Lisa Foo, PhD
By Lisa Foo, Ph.D
The top of many Mother’s Day wish lists is a good night’s sleep for the whole family. What a challenge with our many responsibilities, endless things to think about, and being kept up by other family members!
The average daily sleep requirement is about 14.5 hours for infants, 13 for toddlers, 12 for preschoolers, 10.5 for school-aged children, 9 for adolescents, and 8 for adults. Many of us need higher amounts to compensate for accumulated “debt.” Research has linked insufficient sleep with not only fatigue, but also weight gain, heart disease, and diabetes. Decreased sleep can cause emotional and behavioral problems, including (ironically) child hyperactivity. Driving while drowsy is a major cause of car accidents and related injuries. Sleep serves an important role in learning, so late night cramming can interfere with remembering the information that was studied.
So what causes difficulties with falling asleep, waking during the night, or getting up too early in the morning? Everyone wakes briefly throughout the night when transitioning between deeper and lighter sleep, but most of us return to sleep easily and don’t even recall having been awake. Sometimes, however, our brains “click on” too much or have a hard time “clicking off” as we process stressful thoughts, making it hard to fall asleep or return to sleep.
Many sleep difficulties improve through developing healthy sleep habits. Staying up late and sleeping in on weekends can cause chronic jet lag in which our bodies can’t tell when to feel sleepy. Maintaining a fairly consistent sleep schedule throughout the week can fix that. Relaxing evening activities and predictable bedtime routines signal the body that it is time to sleep. It’s helpful to turn off electronic screens (TV, computers, cell phones, etc.) 30 to 60 minutes before bedtime, as they may keep our minds active and the lights that they emit signal the brain that it’s still daylight and time to be awake.
Regular exercise (not too close to bedtime) can improve sleep, as well as overall physical and emotional health. Utilizing deep breathing, muscle relaxation, and visual imagery can make it easier to fall asleep at bedtime and return to sleep after waking during the night. Noise, brightness, and temperature levels of the bedroom, as well as the comfort level of the bed and bedding, should be conducive to sleep. It’s helpful to avoid the bedroom during the day so that when you get into bed at night your mind associates that space with sleep and becomes drowsy, just as we often become hungry when entering a kitchen. When having prolonged awakenings during the night, try getting out of bed, going to another room with the lights dimmed, and doing something relaxing until you feel sleepy enough to return to bed.
Caffeine stays in the body for hours before being fully eliminated, so caffeinated coffee, tea, soda, and energy drinks can be eliminated or reduced and consumed only in the morning. “Decaf” coffees usually still contain some caffeine, and if taken in large quantities or throughout the day, can still interfere with sleep. While alcohol can cause sleepiness, it can also disrupt nighttime sleep. Abusing other chemical substances can also cause sleep problems. Regular use of over-the-counter sleep aids is not recommended without consulting with a medical provider, as long term use can cause grogginess or memory problems, and they may also become less effective over time. Sleep medications should NOT be mixed with alcohol, as the result can be fatal.
It sometimes can be tricky to use these recommendations with a child who doesn’t see the importance of sleep. Children may also need parents to ease bedtime fears or set limits regarding bedtime or middle-of-the-night behavior. It may also be necessary to address any larger anxiety or behavior problems. If your teenager is not getting enough rest, you might choose to have electronic devices turned into you before bedtime so as to reduce the temptation to talk or text during the night. Infant and toddler sleep is especially challenging due to the complexities of naps, nighttime nutritional needs, and little ones’ limited comprehension abilities.
Difficulties sleeping or chronic daytime sleepiness can be symptoms of underlying medical conditions. Individuals with sleep apnea have difficulty breathing while sleeping, and so without even knowing it experience frequent brief awakenings to breathe. Being overweight increases the risk of apnea, though individuals at a healthy weight can also have this condition. Discomfort, pain, or heartburn can cause sleep difficulties and may be assisted by strategies such as relaxation, not eating or drinking close to bedtime, avoiding trigger foods, or receiving appropriate medication.
If you or a loved one experiences sleep difficulties that are interfering with emotional or physical functioning, please consider seeking help from a mental health or medical provider. We can help create a plan to make it easier to fall and stay asleep, and also screen for and treat underlying disorders. For example, psychotherapy might be useful to address depression or anxiety, or behavioral therapy could help train a young child to follow bedtime limits. Individuals with sleep apnea can often be helped by a device that helps them breath better at night, or with assistance losing excess weight that is contributing to the problem. Sometimes prescription medications for other conditions can interfere with sleep and so can be switched, reduced, or eliminated in consultation with your provider. If a member of your family experiences other problematic sleep-related behaviors (screaming or walking while still sleeping, bedwetting or frequent urges to toilet during the night, attacks of excessive sleepiness during the day, etc.), please make sure to have them professionally evaluated.
I’ll end with a confession – I have children, and some of this article was written in the late evenings after they went to bed. And my infant sometimes woke me up a few hours later. Life happens. However, instead of just telling myself “I’ll sleep after I finish everything on my list,” I try to prioritize tasks so that I finish the most important ones before stopping for bedtime. Our children follow the examples that we set. Parenting takes a lot of energy and patience, both of which are easier to provide when we are well rested. I wish us all the best on our quest for households full of sweet dreams.
Lisa Foo, PhD, is a psychologist in private practice in Lexington. Dr. Foo is a Harvard graduate and Fulbright scholar who specializes in assisting individuals and families affected by health-related concerns. She previously worked as a senior psychologist and supervisor at a Level 1 trauma center. 33 Bedford Street, Suite 11; 612-237-8471; drlisafoo@gmail.com; www.drlisafoo.com .
