps in on the weekends, their circadian clock delays to the new wake time, and it can take them a rough couple of days to readjust at the beginning of each week.
If this is chronic enough, they can develop a circadian rhythm disorder, in which the circadian clock does not match the demands of their school schedule. Our ability to focus is at its peak approximately three hours after our stable wake time, which means that a child sleeping until 10 AM on the weekends may shift their peak focus to 1 PM, often later than they really need to be able to focus in school.
It is not uncommon for me to see parents trying to compensate with caffeine in this age group, and there are concerns with caffeine consumption in children.
In May 2013, the FDA announced that they would be conducting an investigation of caffeine consumption in children after some academic studies indicated that the effects can harm brain development. So, skip the caffeine and give them adequate time to sleep!
Screen Time and Resistance to Bedtime
Additional behavioral challenges for sleep continuity include struggles over screen time and general resistance to bedtime.
“it is best to eliminate screens an hour prior to desired sleep time.”
For some kiddos, the idea of sleeping independently can still be a challenge in this age group, but their increasing body size makes it a lot harder for them to worm into bed between mom and dad. In my clinical work, I often find that kids who are struggling with sleeping independently can do a really good job vocalizing why they are struggling, which gives us a good path to work toward a solution.
For example, the bedroom may feel strange or uncomfortable, and this can be an easy fix. Let them give input on how they would like the bedroom to be arranged, and be supportive of some of the struggles they may experience.
It is essential to be supportive and validating of emotions, but remain consistent with encouraging them to sleep in their own bed. Help them to identify safety devices (yes, even middle schoolers may be more comfortable with their blankie still in bed with them) and encourage the utilization of these devices when they are in bed.
One bright kiddo who I saw came up with the idea of placing pictures of her favorite friends and family events on her ceiling. She kept a dim flashlight on her nightstand and could shine the flashlight on the pictures if she was feeling scared.
Place the focus on steps to success rather than frustration over the existing challenge, and establish rewards for successful nights.
As far as screen time is concerned, it is best to eliminate screens for an hour prior to desired sleep time. In our house, we don’t have screens after dinner, so the kids engage in reading or play prior to bed instead of video games or TV.
It took several months for this to be a pattern, but we no longer have any challenge to this schedule. Always remember that we need to dark to sustain stable sleep, so dark during sleep hours is a consistent goal.
Parasomnia: Sleepwalking or Somnambulism
The most common parasomnia in this age group is sleepwalking or somnambulism.
Somnambulism occurs in that beautiful, deep sleep pictured earlier, so there is no conscious thought associated with the behavior. It tends to occur most often when children are sleep deprived or stressed, so sleep scheduling can be even more critical in this group.
“Somnambulism tends to disappear around puberty in many children, so it will likely be a distant memory in a few years.”
This behavior is not as disruptive to the family as night terrors, so most parents opt to ensure safety rather than trying to actively eliminate the behavior. The best way to ensure safety is to make certain that there is a clear path, and that all exterior doors are not easily opened.
It is not uncommon for people to open simple locks or perform very automated tasks while sleepwalking, so it is essential to try to make exiting the home a very complicated process. Many deadbolts have an internal key option, and it may be worth a call to the locksmith to make this change.
Adults with somnambulism have been witnessed trying to drive, eat, and engage in other common behaviors, so do not be surprised if your child seems to be awake but acting somewhat oddly.
The concept of not waking a sleepwalker comes from the idea that they are in a very deep sleep, and will not be coherent should you wake them (and might even be a little startled by the event) so it is best to simply guide them back to their room.
Establish a Good Sleep Routine
One last bit. The middle school years are the time that kiddos start to begin to practice independence in a more meaningful way, and sleep routine can be a good part of this process.
Help them to establish a good wake time for each day, and show them how to use their alarm clock. We use alarm clocks in the sleep clinic for two purposes: establishing a wake time and also creating a specific time that time in bed is over.
For those larks out there, having an alarm can help them to keep from creeping into an earlier rise time, and for those owls, the alarm can help make sure they remain consistent with their schedule, even on the weekend. Help them to practice independence with their sleep and wake routine, but make sure that you are consistent with your expectations of timing.