Sleeping Difficulties?
Why Is Sleep Important?
Sleep issues are common among children, with up to 40% experiencing sleep problems at some stage in their development. These issues can disrupt the entire family, as frequent night wakings require parental intervention to help the child return to sleep. Sleep is a vital component of human physiology, and there are several theories explaining its necessity. Sleep supports various aspects of daily life, including protection, regeneration, and restoration. Recent studies underscore its significance in memory function and learning. Adults use sleep to consolidate knowledge during slow-wave sleep and motor skills during REM (rapid-eye-movement) sleep. In contrast, children focus on consolidating knowledge over motor skills. There’s a strong connection between sleep quality and quantity with daytime cognitive and behavioral performance. For instance, a study showed that reducing a child’s sleep by just one hour at 40 months of age can affect their academic performance at 6 years old. This adds to the growing evidence that maintaining healthy sleep patterns is crucial for later behavior and academic success.
How Much Sleep Should My Child Get?
Initially, newborns need up to 16 hours of sleep within a 24-hour period, split between day and night. Their sleep cycle is initially driven by feeding needs, with night wakings occurring every 2-3 hours and occasional 5-hour stretches, while daytime sleep is divided into four naps, typically lasting around 2 hours each. By six months, a child’s nighttime sleep patterns start to align more closely with those of adults, and regular nighttime feedings are no longer necessary. Studies have shown that reducing nighttime wakings can prolong breastfeeding. As children grow, their total sleep hours gradually decrease, dropping to about 12 hours by age 3. Daytime naps also decrease, reducing to one nap by 18 months and eventually disappearing by age 4.
What Could Be Disrupting My Child’s Sleep?
- Cow’s Milk Protein: Sensitivity to cow’s milk protein has been linked to colicky symptoms in newborns. A study in 2006 found that removing cow’s milk protein from an infant’s diet improved sleep patterns in nearly 85% of cases.
- Nocturnal Enuresis (Bed-wetting): Affecting up to 20% of 5-year-olds, bed-wetting may reflect brain maturity. Children who experience developmental delays at one and three years old are more likely to have bed-wetting issues at age 6.
- Night Terrors: Typically occurring in children aged 3-8, night terrors often happen during stressful times or extreme fatigue. They involve episodes where the child may sit up, scream uncontrollably for up to 30 minutes, and experience rapid heartbeat, rapid breathing, and other autonomic symptoms.
- Obstructive Sleep Apnoea: Affecting 1-3% of children, obstructive sleep apnoea is often identified by snoring, difficulty breathing, or mouth-breathing during sleep. Common causes include enlarged tonsils and adenoids, often associated with infections, allergies, or sensitivities like cow’s milk protein.
- Atopic Dermatitis: Conditions like eczema can disrupt sleep due to itching and scratching, and interactions between the immune system and circadian rhythms may contribute to wakefulness.
- Lifestyle Factors: Early school start times, excessive homework, busy evenings, and electronic device use can impact sleep. Studies show that electronic screens reduce melatonin production, a hormone essential for sleep.
- Colic: Affecting up to 21% of infants, colic is often the reason parents seek professional advice. Recent literature suggests that musculoskeletal discomfort might contribute to colic and associated sleep disruptions.
How can you tell if your child is struggling with sleep?
- Does your child take more than 30 minutes to fall asleep?
- Does your child wake up more than once during the night?
- Does your child snore? (Or breathe through their mouth?)
- Is your child very restless at night?
- Do they wake still feeling tired?
Manual therapy, such as that done by Chiropractors, may help restore proper spinal and nervous system function. Research has indicated that by improving a child’s spine and nervous systems they had a noticeable improvement in sleep duration, reduced night-waking, and a reduced length of time required to fall asleep. This has been attributed to a reduction of pain or discomfort experienced by the child, improved feeding quality, improved biomechanics of the spine and musculoskeletal system and improvement in the neurological function of the child.
An initial consultation at Kairos Chiropractic will incorporate a thorough assessment which would aim to establish potential causes of the interruption to your child’s sleep. This will help to determine the best treatment for any spinal or musculoskeletal conditions, as well as discuss appropriate management for any other causes of sleeping problems. This management ultimately may help to promote more positive long-term outcomes, as well as a happier and healthier child.
Useful Reading:
1. Novel mechanisms, treatments and outcome measures in childhood sleep.Colonna, Annalisa, et al. 2015, Frontiers in Psychology.
2. Sleep Disorders and Sleep Problems in Childhood. Thiedke, C. Carolyn. 2001, American Family Physician, pp. 277-84.
3. Associations Between Sleep Duration Patterns and Behavioral/Cognitive Functioning at School Entry. Touchette, Evelyne, et al. 2007, Sleep, pp. 1213-1219.
4. Australian Breastfeeding Association. Do I need to wake my baby for feeds?Australian Breastfeeding Association. [Online] August 2012. https://www.breastfeeding.asn.au/bfinfo/do-i-need-wake-my-baby-feeds.
5. Help Me Make It Through the Night: Behavirol Entrainment Breast-Fed Infants’ Sleep Patterns. Pinilla, Teresa and Birch, L. Leann. 2, s.l. : Pediatrics, 1993, Vol. 91, pp. 436-444.
6. Kliegman, Robert M., et al.Nelson Textbook of Pediatrics (19th Edition).Philadelphia : Elsevier Saunders, 2011.
7. Chiropractic Management of Cow’s Milk Protein Intolerance in Infants With Sleep Dysfunction Syndrome: A Therapeutic Trial. Jamison, Jennifer R. and Davies, Neil J. 2006, Journal of Manipulative and Physiological Therapeutics, pp. 469-474.
8. Mechanism of Sleep Disturbance in Children with Atopic Dermatitis and the Role of the Circadian Rhythm and Melatonin. Chang, Yun-Seng and Chiang, Bor-Leun. 2016, International Journal of Molecular Science, pp. 462-473.
9. Long-Term Effects of Infant Colic: A survey comparison of Chiropractic treatment and nontreatment groups. Miller, Joyce E. and Phillips, Holly Lane.2009, Journal of Manipulative and Physiological Therapeutics, pp. 635-638.
10. Management of musculoskeletal dysfunction in infants. Yao, Dan, Deng, XingQiang and Wang, MingGuang. 2016, Experimental and Therapeutic Medicine, pp. 2079-2082.
11. Chiropractic care of a pediatric patient with symptoms associated with gastroesophageal reflux disease, fuss-cry-irritability with sleep disorder syndrome and irritable infant syndrome of musculoskeletal origin. Alcantara, Joel and Anderson, Renata. 2008, Journal of the Canadian Chiropractic Association , pp. 248-255.
12. Osteopathic Manipulative Treatment for Pediatric Conditions: A Systematic Review. Posadzki, Paul, Soo Lee, Myeong and Ernst, Edzard. 2013, Pediatrics, pp. 140-152.