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Sleep and toddlers - Sarah Blunden


Sleep can be one of the most challenging issues for parents. In the toddler years parents may be unsure about how much sleep their child needs, and when, and how to tell if they are getting enough sleep.

Dr Sarah Blunden is a sleep researcher and clinical psychologist who works with parents, teens and children around sleep. On behalf of Parenting SA, Dr Blunden helps parents understand the sleep needs of toddlers, what affects this and how to help them develop good sleep routines.

The Parenting SA website also has a broad range of Parent Easy Guides for parents of children aged 0 to 18 years.

Transcript

Hello there, my name is Sarah Blunden. I am a sleep researcher and a clinical psychologist and I work with children, teens and their families around sleep. I am going to give you some helpful hints today about sleep and toddlers.

When trying to understand about sleep and toddlers it is helpful to understand about their development in general. Toddlers are in the time of their life when they are searching for more independence. They want to be separate from their parents but they really want to be with their parents. So it is a time of a lot of behaviour change.

Young toddlers need somewhere between 12 and 14 hours sleep in a 24 hour period. That means overnight as well as the daytime naps. An older toddler may need somewhere between 10 and 13 hours over that period, again between the night time sleep and daytime naps. And the reason why that is not very precise is because every child is actually very different and therefore we have a range of sleep rather than a magic number.

Of course as toddlers get older their sleep will decrease little by little, and usually by age of 5, when toddlers are going to school, they won’t be napping at all.

Probably the best way to find out whether your toddler is sleeping well enough is to see what they feel like when they wake up in the morning. If they wake up and they are bright eyed and bushy tailed, and they are ready to take on the day, and they are happy, they have probably slept enough. I think parents can probably tell if the toddler wakes up and they are a bit grumpy and tired. Then they haven’t slept enough.

The most common type of sleep problems in toddlers revolve around really the fact that toddlers do not want to sleep by themselves. They don’t want to be alone at night time and so they often have bedtime refusal, bedtime resistance and tantrum behaviour at bedtime. This is because they do not want to be by themselves. Accompanying that problem might be that parents would stay with the child until they get to sleep, or the child might sleep in Mum and Dad's bed, or there might be something or someone else that might stay with the toddler to keep them asleep. And that means that the toddler depends on those things to be able to get to sleep. Now of course that happens at the beginning of the night but also during the night when they wake up.

One of the big problems that parents perceive in toddlers is the fact that they wake up a lot at night, but that actually is very normal. Toddlers wake up a lot overnight and so it’s not really the problem of waking up, it’s actually what happens when the toddler wakes up. Parents need to re-establish those same associations overnight. Such as perhaps them, or perhaps a bottle or even a breast feed to sleep.

Another major problem that toddlers have in sleep is when they have scary dreams and nightmares, or when they have perhaps sleep talking and sleep walking. When a toddler wakes from a scary dream or nightmare they will need comfort from parents because they have had a scary dream and they don't understand the difference between reality and a dream. One of the difficulties is telling the difference between nightmares and night terrors. In fact night terrors are the same as sleep talking and sleep walking, only just worst. A night terror, or sleep walking or sleep talking, happens when a child is in very deep sleep and a night terror or sleep walk is a phenomena that happens during that deep sleep. When parents try and comfort their child the child actually won’t respond and that is because they are very much asleep. That is very different to a nightmare which is a dream. A child will wake, be frightened and require comfort. In a night terror that often won’t work.

If your child is having what you think might be a night terror, the best way to tell is to stand next to the child, make sure they are safe, stand with them, but if they do not respond to your presence they are probably not awake. In which case they probably are having a night terror, and if you stand next to them and keep them safe they most probably will go back to sleep by themselves. One of the big problems at this age of course is that toddlers become fearful at night and those toddlers need your help to be able to be brave enough to sleep by themselves.

A final problem with toddler sleep is when their bedtimes or their wake times is actually quite different from day to day. It is really important that the sleep times and wake times stay quite the same. If we have a toddler who sleeps at 7 o’clock one night and 9 o’clock the next night, it is very unhelpful for sleep and for sleep health.

Sleep is very important for all areas of general health. One of the main areas that is affected by poor sleep in toddlers is cognition. This is their thinking, their learning, how they remember, how they concentrate, how they problem solve.

Another area that is affected when toddlers do not get enough sleep is emotional. Their emotions become very volatile, they are irritable, they can be aggressive, they can be hyperactive, they can’t concentrate and they certainly can’t make a decision. We know problem solving and decision making in toddlers is difficult anyway.

The third area that is affected by poor sleep in a toddler is behaviour. Their behaviour can become more erratic, more irritable, they can become hyperactive, they can even become aggressive.

The final area that is affected when toddlers do not get enough sleep is physical activity. They tend to have more accidents, they tend to break more bones, they find themselves at the doctor more often and they are more likely to be overweight, eat junk food and not do physical activities.

So what can you do to try and help your toddler get good sleep? The first thing is to probably try and help your toddler be an independent sleeper so they can learn to self sooth and get to sleep without you, or any other thing that they can’t do themselves. They need your help and support to do that because they might be frightened and they are not feeling very brave, they want to be with you. We can teach our toddlers how to sleep alone and independently just like we can teach them to brush their teeth.

If a parent is staying with a child to go to sleep then we can withdraw from their room slowly and surely, rewarding them for their efforts to be brave while they are waiting. If they need something, like perhaps a bottle to get to sleep, perhaps we can help them to help themselves to their own little sippy cup. They then become more independent. They like that and we reward them for their braveness.

We have to help our toddlers to have regular sleep patterns, that their bedtimes and wake times are fairly similar from day to day, and from morning to morning. Having a calming and soothing bedtime routine is very important, and that could be something like having a bath, going to the bedroom, reading some books, lying on the bed together and telling some stories.

So in summary sleep is very important for toddlers. The amount of sleep they need changes as they get older and varies from child to child. Sleep is very important for cognition, emotions, behaviour and physical activity. If you think your child has a sleep problem, get some help.

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