Sleep in Infants and Young Children: Part One: Normal Sleep

Katherine Finn Davis RN, MSN, CPNP; Kathy P. Parker PhD, RN, FAAN; Gary L. Montgomery MD


J Pediatr Health Care. 2004;18(2) 

In This Article

Abstract and Introduction

The importance of sleep to overall health and well-being is becoming increasingly appreciated; however, clinicians may not have a sound understanding of the fundamentals of sleep. This review of normal pediatric sleep is meant to provide a foundation for the pediatric nurse practitioner to develop and use in clinical practice. Key concepts such as normal sleep physiology including biological rhythms and stages of sleep are discussed. Developmental changes in sleep seen in the transition from infancy to young childhood are highlighted, and strategies for instituting and maintaining normal sleep behaviors are recommended. Part 2 of this series will address common sleep problems experienced by young children.

Optimal sleep is essential for normal growth and development, emotional health, and immune function. Parents often have concerns regarding their child's sleep. However, clinicians are often ill prepared to handle these issues. The lack of adequate education in the area of sleep is a concern that has only recently gained recognition. Most nursing undergraduate programs offer minimal pediatric sleep education. Sixty-three percent of undergraduate programs were found to offer 1 hour or less of instruction on normal sleep, and 56% provided 1 hour or less of instruction on sleep disturbances. At the graduate level, programs average only 5 hours of classroom instruction on sleep and sleep disorders, and 17% of programs provide no instruction in any form (Report of the National Commission on Sleep Disorders Research, 1993). Additionally, a 1994 national survey of 156 pediatric residency programs reported that physicians obtain an average of only 5 hours of didactic instruction in pediatric sleep during the entire 3-year residency. Even more disturbing was the fact that more than 50% of programs offered no classroom educational opportunities at all (Mindell, Moline, Zendell, Brown, & Fry, 1994).


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