I don’t think I am alone when I say that the COVID-19 pandemic has affected the way my children have been sleeping. We are very fortunate to have two toddlers with great sleeping habits and before the stay at home orders started, my 4 year old slept 11-12 hours a night and my 2 year old slept 12-14 hours per day.
Shortly after school was cancelled, my daughter started waking up in the middle of the night and coming into our bed. My son started to drop his 2-3 hour afternoon nap. Since then, we have made some gains and my daughter now wakes up early (6:45-7:00 AM) to come into our bed and my soon naps most days but not all. These changes made me wonder if there was anything I could be doing to help them return to their usual routine.
Sleep is very important in maintaining good health and emotional well-being as well as effective functioning of the immune system. We also know that getting the right amount of sleep is important for children and can help improve attention, behavior, learning, memory, and overall mental and physical health. Guidelines vary but the American Academy of Pediatrics recommend that infants under 1 year old get 12-16 hours, children 1-2 years old get 11-14 hours, children 3-5 years old get 10-13 hours, children 6-12 years old should get 9-12 hours, and teenagers 13-18 years old should get 8-10 hours per night (hopkinsallchildren.org/ACH-News/General-News/The-importance-of-sleep-for-kids).
Different age groups have presented different challenges in maintaining a good sleep schedule. The restrictions imposed by the pandemic have disrupted almost all of our children’s routines and it is no surprise that sleep was affected as well.
It is not all bad news. There are many things we can be doing to help children of all ages optimize their sleep.
- Create a set routine: this should include specific times for school or other activities now that we are going into summer and consistent bedtime and wake times. It is ok if it looks different than how things were before the pandemic. For example, a lot of my teenage patients have greatly benefitted from later bedtimes and wake times (midnight to 10 AM) and their chronic migraines improved or even resolved, which is most likely due to a combination of better sleep and less stress from school.
- Keep nap times: even if nap time seems less necessary now, it is important to keep the routine consistent as mentioned earlier. Even when my son refuses to nap, we still put him down at the same time every day. Some weeks, we have to take him out due to crying and not falling asleep after being in the crib for an hour or more but as time has gone on, he now falls asleep more often than not.
- Address underlying anxiety and questions: this will vary greatly per age group but it is important to keep the conversation open regardless of age. Children may manifest their anxiety by trying to hop into bed with you or ask you to stick around in their room until they fall asleep. Older children or teenagers may look for answers elsewhere. Addressing our own feelings of uncertainty and worry can be helpful for the whole family. Finding time during the day to discuss any issue before bed time can be very helpful in easing recurring thoughts that can interfere with falling asleep.
- Take care of yourself: you have heard this a million times in many different situations. You cannot take care of others in an effective way if you are not doing well yourself. Things I have found helpful include meditation, journaling, avoiding news outlets before bed time, avoiding social media before bed time, and regular exercise.
- Specific challenges: if your child has a hard time falling asleep, you can help create sleep onset associations that are independent from you, such as a teddy bear or blanket. Avoid staying in the room until they fall asleep, as you want your child to be able to fall asleep by themselves. For those children who make a lot of requests (water, potty, hugs) or call backs, try bedtime tickets that can be used for one or two call backs per night and that is it.
Please be kind to yourself and your family. These are trying times for everybody and we are all navigating uncharted territory. The above are suggestions on how to help but every family will look different. I have to admit that I don’t necessarily mind my daughter coming into our bed in the morning to snuggle before I get ready for work, especially when she falls back asleep for another hour or so.
Sweet dreams!
