18 January 2017
At Westchester Health Pediatrics, one topic that seems to cause parents more angst than almost any other is sleep. “Is my baby/toddler/adolescent/teenager getting enough sleep?” is something we get asked just about every day. Our answer? It depends on the age of your child.
A helpful rule of thumb is: if your child wakes up groggy or is overly sleepy during the day, he/she is not getting enough sleep. If this is happening consistently, consider making his/her bedtime earlier.
Although there is no magic number for how much sleep your child needs, knowing how much sleep most children your child’s age should be getting can help you gauge your child’s sleep requirements. To help parents do this, we’ve created the following sleep guidelines grouped by age of the child. Hopefully, maybe now everyone can rest a little easier!
Children’s sleep needs
1-4 Weeks Old: 15-16 hours per day
Newborns typically sleep about 15-18 hours a day in short periods of 2-3 hours. Premature babies may sleep longer and colicky ones shorter. Since newborns do not yet have an internal biological clock (as any parent of a baby can tell you), their sleep patterns are not in tune with daylight and nighttime cycles.
1-4 Months Old: 14-15 hours per day
By 6 weeks old, babies begin to settle down a bit and start developing more regular sleep patterns. The longest periods of sleep run 4-6 hours and tend to occur more regularly in the evening. For the most part, the confusion between daytime and nighttime ends.
4-12 Months Old: 14-15 hours per day
While 15 hours of sleep is ideal, most infants up to 11 months old typically sleep about 12 hours. Establishing healthy sleep habits is a primary goal during this period, as babies are now much more social and their sleep patterns start to become more adult-like.
Regarding naps, babies typically take three naps at this age, dropping down to two around 6 months old, at which time (or earlier) they are physically capable of sleeping through the night. Establishing regular naps generally happens at the latter end of this time frame as their biological rhythms mature. Midmorning naps usually start around 9am and last about an hour. Early afternoon naps start between noon and 2pm and last an hour or two. And late afternoon naps may start anywhere from 3-5pm, varying in length.
1-3 Years Old: 12-14 hours per day
As a child matures toward 18-21 months of age, he/she will likely lose the morning and early evening nap and nap only once a day. While toddlers need up to 14 hours a day of sleep, they typically get only about 10. Most children from about 21-36 months of age still need one nap a day, which may range from one to 3½ hours long. They typically go to bed between 7-9pm and wake up between 6am and 8am.
3-6 Years Old: 10-12 hours per day
Children at this age typically go to bed between 7-9pm and wake up between 6-8am, just as they did when they were younger. At age 3, most children are still napping, while at age 5, most are not. Naps gradually become shorter, too. New sleep problems do not usually develop after age 3.
7-12 Years Old: 10-11 hours per day
At these ages, with school, sports, music, clubs, hobbies and family activities, bedtimes gradually become later and later, with most 12-years-olds going to bed around 9pm but this can range anywhere between 7:30-10pm. There is also a range of total sleep time (9-12 hours) although the average is only about 9 hours.
12-18 Years Old: 8 – 9 hours per day
Sleep is just important for a teenager’s health and well-being as it is for younger children, maybe more so. It turns out that many teenagers actually may need more sleep than in previous years, but for most of them, school, sports, dating and other commitments take precedence, routinely robbing them of the proper amount and quality of sleep.
Negative consequences of not enough sleep
The reasons for your child getting a good night’s sleep go well beyond grumpy moods. If he/she is not sleeping well, or not sleeping enough, this could translate into problems with behavior, attention, learning and memory. Less sleep, especially under 4 years old, has also been found to increase hyperactivity-impulsivity and lower cognitive performance on neurodevelopmental tests. Also, there is growing evidence that not getting enough sleep results in metabolic changes that may contribute to the development of obesity, insulin resistance, diabetes and cardiovascular disease.
According to a 2008 study from Johns Hopkins University, for each additional hour of sleep, the risk of a child becoming overweight or obese was lowered on average by 9%. The study also found that children who slept the least had a 92% higher risk of being overweight or obese compared to children with longer sleep duration.
Is your child getting enough sleep? Take this test.
If you answer yes to all of these questions, your child is getting enough sleep:
- My child falls asleep in less than 20-30 minutes of bedtime.
- My child wakes up easily in the morning at the expected time.
- My child appears well rested during the day.
- My child stays awake without taking a nap during the day (for children who have outgrown a daytime nap).
- My child stays awake during quiet activities, such as driving in the car or watching TV.
If you answer yes to any of these questions, your child is not getting enough sleep.
- My child has a hard time waking up in the morning.
- My child falls asleep after being woken up and needs to be awakened repeatedly.
- My child yawns frequently during the day.
- My child complains of feeling tired.
- My child prefers to lie down during the day, even if it means he/she will miss activities with friends and families.
- My child wants to nap during the day.
- My child lacks interest, motivation and attention.
- My child falls asleep or seems drowsy at school or at home during homework.
When you should take your child to the doctor for a sleep problem
We recommend that you take your toddler or preschooler to the doctor if he/she has any of the following:
- medical problems or pain that is affecting sleep
- persistent and loud snoring or pauses or problems with breathing while sleeping
- seems irritable, hyperactive, inattentive or sleepy during the day
- excessive anxiety about being separated from you during the day and night
- problems with sleep that developed suddenly
- problems changing from two naps to one nap a day
- night terrors, sleepwalking, or nightmares that happen often
Take your child to the doctor if he/she has any of the following:
- your child’s teacher tells you he/she seems tired even though you think your child is getting enough sleep
- new night terrors or sleepwalking that he/she didn’t have before 6-7 years old
- a need for regular naps
- loud snoring, breaks in breathing or extreme restlessness at night
Take your teenager to the doctor if he/she has any of the following:
- excessive sleepiness during the day
- lower grades in school
- you suspect a mood disturbance
- concerns about sleep or daytime performance
If you’re concerned that your child is not getting enough sleep or is developing sleep issues, please come see us
If your child’s sleep is becoming an issue for your child and your family, please make an appointment with Westchester Health Pediatrics to come in and talk to one of our pediatricians. We will meet with you and your child, examine and diagnose the problem, and together with you, decide on the best course of action so that hopefully everyone can rest easy.
By Jacklyn Alfano, MD, FAAP, Pediatric Physician with Westchester Health Pediatrics, member of Northwell Health Physician Partners