BED­TIME BLUES

Bub­ble tea and other sur­pris­ing sleep snatch­ers.

Young Parents (Singapore) - - Contents -

Chil­dren need much more sleep than adults, and not get­ting enough af­fects their at­ten­tion, con­cen­tra­tion, rea­son­ing and prob­lem-solv­ing – ev­ery­thing that is re­quired for them to per­form well in school, says Dr Chong Yaw Khian, chief of Sleep Dis­or­der Ser­vices at Tan Tock Seng Hospi­tal, Na­tional Health­care Group.

Suf­fi­cient sleep also keeps the mem­ory in top-notch con­di­tion. With­out it, it is harder for your child to re­mem­ber what he learnt and ex­pe­ri­enced dur­ing the day, he adds.

Here, we get the sleep ex­perts to share six things that can sab­o­tage a good night’s rest for Ju­nior, and tips to fix them.

1 Your kid is too tubby

Does Ju­nior snore at night and ap­pear very sleepy in the day? A good night’s rest can re­main elu­sive if your child is too fat.

Obe­sity can cause a con­di­tion called Ob­struc­tive Sleep Ap­noea (OSA), ex­perts say. This oc­curs when your child re­peat­edly stops breath­ing when he is asleep, and cuts off oxy­gen to his vi­tal or­gans like the brain and heart.

This sleep dis­or­der is par­tic­u­larly detri­men­tal for grow­ing kids as get­ting suf­fi­cient oxy­gen is crit­i­cal for their growth and brain devel­op­ment, TTSH’s Dr Chong shares.

About a fifth of obese kids may get it as they have more fatty tis­sue in the throat and neck, which af­fects air­flow dur­ing breath­ing, says Dr Theo­dric Lee, a pae­di­a­tri­cian at Thom­son Pae­di­atric Cen­tre with a spe­cial in­ter­est in re­s­pi­ra­tory and sleep medicine.

Breath­ing, es­pe­cially dur­ing sleep, may also re­quire more ef­fort when there is ex­cess chest and stom­ach fat, he adds.

Kids may get OSA due to en­larged ton­sils and ade­noids (the patch of tis­sue sit­ting at the back of the nasal pas­sage), which are hered­i­tary.

WHAT TO DO Get your kid’s ex­cess weight in check. To do this, there is no quick fix, says Dr Lee. “Par­ents have to pro­mote a healthy life­style, in­clud­ing a healthy and well-balanced diet, avoid snack­ing and sweet­ened bev­er­ages,” he says.

Get­ting your kid’s sleep habits in or­der (see side­bar 1-2-3, Let’s Sleep!) is as im­por­tant as com­bat­ing obe­sity. A study found that teens who reg­u­larly slept less than six hours per night were 20 per cent more likely to be­come obese by the time they reached 21, Dr Chong shares.

If you sus­pect that your child has OSA, take him to see a sleep spe­cial­ist, he ad­vises. Your child might be re­quired to un­dergo an overnight sleep study known as an overnight polysomnog­ra­phy (PSG), says Dr Lee.

This re­quires him to be mon­i­tored overnight in a pae­di­atric sleep lab by sleep tech­ni­cians and as­sessed by doc­tors trained in pae­di­atric PSG.

“For kids with OSA due to en­larged ton­sils and ade­noids, surgery to re­move the ade­noids and ton­sils is the first-line treat­ment and is a cure for ma­jor­ity of the cases,” says Dr Lee. There are also other non-in­va­sive meth­ods like hav­ing your child use a con­tin­u­ous pos­i­tive air­way pres­sure ma­chine to keep the air­ways open while he sleeps.

2 The wrong food and drinks at the wrong time

A cup of bub­ble tea in the evening af­ter tu­ition class, soft drinks at din­ner­time and some cook­ies be­fore bed­time. Be­fore you know it, your kid’s wide awake at bed­time.

The wrong food and drinks can in­ter­fere with Ju­nior’s sleep, ex­perts say. For ex­am­ple, bub­ble milk tea and soft drinks con­tain high sugar con­tent and are stim­u­lants.

Not only do high sugar foods cause obe­sity, they also cause in­sulin surges in the body, which af­fect your child’s qual­ity of sleep, Dr Chong ex­plains.

Any food taken too near bed­time can af­fect the sense of rest­ful sleep, he adds. “Par­tic­u­larly bad are cook­ies and sug­ary snacks. They have a high glycemic in­dex (GI) which wors­ens gas­tric pro­duc­tion,” says Dr Chong. High GI food is di­gested and ab­sorbed into the body more quickly, and causes blood sugar surges.

WHAT TO DO Avoid feed­ing your kid a heavy meal about three to four hours be­fore bed­time, and of­fer health­ier bev­er­age al­ter­na­tives, Dr Chong says.

Hold the en­ergy and sports drinks, too. If your kid needs to re­hy­drate af­ter run­ning around at the play­ground or af­ter his co-cur­ricu­lum ac­tiv­ity in the evening, stick to plain wa­ter.

Sports drinks typ­i­cally con­tain large amounts of stim­u­lants like caf­feine, and most kids en­gag­ing in rou­tine phys­i­cal ac­tiv­ity don’t need them, says the Amer­i­can Acad­emy of Pe­di­atrics. It warns that some cans of en­ergy drinks can have more than 500mg of caf­feine – equiv­a­lent to 14 cans of soft drinks.

3 Too much screen time and not enough out­door time

Your kid may pre­fer the iPad, but get­ting out­door time mat­ters when it comes to his health, in­clud­ing pro­mot­ing good sleep. Spend­ing time in day­light helps to reg­u­late our body clock, which tells us when to wake and fall asleep.

On the other hand, spend­ing too much time in front of blue light from the smart­phone or com­puter near bed­time tricks the brain into think­ing it is still day­time, Dr Chong warns. “This means your child may feel wide awake when he should be wind­ing down for sleep,” he says.

WHAT TO DO Your child needs day­light in the morn­ing to set his body on “alert” mode, so soak up some sun­shine out­doors af­ter wak­ing, Dr Chong says. Try walk­ing to school or to the MRT sta­tion.

Avoid bright lights two hours be­fore sleep, Dr Lee adds. Switch off gad­gets, such as the TV, com­puter screens and smart­phones.

This in­cludes Ju­nior’s high-tech wrist band that links up to his smart­phone and mon­i­tors his sleep cy­cle. Rather than help your kid sleep bet­ter, many sleep ex­perts be­lieve they cause more stress and in­ter­fere with sleep in­stead,

Dr Chong shares.

4 A restless room­mate

In Sin­ga­pore, about 80 per cent of kids un­der the age of three share a bed­room and 30 per cent bed-share, says Dr Lee. Now imag­ine try­ing to get a good night’s sleep when the per­son in the same bed­room has a stuffy nose, coughs or snores through the night.

Whether your kid is shar­ing a bed­room with you, his si­b­lings or Grandma, a co-sleep­ing ar­range­ment may af­fect sleep qual­ity. “Bed­time be­hav­ior or ac­tiv­ity of one per­son will im­pact another’s sleep,” says Dr Chong.

WHAT TO DO There is no one-size-fits-all sleep­ing ar­range­ment for fam­i­lies, Dr Lee says.

“Par­ents have to con­sider their val­ues and pref­er­ences, as well as phys­i­cal en­vi­ron­ment, such as the num­ber of rooms in the house, and de­cide what is best for them and their child,” he adds.

For ex­am­ple, if you don’t mind shar­ing a room with your tod­dler, but want to move him from your bed, con­sider us­ing a mat­tress or bed in the same room.

More im­por­tantly, es­tab­lish a con­ducive sleep en­vi­ron­ment and good

sleep habits. It is best to keep the room quiet, dark­ened and around 24 deg C, Dr Chong shares.

“If there are sev­eral peo­ple in the room, then ev­ery­one should prac­tise the same habit at bed­time, such as lights off at the same time, keep­ing quiet and re­frain­ing from do­ing things that will dis­rupt another per­son’s sleep,” says Dr Chong.

5 You let your kid “catch up” on sleep over the week­end and dur­ing the hol­i­days

Ever won­dered why it is so dif­fi­cult to get Ju­nior to wake on Mon­day morn­ings? It is a sign that his body’s nat­u­ral rhythm has been thrown out of sync, no thanks to those long morn­ing lie-ins and af­ter­noon naps over the week­end, Dr Chong shares.

“It is a myth that kids will just fall asleep when they are tired and don’t need a fixed bed­time,” he adds.

When your usual sleep rou­tine is messed up, the body’s bi­o­log­i­cal clock may still be in deep sleep and is not ready to wake at the time the alarm goes off.

“Most peo­ple as­sume school hol­i­days and week­ends are a great time to catch up on missed sleep. But chang­ing the sleep rou­tine in this man­ner ac­tu­ally tends to leave one feel­ing dis­ori­en­tated and ir­ri­ta­ble, rather than re­ju­ve­nated,” ex­plains Dr Chong.

WHAT TO DO Re­set your child’s body clock by go­ing to bed ear­lier a few days be­fore the hol­i­day break ends. If he stays up late on Fri­day night, try get­ting him to go to bed ear­lier on Satur­day night, Dr Chong ad­vises.

If that fails, and you’ve not had a chance to get your kid’s sleep sched­ule back to nor­mal be­fore Sun­day night, Dr Chong sug­gests get­ting him to go to bed an hour ear­lier than usual on Sun­day night to pre­pare him for the wak­ing time change.

In the morn­ing, don’t let Ju­nior snooze even if you’re tempted to let him catch five more min­utes of sleep. Dr Chong says this may cause the per­son to en­ter deep sleep, which is harder to wake from than the light sleep that oc­curs an hour be­fore the body nat­u­rally wakes.

6 He’s do­ing strange things in his bed

In­stead of sleep­ing peace­fully, why is your kid cry­ing and scream­ing in fear, or up and about at night be­hav­ing bizarrely, like pee­ing in the cup­board?

Para­som­nias like sleep­walk­ing, night­mares and night ter­rors are rel­a­tively com­mon among kids, says Dr Lee. About 15 per cent of kids sleep­walk and up to 6 per cent may ex­pe­ri­ence sleep ter­rors.

These dis­rup­tive sleep dis­or­ders may run in fam­i­lies, and can be trig­gered when your child does not get enough sleep or ex­pe­ri­ences changes in his sleep sched­ule, for ex­am­ple when he starts school.

A sleep dis­or­der like OSA, fever and ill­ness may also trig­ger these para­som­nias, Dr Lee shares.

WHAT TO DO If your kid has a ten­dency to sleep walk, Dr Lee ad­vises safe-proofing your home by in­stalling gates at the top of the stair­way, as well as lock­ing doors and win­dows to pre­vent in­jury.

Stick to reg­u­lar bed­times and make sure Ju­nior gets enough sleep. Re­frain from wak­ing him when he is in the mid­dle of a sleep­walk­ing or night-ter­ror episode. In­stead, guide him to bed with­out wak­ing him.

“Your child will usu­ally be very dis­ori­ented if awo­ken. It is also un­help­ful to dis­cuss the event with your child the next day be­cause he will not re­mem­ber what hap­pened.

For night­mares, calmly re­as­sure your child that ‘it was only a dream’,” ad­vises Dr Lee.

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