Importance of sleep:

Sleep is a dynamic process that includes two main types: non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. Each night, children cycle through these stages, with each lasting about 90 to 120 minutes. These cycles are crucial for physical, emotional, and cognitive development and restoration. 

NREM sleep has three stages, each having different depths of sleep and restorative functions. Stage 1 transitions a person from wakefulness to light sleep. During this stage children can be easily awakened. Stage 2 is a deeper stage of sleep that involves a drop in body temperature and a slowing heart rate, making up about 40-50% of sleep time. The brain becomes less active. Stage 3, or deep sleep, is the most restorative, where tissue growth and repair occur, and the immune system is strengthened, comprising about 20-25% of total sleep time. During deep NREM sleep, the brain is at rest and the body focuses on restoration.

REM sleep is something entirely different. During REM sleep, the brain is highly active, with vivid dreaming occurring. REM sleep is vital for brain development and cognitive functions. This enhanced brain activity aids learning, memory consolidation, problem-solving, and emotional regulation. Proper REM sleep also supports academic performance, emotional health, and creativity.



In children REM sleep enhances imaginative skills and fosters problem-solving. By processing information and experiences from the day, REM sleep helps children consolidate new learning, enhance problem-solving skills, and retain memories, which is essential for academic performance and cognitive development. REM sleep stimulates neural development, affecting everything from motor skills to language acquisition.

Another significant aspect of REM sleep is its contribution to emotional health. During REM sleep, the brain processes and regulates emotions. This activity is especially important for children and adolescents, who are continually encountering new social experiences and emotional challenges each day. Adequate REM sleep may contribute to better emotional regulation, reducing feelings of anxiety and stress, and supporting mental well-being. The opposite is also true, sleep deprivation can lead to emotional problems and depression as the brain is deprived of this important stage of sleep. Dreaming helps kids process the events of the day in positive ways.

REM sleep is also vital for creative thinking and insight. The brain’s unique pattern of activity during REM helps in forming connections and associations between unrelated pieces of information, enhancing creativity and potentially leading to innovations in thinking. For children, who are naturally curious and constantly learning new things, this stage of sleep can foster imaginative skills and creative problem-solving.

As children grow, their sleep patterns change. Over time a child’s REM sleep decreases and their NREM restorative sleep increases. REM sleep supports brain connections, cognitive skills and mental health while NREM sleep promotes restorative activities of the tissues of the body while the brain rests. Both types of sleep are crucial to good health. All these factors underline the importance of both REM sleep and NREM sleep as cornerstones of both physical and mental health.

In babies, as they sleep each night, time in deep NREM sleep decreases throughout the night, and the proportion of REM sleep increases with each subsequent sleep cycle, thus supporting emotional and cognitive well-being. This balanced distribution of sleep stages ensures that children get the restorative benefits of NREM sleep they need for healthy growth and functioning and the stimulation of the brain that REM sleep affords. As you can see, children need their sleep!

Not Sleeping Through the Night:

“Why doesn’t my baby sleep through the night?” is a question that we are asked many times in our practice. Most parents do not realize that it is their (the parents) behavior in the vast majority of cases that is responsible for their infant or child’s nighttime awakening.

Attention to three areas of parental behavior can cure the vast majority of nighttime awakening. Most children, especially during the first year of life, awaken up to four to five times each night as they progress through the different stages of NREM and REM sleep, even though the parents may not be aware of this night time awakening. However, most of these children can put themselves back to sleep without parental help.

Children who have not learned to master this will cry for their parent. If you provide too much attention, your child will become dependent upon you for returning to sleep. Children with this behavior are known as trained night criers.

Usually, the child will be rocked to sleep by his parent and placed in bed asleep. Then, the parents will tiptoe out of the room to make sure not to wake the baby as the baby is in Stage 1 NREM sleep and is easily arousable. Whenever the child awakens, the parent will immediately come back into the room and re-rock the child to sleep again. This pattern is repeated over and over, making for exhausted parents and children alike.

Infants who are fed at night when they wake up are called trained night feeders. It is only during the first two to four months of life that a child may need to be fed at night. From birth to two months of age most babies normally awaken two times per night for feedings. Between two and three months of age, most babies will need one middle of the night feeding. By four months of age, over 90% of infants can sleep more than eight hours consecutively without feeding. Only premature and small newborn infants need to be awakened for nighttime feedings. You should let your child sleep through the night if he will, especially after four months of age.

Fearful night criers are children who are fearful or who panic when the parent leaves the room. Many times, these children will becomes extremely manipulative, crying until they vomit, or crying nonstop for hours. These children do not tolerate separation from their parents very well. Most parents feel guilty about letting them cry and will give in to their bedtime demands.

The child, thus, “rules the roost” and parents have a great deal of difficulty in disciplining them. Many times fearful night criers turn into young children who throw tremendous temper tantrums. This is most likely due to a lack of discipline. Events surrounding bedtime are extremely import- ant in your child’s discipline.

Some children have aspects of trained night feeders, trained night criers, and fearful night criers in the cause of their sleeplessness. We recommend that you take the following steps to promote healthy sleep habits for your child.

1. Put your child to bed while he is awake. It is disorienting to a child to go to sleep in his mother’s arms in a rocking chair during a feeding and then awaken in his crib without his mother being present. The last memory of your baby before he goes to bed should be of his crib, not of you, your breast or the bottle.
2. Don’t feed your baby at night. If your baby is four months of age or older, he does not require nighttime feedings. If he awakens at night and demands something to eat, give him water only, and after a few days discontinue this. It is OK to feed your baby prior to going to sleep, but do not let your baby keep his bottle in the bed and use it as a pacifier. Offer him a pacifier instead. You should increase the daytime feeding intervals to at least every three hours. A child that feeds every two hours in the daytime cannot be expected to make it eight to ten hours at night without feeding.
3. Have your child sleep in his own bed in his own room. Letting the child sleep with you in your bed or having the crib next to your bed is not a good idea. This will further foster your baby’s reliance on you for normal sleep.
4. Eliminate long daytime naps. If your baby has slept for more than two to three hours, you should awaken him. If he is taking several naps per day, you should try to decrease that number.
5. Don’t change your baby’s diaper during the night. Babies can survive until morning with a wet diaper. Of course, if the diaper is soiled or if you are treating a diaper rash, you can change it. 6. Keep the room dark. Most of the time if a baby cannot see anything he will go back to sleep.

To convert your baby from a trained night feeder, a trained night crier, or a fearful night crier to a child who sleeps all night will require patience and diligence on your part. We realize that if you institute the measures outlined above, this will more than likely initiate crying at bedtime for your child. We recommend not giving in to your child’s wants but forcing him to conform to the above pattern. This will enable your child to develop healthy sleep habits that will last a lifetime.

We do not recommend letting your child scream for hours on end without comforting and consoling him. Usually, we would recommend that you check on your child periodically while he is crying to make sure that he is OK. You should comfort your child, but do not turn a light on, nor entertain him. Once the crying has subsided, you should leave the room again. You should not pick up your child while you are trying to retrain his sleep habits. Usually, within a very few days of the above treatment, your child will be sleeping all night long.

Other problems associated with:

Night terrors

Obstructive sleep apnea

Snoring

Wetting the bed