Sleep in infancy: Healthy babies born on time usually sleep for a total of 16 hours. However, in 16 hours of sleep, waking periods are observed at 2-4 hour intervals during the day and night. The reasons for waking the newborn from sleep may be due to nutritional needs, the biological circadian rhythm not yet well developed, or other reasons. While the day-to-day changes in newborn sleep are rather vague, with weeks and months the changes in sleep duration and organization become more striking. With the maturation of the brain, environmental and social stimuli begin to be perceived better; sleep time gradually lengthens and turns into night sleep. Consolidation (consolidation) of newborn sleep, which is characterized by divisions in short periods, into night sleep is called settling. Most of the healthy three-month-old babies have long night sleeps; these sleep periods can only be interrupted for short periods of time for feeding purposes. Although night feeding is not a biological need in 5-6 month old babies, it can continue as a learned behavior in some. Teething and separation anxiety are possible factors that disrupt sleep in babies aged 6 to 12 months. Only 10% of 12-month-old babies have interruption in night sleep.
In the second and third months, with the maturation of the circadian rhythm, the newborn’s polyphasic sleep/wake pattern begins to transform into longer daytime wakefulness and nighttime sleep. While the longest sleep period in a two-week-old baby is 4 hours, it is 7 hours in a 5-month-old baby. Between 5 and 12 months, the duration of sleep tends to remain constant. Most babies aged 6 to 9 months now sleep all night. During this period, night sleep is about 10-12 hours; In addition, daytime naps are observed 2-3 times for a total of 2-4 hours. Daytime naps decrease as the child’s age increases. While an average of 3.5 daytime naps is observed in the newborn, it is an average of 2 times in 12 months of age. Night waking decreases with increasing age; A 1-month-old baby wakes up about 2.5 times, while the 12-month-old averages less than 1 time. In addition, the night waking periods are shortened.
Sleep in neonatal and pre-school period (1-5 years): Actigraphy studies show that 12-month-old children usually sleep at 20:00, while 18-month-old-5 year olds sleep between 21:00 and 21:30. has shown. In the first 5 years, the time to wake up is usually at 7. As age increases, the amount of sleep decreases in toddlers and preschoolers. A 3-year-old sleeps an average of 13.2 hours; The average for a 4 year old is 11.8 hours. In the second age, daytime sleep is observed once; In many children, daytime sleepiness disappears by the age of 3 years. The main factors affecting the disappearance of daytime sleepiness are starting kindergarten, school programs, cultural preferences, parental expectations, family routines and individual differences. Nighttime awakenings are common in toddlers and preschoolers. Sleeping with parents or siblings during this period is common in some cultures. In the case of co-sleeping, conflicts about waking up at night and going to sleep are more frequent. Various factors can affect night waking; however, when the child wakes up and goes to sleep on his own without the help of the parents, it determines the continuity of this situation or whether it will be a problem for the parents.
Middle childhood/pre-adolescent sleep: Total sleep time continues to decrease in the school age, pre-adolescent period. A 5-year-old sleeps an average of 11.4 hours, while 8-10-year-olds sleep about 9-10 hours. A 12-year-old sleeps an average of 9.3 hours. Daytime sleepiness is rare during this period. Daytime sleepiness often indicates a lack of nighttime sleep or another sleep disorder. As the child gets older, the time to go to bed is delayed, but the time to wake up in the morning is mostly influenced by the school schedule. Compared to younger children, children in middle childhood have more morning sleepiness with less sleep. This suggests that the need for sleep continues despite a decrease in sleep duration. In addition, girls between the ages of 4-12 sleep a little more than boys.
Sleep in Adolescents: During adolescence, the amount of sleep continues to decrease. While 13-year-olds sleep an average of 9 hours, 16-year-olds sleep 7.5-8 hours. In one study, adolescents rated that they slept about 30 minutes less compared to actigraphy results. Although there is a gradual decrease in sleep duration during adolescence, it has been reported that the mean time to sleep in MSLT test decreases sharply in the early stages of healthy adolescence and remains low in later adolescence periods. This suggests that the need for sleep in adolescence continues as in previous years. During the onset of puberty, a shift in sleep/wake pattern is observed with a decrease in total sleep time. Adolescents sleep later and wake up earlier. School-related expectations and school hours are often the cause of this condition. In adolescents, sleeping late, doing homework, doing activities outside of school, entertainment activities (TV; computer; internet; mobile phone), working at a job, making the decision to go to bed with the decrease of parental authority are associated with changes in sleep/wake patterns. In addition, adolescents consume three times more caffeinated beverages than pre-pubescent children, which can disrupt sleep. Intake of certain medications (eg, stimulants) and alcohol/substance use may adversely affect adolescent sleep. On weekends and holidays, many adolescents sleep late and wake up late. For example, in late adolescence, there is an average of 1-2 hours of sleep on the weekend compared to weekdays. Weekend wake-up time delay is 1.5-3 hours for middle school age children compared to weekdays, while this difference is 3-4 hours for high school age children. These data show that adolescents tend to go to bed late and wake up late. Irregular sleep habits may contribute to sleep disorders in some adolescents.
The presence of parents during going to sleep, making changes in sleep hours, going on a vacation/journey, sleeping together, excessive permissive and unlimited parental attitudes, conflicting attitudes between parents, unrealistic parental expectations and pre-sleep The child’s feeding/breastfeeding can affect night wakings and are caregiver issues. Similarly, insecure mother-child attachment, parental anxiety and depression are risk factors for night awakenings in young children.
Medical conditions (e.g., reflux, pain, infection, allergies, restless legs syndrome, separation anxiety, teething, oppositional defiant disorder, drug use), acquisition of typical developmental stages (e.g., night time with the acquisition of imagination skills) fears may increase; with the increase in the need for autonomy and independence, it may develop resistance to sleeping at night), the child’s biological rhythm (night owls) and parental expectations in terms of sleep cycles, the child’s difficult temperament may negatively affect his ability to sleep, wake up frequency or self-soothing ability, and it may affect more children. are related factors. Environmental features such as the quietness of the sleeping room, the appropriate temperature and light, and the comfort of the bed may affect the child’s sleep.
Children and adolescents who have sleep problems should be evaluated by a child and adolescent psychiatrist.
