Early Childhood: Ages 5-9
PILLAR FOUR: SLEEP
Adequate sleep helps to reduce the risk of obesity for both adults and children.
The National Sleep Foundation recommends nine to 11 hours of sleep for children ages 6 to 9, although as few as seven hours and as much as 12 hours also may be appropriate. (Five-year-olds need 10 to 13 hours with as few as eight and as much as 14.)
Sleep disturbances often can keep this age group from getting their required rest. Two of the more common are sleepwalking and obstructive sleep apnea.
Sleepwalking. About 15 percent of children sleepwalk at some point. It is also more common among early school-age kids than any other age group as 6 percent have several sleepwalking events each week.
Sleepwalking is characterized by behaviors like sitting up in bed abruptly and navigating clumsily around the home. It typically occurs one to two hours after the onset of sleep during Sleep Stage IV when the deepest sleep occurs.
Safety is paramount in sleepwalking scenarios. Here is what parents should know if they experience their child sleepwalking:
- Secure windows and doors to the outside or any potentially hazardous areas. Installing safety alarms also may be necessary.
- A child is often unresponsive and difficult to arouse while sleepwalking. Do not force the child awake. Instead, redirect him or her to bed.
- Sleepwalking is sometimes associated with nocturnal enuresis (bed wetting).
Obstructive Sleep Apnea (OSA). OSA is a disorder in which a sleeping person experiences either partial upper airway obstruction for prolonged periods or complete upper airway obstruction intermittently.
OSA can occur in all age groups, but it is most common between the ages of 2 to 6. Children with OSA frequently snore with periodic pauses or gasps in their breathing. Snoring can disrupt their sleep and cause problems with attention, concentration, and daytime sleepiness.
Always screen children for snoring during wellness checks. Refer any child who snores three or more nights per week, and has any OSA symptoms, to a sleep medicine physician/sleep lab, or a pediatric ear, nose, and throat physician. A polysomnography—a test used to diagnose sleep disorders—can diagnose OSA.
School-age children who are overweight or obese are at higher risk for OSA, although this becomes more apparent in preadolescents and adolescents. OSA symptoms can improve with a healthier weight.
Children with OSA also may require an adenotonsillectomy as early childhood is when tonsils and adenoids are most massive relative to the size of the oropharynx.
Some children with OSA may need to use a Continuous Positive Airway Pressure (CPAP) machine at night. However, this is a second-line option for children who are not surgical candidates as it is often poorly tolerated.