Help child adjust sleep schedule in time for school

Each month physicians from ProMedica, Mercy Health Partners, and the Toledo Clinic will write columns about health matters.

Ready for the start of a new school year?

Summer is a great time to learn something about your child's sleep habits and needs. As the days get longer and family rules are a bit more relaxed, what time do your children naturally gravitate toward sleep? Without alarms and school buses to disturb their morning slumber, what time do they spontaneously wake up? And in what kind of mood? Think about these points and you'll get a feel for two of the main principles that govern your child's sleep: sleep quantity and sleep rhythms.

The amount of sleep a child needs is a function of age and developmental status. Most elementary schoolchildren need at least 10 hours of sleep per night, and adolescents need at least nine. Across all age groups, national surveys indicate that children are routinely getting one to two hours less per night than they truly need. This is particularly true during the school year, when countless after-school activities and commitments gradually erode the amount of time for nighttime sleep.

With most schools starting around 7:30 to 8:30 a.m., squeezing in nine or 10 hours of sleep demands a bedtime between 8:30 to 9:30 p.m. While you might convince your third-grader to give this a try, the parent of any teenager can clearly describe the struggles that lie ahead. Not only are high school students routinely busier in the evening hours, but their biological rhythms are "phase delayed," so the brain mechanisms that trigger the onset of sleep don't typically kick in until around 11:00 p.m.

The human circadian system, or the internal "human clock," operates on chemical rhythms that tell your body when to sleep and when to be awake. These rhythms develop out of consistent schedules and are quite difficult to change, especially in the direction of moving things backward. Two summer months of a delayed sleep schedule can ingrain things rather deeply. Therefore, adapting to a new school schedule requires one to three weeks of "prep time," depending on the magnitude of the shift that's necessary before the start of school.

Intuitively, most parents focus their attention on setting a new (earlier) bedtime. This approach falls short when we realize that nobody can make another person fall asleep. What we can do, however, is wake someone up … and this is where parents should exert their first attempts at change. Set a consistent (early) morning wake time and stick to it seven days a week. Keep your child busy all day in an effort to prevent any daytime napping. Encourage, but don't demand, an earlier bedtime for the first few days. Several nights of inadequate sleep, combined with no daytime napping, creates a temporary condition of sleep deprivation. This then strengthens the drive to sleep at an earlier time in the evening, and the new bedtime will naturally fall into place.

Smaller shifts (less than 90 minutes) can often be accomplished by gradually advancing the child's bedtime in the two weeks prior to the start of school. Determine the "summer bedtime," then advance the bedtime in 30 minute increments until you reach your desired school bedtime. Allow the child to adapt to each new bedtime for four or more days, depending on how much of a shift you're making and how many days you have before the start of school.

Although the process can be trying, the benefits of a good night's sleep are worth the effort. Research shows that a sleep-deprived child experiences a host of cognitive deficits, including impaired attention, concentration, memory, judgment, problem-solving, decision-making, and overall mental acuity. Clearly this places the child at a distinct disadvantage for academic success. From a behavioral perspective, chronic sleep deprivation has been linked to impulsivity, aggression, moodiness, and interpersonal conflicts.

So, what can parents do to help?

First, prioritize sleep in your household. If you're a poor role model for sleep, your child will quickly follow suit. Establish a consistent bedtime and resist the impulse to alter it based on social pressures. Limit after-school and evening commitments for you and your kids to avoid running into the inevitable end-of-the-day time crunch.

Second, allow for "down time" an hour or two before bedtime for everyone to unwind from a stressful day. Remember that relaxation — the best prescription for a good night's sleep — starts before bedtime, not at bedtime.

Third, help your child create an environment that's conducive to good sleep. Make sure their bedroom is comfortable, dark, and quiet; and remove as much "technology" as possible (cell phones included!).

Last, avoid the temptation to allow your child to "sleep in" on Saturday and Sunday mornings as a way of catching up on lost sleep. This favorite teenage trick does nothing more than to shift the sleep rhythms in the wrong direction, creating trouble falling asleep on Sunday night, and a miserable start to the school week.

Michael Neeb, PhD, is director of Mercy Sleep Services.