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

Disclosures

J Pediatr Health Care. 2004;18(2) 

In This Article

Sleep in 1- to 5-Year-Old Children

In comparison with studies of newborn and infant sleep features, very few studies have examined the normal sleep features of toddlers or preschool-aged children. Therefore, adequate or optimal sleep in children is a concept that is not well defined (Dahl, 1995). It is known that rate of change in sleep drastically slows, compared with infancy. The sleep/wake cycle and amount of sleep a child requires is physiologically determined by age and development but is also influenced by individual family schedules. As the child matures, sleep requirements steadily decrease. Total daily sleep need decreases to about 13 hours by age 2 years, 12 hours by age 3 to 4 years, and 11 hours by age 5 years (Roffwarg et al., 1966) (see Figure 1). However, there is considerable individual variability. The majority of the sleep is concentrated in the nighttime hours with an average sleep period of 10 to 12 hours in length (Sheldon, 2002).

Average total daily sleep requirement for infants and young children. (Data from Ferber & Kryger [Eds.]. [1995].)

Daytime naps are still common in this age range and supplement the longer nighttime sleep period to meet a child's total sleep requirement. The average 1- to 2-year-old takes one or two naps. These naps vary in length and timing. However, they are usually short (typically totaling 11/2 hours per day) and occur mid morning and early afternoon. The morning nap is eliminated first, followed by the afternoon nap (Sheldon, 2002). As daytime sleep decreases, total nighttime sleep should increase somewhat in this age group, because 1 hour of daytime sleep is roughly equal to 1 hour of nighttime sleep. In the United States, naps are often given up in the preschool years because of schedule demands and may be considered unusual if still required after age 5 years (Anders et al., 1995; Dahl, 1998 and Ferber, R, 1995). However, these schedule demands, at times, are in conflict with the child's physiologic need for additional sleep.

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