David C. Rettew, MD, is a child psychiatrist at the UVM Medical Center, where he is Director of the Pediatric Psychiatry Clinic.

Kids need sleep. Without enough of it, they are at increased risk for behavioral problems, attentional difficulties and even obesity. The amount of sleep a child needs is variable and generally depends on the child’s age. The National Sleep Foundation reports that, on average, children need the following amount of sleep:

  • Below 12 months of age:  more than 14 hours per day
  • 1-3 years:  12-14 hours per day
  • 3-5 years:  11-13 hours per day
  • 5-12 year:  10-11 hours per day
  • Adolescents: 8-10 hours per day

Many children have trouble getting or staying asleep. More and more parents are turning to medications and over-the-counter pills such as melatonin. While some studies show that they are generally safe and effective in the short term, their long-term safety has not been established and many parents report that they lose their efficacy over time, resulting in higher doses or switches to more powerful agents.

Before considering this path, it is worthwhile to think about family sleep practices, often called sleep hygiene. Of particular significance to children are the following items that can markedly improve sleep without resorting to pills.

  • Exercise. Kids weren’t designed to sit around on the couch all day, and parents shouldn’t be surprised when more sedentary children don’t feel tired at night. Start early in enforcing regular exercise and limits on television and video games.
  • Caffeine. Most parents know about coffee and cola, but caffeine can be found in many other food products from chocolate to other types of soda. These items can make it very difficult to fall asleep.
  • Bedtime routines. While a slightly later bedtime at night on weekends and vacations is probably okay, most kids get to sleep better when their bedtime is consistent and part of a nightly routine.
  • Sleeping environment. Keep TVs and computers out of child bedrooms, and have good shades on the windows. Temperature, noise, and the mattress can all play a role in making an optimal environment for sleep.

Following through on improving a child’s sleep hygiene can be challenging but often extremely effective. If problems persist, it is worth talking to your child’s doctor to get further advice and coaching and ask whether consultation with a sleep expert might be indicated.

David C. Rettew, MD, is a child psychiatrist at the UVM Medical Center, where he is Director of the Pediatric Psychiatry Clinic.  He is also Director of the Child & Adolescent Psychiatry Fellowship and an associate professor of Psychiatry and Pediatrics at the Larner College of Medicine at UVM.


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