Sleep in Childhood

Sleep is rapidly reversible state of reduced responsiveness, motor activity and metabolism. The sleep structure is a highly organised progression directly related to maturation and development of the brain. Circadian rhythms or the sleep wake cycle are regulated by light and dark and these rhythms take time to develop, resulting in the irregular sleep schedules of newborns. The rhythms begin to develop at about six weeks, and by three to six months most infants have a regular sleep-wake cycle.

Sleep is especially important for children as it directly impacts mental and physical development.

Function of sleep

  • Rest and Restoration
  • Repair and growth
  • Learning & memory consolidation

Normal sleep requirements

Sleep duration recommendations by age from the National Sleep Foundation

Consequences of insufficient sleep

  • Excessive daytime sleepiness
  • Fatigue, lethargy and bodily complaints
  • Impairment of mood, behavioural control
  • Impairment of cognition, vigilance
  • Declining performance in school, sports  and games
  • Compromised immune system and affected appetites
  • Overuse of potentially harmful alertness-promoting agents e.g. caffeine, nicotine
  • Increased risk-taking behaviour, injuries including sports, occupational and motor vehicle injuries
  • Increased risk of poor cardiovascular and metabolic health e.g. hypertension, diabetes, heart disease

Sleep and Medical disorders

Many medical conditions can disrupt sleep for example:

  • Asthma
  • Allergic Rhinitis
  • Atopic Eczema
  • Gastro oesophageal reflux
  • Epilepsy, Scoliosis and Neuromuscular disease
  • Developmental disorders
  • Psychiatric disorders

Optimal management of the associated medical problem can reduce disruption of and improve quality of sleep.

Does your child have a problem?

This checklist helps elucidate possible sleep problems in your child:

Bedtime problems

  • Does your child have any problems going to bed? Falling asleep?

Excessive daytime sleepines

  • Does your child have difficulty waking in the morning; seem overtired or sleepy a lot during the day?
  • Does she still take naps (inappropriate for age)?

Awakenings during the night?

  • Does your child seem to wake up a lot at night? Do they have trouble getting back to sleep?
  • Any sleepwalking or nightmares?

Regularity and duration of sleep

  • Does your child have a regular bedtime and wake time? School days? Weekends?
  • Do you think he/she is getting enough sleep?


  • Does your child have loud or nightly snoring or any breathing difficulties at night?

When should you see the child sleep specialist?

  1. When the sleep problem is:
    • Unusual
    • Frequent and disruptive
    • Associated with daytime symptoms
  2. When there is habitual snoring
  3. When there are concerns or doubts

Dr Jenny Tang
Asthma, Lung, Sleep & Allergy
SBCC Asthma, Lung, Sleep & Allergy

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