Building Healthy Sleep Habits in Childhood: An Interview with Dr. Barbara Gnidovec Stražišar

First, Dr. Gnidovec Stražišar, can you tell us a bit about why we should pay attention to sleep in children?

Sleep is one of the pillars of health and well-being for everyone. We know from research that this is especially true for the developing brain where insufficient sleep can lead to cognitive and neurobehavioral problems in children.  We must remember that when children or adolescents have problems with sleep or development, they often impact the quality of life of the whole family.

Insufficient and disturbed sleep has been linked to behaviour and learning problems in children and adolescents as well as with their cardiometabolic health outcomes. Thus, if we can teach good sleep habits in infancy and childhood, we are teaching behaviour that ensures a healthy life into adulthood and hopefully healthy sleep for the whole family.

How can parents help teach good sleep habits from a young age? When is it appropriate to teach sleep habits?

One of the prerequisites for good sleep in all life periods is good sleep hygiene. In case this is a term you have not heard before, sleep hygiene is used to refer to sleep environment and behaviours. It is never too early to consider sleep hygiene. From birth on we should provide a child a proper sleep environment, desirably in a separate bed. We should make sure the mattress is firm, clean and fits tightly into the bottom of the infant`s bed. The room should be dark, well-ventilated and smoke and noise-free.

Parents should aim to develop a regular sleeping routine from infancy that helps babies learn to settle for bed and prepares them for sleep. We should encourage self-soothing behaviour and help children to learn proper sleep onset associations and adhere to sleep schedules with fixed times for bed and wake.

What are some positive sleep onset associations for babies and children?

You can start with lighting. Promoting bright light exposure in the morning and dim light condition in the evening prepares the body for sleep and wake appropriately. Other good sleep habits include omitting snacks before bedtime.
As children age, there will be other obstacles to sleep they will need to deal with. Screens and other bright lights should be avoided before bed. Instead, introduce early afternoon physical activity which has a beneficial impact on sleep. Teach children to abstain from caffeine and energy drinks which might impact sleep quality. To avoid social »jet-lag« during weekends, refrain from staying in bed too long after wakening. In order to keep a positive sleep routine, daytime problems and anxiety should be kept out of the bedroom and resolved before going to bed. Daytime naps should also be avoided, especially in adolescents that often suffer from sleep phase delay.

Finally, how do we help our children become aware of the importance of their own sleep so they want to maintain these healthy sleep hygiene habits?

One suggestion is to encourage them to keep an age-appropriate sleep diary. Either by asking them and writing down yourself, an electronic or paper record of each night`s sleep, going through this activity makes both the parent and child aware of how well or poorly the child is sleeping and if need be, this is the information you will need to have a conversation with a sleep specialist. You can start simple with time of lights out, approximate time of sleep and wake and a self-rating of sleep quality. Awareness is the first step toward improvement.