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

Sleep-Promoting Strategies

Normal, healthy sleep/wake patterns are dependent on consistent daytime and nighttime routines that match the child's physiologic and developmental sleep requirements. Adhering to a consistent routine in preparation for bedtime and "lights out" time, as well as consistent morning wake time, naptimes, and feeding/meal times, are of particular importance. These routines help strengthen the child's circadian and homeostatic processes and reduce the likelihood that the child will suffer from insufficient sleep. Children thrive on consistency and routine, and if firm limits are set, bedtime struggles will be unusual. The child's bed should be treated as a place for relaxation and sleep. Therefore, play should not be allowed in the bed and the bedroom should not be used as a place of punishment. During the day, caffeine intake (ie, chocolate, tea, and cola) should be limited, especially after lunchtime. Caffeine can delay sleep onset, reduce total sleep time, and increase the amount of light sleep. These effects of caffeine can last greater than 8 hours (Mendelson and Caruso, 1998 and Roehrs and Roth, 1997). Near bedtime, active play, exercise, and stimulating television and computer programs should be avoided. Bedtime routines such as bathing, reading stories, and brushing teeth in a calming, unhurried manner with a loving yet firm and consistent approach that includes some "one on one" special time with the parent fosters security and promotes the child's ability to fall asleep independently. If positive interactions with parents occur at bedtime, children will often look forward to this time rather than struggling and resisting. The bedroom environment is also important; the child's room should be as dark as possible, the temperature comfortable (not too warm), and noise kept to a minimum to enhance sleep onset and maintenance. Of course, if the child feels more comfortable with a night light, one should be provided, and many young children enjoy the comfort of a transitional object such as a special toy, doll, or blanket.


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