Sunday, 11 November 2012

Sleep and preschool part 1

sleeping together - even now, almost 12 years old, they still like to.
 This is something I guess has been long awaited by quite a few of those who know me - a mother, a preschool teacher and a wife of a sleep researcher - at some point all these experiences would have to be rolled into one post - and this is my first attempt. My husband has sent me an article - I have found some of my own - and so I am going to try and piece together some science and some experience in the preschool world together in the effort to make some sleeping and resting sense for preschool teachers and parents.
midday nap reluctantly taken
At preschool nap time and rest time should not be viewed as a time for staff to take breaks because fewer staff are needed - that is not the reason for nap and rest time. It should be viewed as a pedagogical part of the day - the part of the day where the children are able to sort through there thoughts and the sleepers can transfer short term memories to their long term memory and therefore aiding their ability to learn.
deep sleep during the day
 Attention can be maintained at a maximum level only for a
limited duration. It typically waxes and wanes, and so does activity
in brain networks regulating arousal and attention. Sleep deprivation
aggravates this “state instability” of interleaved periods of
normal versus attenuated performance and activation of attention
networks  
.Sleep, Cognition, and Behavioral Problems in School-Age Children: A Century of Research Meta-Analyzed. Rebecca G. Astill, Kristiaan B. Van der Heijden, Marinus H. Van IJzendoorn, and Eus J. W. Van Someren
Online First Publication, April 30, 2012. doi: 10.1037/a0028204


We can hardly expect children to have full focus for a full day at preschool, they NEED down time either sleep or a rest, not only from a cognitive perspective but also from an emotional perspective. All parents and teachers can vouch how children are far more grumpy and tend to have emotional responses to things they would normally be able to deal with after a late night - for me today is one of those days!

Most sleep research is carried out on adults, or children with sleep problems, there is not the same amount of research on healthy young-and-school aged children. My husband has wanted to do research to find out more about the sleep needs and the importance of sleep for preschoolers but there is not the same financial interest in backing research in children... 

...sleep duration in healthy children shows
considerable interindividual variability. This variability is associated
with variability in cognitive functioning and behavioral problems.
Cross-sectional studies in community samples suggest relations
of the quality or duration of sleep with cognitive measures,
such as executive functioning (Sadeh, Gruber, & Raviv, 2002),
intelligence (Busby & Pivik, 1983), and academic grades (Buckhalt,
El-Sheikh, Keller, & Kelly, 2009; El-Sheikh, Buckhalt,
Keller, Cummings, & Acebo, 2007). Short sleep duration has also
been linked to behavioral problems (Aronen, Paavonen, Fjallberg,
Soininen, & Torronen, 2000; Lavigne et al., 1999; Paavonen,
Porkka-Heiskanen, & Lahikainen, 2009). Some studies, however,
did not find any associations of sleep quantity or quality with behavioral problems 
or cognitive outcomes such as academic achievements 
(Eliasson, Eliasson, King, Gould & Eliasson, 2002;
Loessl et al., 2008; Mayes, Calhoun, Bixler, & Vgontzas, 2008;
Terman & Hocking, 1913).

.Sleep, Cognition, and Behavioral Problems in School-Age Children: A Century of Research Meta-Analyzed. Rebecca G. Astill, Kristiaan B. Van der Heijden, Marinus H. Van IJzendoorn, and Eus J. W. Van Someren
Online First Publication, April 30, 2012. doi: 10.1037/a0028204

There is also a need for more studies to look into children's sleep quantity and sleep efficiency (how much of the time in bed is spent sleeping). The article does go on to say that as far as all the studies and research show that sleep DOES influence a child's day -

The results show conclusively that shorter sleep
is associated with worse cognitive functioning and more behavioral
problems.

In particular, shorter sleep is associated with
worse school performance and executive and multiple-domain
cognitive functioning, as well as with more internalizing and
externalizing behavioral problems. Sustained attention, intelligence,
and performance on explicit and implicit memory tasks
were not significantly associated with sleep duration.




So what this all implies is that getting enough sleep is important to not only a child's cognitive development but also their emotional stability. Many preschool teachers will have seen that by the end of a long day emotions tend to run higher among the children. 

AgeNighttime SleepDaytime SleepAverage Total Sleep
2 years10.5 to 12.5 hours1 to 3 hours (1 nap)11.5 to 15.5 hours
3 years10.5 to 12.5 hours1 to 3 hours (1 nap)11 to 14 hours
4 years10 to 12 hours0 to 2.5 hours (1 or no nap)10 to 13 hours
5 years10 to 12 hours0 to 2.5 hours (1 or no nap)10 to 12.5 hours
• Note: The two sets of numbers don't always add up because children who take longer naps tend to sleep fewer hours at night, and vice versa.
How much sleep does your preschooler need?  Most sites recommend more or less the same amount of sleep as what is suggested above. Although I can imagine that there will be some reactions about 2 and 3 year olds needing naps - as I know I have parents coming to me asking me not to allow their children to sleep during the day as it affects their night sleep. After seeing many children struggle to keep awake during rest time I felt like the meanest person on the planet prodding and poking them trying to keep them awake - that is when I have had the great fortune to have a sleep researcher husband to turn to. He has recommended that these children should have a 10 minute power nap to help them over come their tiredness but also not to interfere with the parents wishes for the night sleep to be prioritised. It does make a difference - and parents have found this to be a good idea, but sometimes it has been hard to wake up these children after 10 minutes. But a proper nap of at least 30 minutes is what he would recommend.

the delights of motherhood
 Children today probably have a much more stimulating life that what was on offer to children in our day and before that. Children are having to prepare for school at an ever younger age in many countries (thank goodness I live and work in Sweden where school starts at 7, although the final year preschool is now mostly found in schools...). The size of groups in preschools are tending to increase which means that children need more negotiation tools, do not have the same access to teachers on an individual level and it is harder to find a quiet corner for some down time when needed - so naps and rests will have more importance to support a child's needs to deal with the social side of preschool. Of course naps and rest is not always so flexible in an institution - and preschool is a kind of institution (even though it doesn't seem to have the most positive ring to the word). How can a teacher allow a child to rest or sleep when they need in a day of schedules? How can we offer a child the need to rest indoors when its an excursion day and everyone is supposed to be outdoors? No matter how flexible we want to be in a preschool we can never be as flexible to the needs of individual children as in their homes - where they can go into their own room to play with lego, dolls, cars or draw for a moment of relaxation, or find a corner to read for a while before joining the family again. The maximum fee policy for preschools in Sweden has also resulted in a greater number of children having longer days at preschool - we as teachers and parents need to be aware how this affects the children's need for sleep. We also have to consider that volume of preschools has an effect on children and also the fact that the amount of viruses and other sicknesses that are easily spread when many young children meet will also exact their toll on a young body - maybe your child does not get visibly sick, but they may be still fighting off the sickness.

So what can we do? There are studies that massage has an important calming effect, allowing rest and helping the emotional climate of a preschool, classical guitar music has been suggested to aid falling sleep faster, we can become better at reading the individual needs of children - are they crying and shouting because they are angry - or do they need some down time? Are children getting enough physical contact during the day - hugs, sitting on knees etc does not compromise a child's independence but it can contribute to allowing the child feel secure and less stressed in a busy and stimulating environment. Do we, as preschool teachers, need to consider the fact that a second rest time needs to be introduced into the daily routine so that children with long days have access to enough downtime through out the day - as over-tired children often find it harder to fall asleep (and then if they cannot fall asleep they then start the next day with a sleep deficit and all the grumpiness that can come with that - and so the vicious circle begins...). Should teachers know about the bedtime routines of children at home? Would this help to explain how a day should be adjusted for a child - for example if we know a child stays up late every night in order to say goodnight to a parent who comes home late (or because the child wants to and the parents have not established a routine for early nights) then maybe a preschool could offer this child more opportunities to down-time during the day if a nap is not an option (parents have requested no naps). This is one of those areas that blurs - there should be a home and preschool cooperation but sometimes one feels that this is one-sided  and that it is about bringing the parents into what we do in the preschool and that we as teachers have no business in the lives of the children in their homes (unless a parent asks for advice) - how can we best support the children and their sleep needs when we as teachers don't really see their sleep but do deal with the results of lack of sleep? As a teacher to parent readers - how can we better collaborate in this area? Please leave comments.

At this point I am going to leave this post for now - and wait for comments - as I hope there will be many - as I feel the comment will help direct how I can further look into preschoolers and sleep, and also what questions I can ask my husband.

Below are a few articles I have looked at as well as the links that have already been given. I found the one by Catarine Wahlgren very useful and for you readers without Swedish, I apologise and hope that you can translate it as it was a worthwhile read, long, yes, but accessible and not full of name of brain parts and other scientific jargon found in the papers and articles my husband send me (I know they make sense to him - but sometimes they are just a bunch of letters to me - lol)

tiny premature babies - 6 weeks early
Förskolan - nödvändighet eller möjlighet?: Behovet av förskolan och dess konsekvenser för barnet sett ur ett föräldraperspektiv - Johansson, Jessica; Lindh, Emelie  http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-5487

Stress hos barn i förskolan: En studie om förebyggande arbete mot stress hos barn i förskolan - Giang, Kim Huong; Kavand, Ulla http://lnu.diva-portal.org/smash/record.jsf?pid=diva2:560421

Det kompetenta barnet i behov av kompetent omsorg för återhämtning i förskolans vardagsarbete: Att "bara vara" och "göra ingenting"  - Wahlgren, Catarina  http://hig.diva-portal.org/smash/record.jsf?pid=diva2:532620


Music Enhances Sleep in Preschool Children - Tiffany Field http://www.tandfonline.com/doi/abs/10.1080/0300443991500106

Preschool Children's Sleep and Wake Behavior: Effects of Massage Therapy - Tiffany Field, Tracy Kilmer, Maria Hernandez‐Reif & Iris Burman http://www.tandfonline.com/doi/abs/10.1080/0300443961200104


BIG thank you to my husband, John, for checking this post before publishing to give the sleep facts his seal of approval. 2 small changes were made to ensure scientific correctness! 

3 comments:

  1. Very interesting reading!
    I would love to hear some of your thoughts and experiences of power struggles related to sleep. My son (now almost 4) has been resistant to falling asleep more or less since birth and has always slept less than the recommended amount. By the time he was a year old, my husband and I found ourselves in the middle of an intense sleep power struggle with our son. I/we spent a good deal of the day and several hours each evening "getting our son to sleep" (not to mentioned having to get him back to sleep several times a night). I was beyond tired myself, and stressed out, reading sleep tables that insisted that my son *needed* X amount of sleep, and we weren't coming anywhere close. I very much felt like I was failing to provide for one of my son's most basic needs.
    Now, in hindsight, I can see that, at least for us, the power struggle was a big part of the problem. My son was surely picking up on our frustration, making it harder and harder for him to relax and fall asleep and so a bad cycle was created. I finally gave up daytime efforts to get my son to nap just before he turned 2 1/2... the only ways he would ever fall asleep during the day were in the stroller or the car, and it was always a struggle. When we finally stopped trying to get him to nap, it felt like such a huge weight was lifted off my shoulders... Yes, he was very tired for a month or two while he adjusted but I really feel it was worth it. BTW, my son never napped at preschool - after a month of tearful trying, I picked him at at 12pm so he could nap at home.
    So my opinion at this point, is that, YES, sleep is very important! However, stressing about sleep can be really damaging, to both parents and child. I would love to hear some thoughts about this - especially coping strategies for those of us with less than brilliant sleepers... Thanks, Caitlinn

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  2. Thank you for your valuable feedback. I agree wholeheartedly that stressing over sleep is a sure fire way to keep children and yourself awake. My own son has not liked the idea of going to bed, or falling asleep (including during the night) for a whole variety of reasons, but we have tried our best not to stress, we have tried to figure out how to give him power in something that essentially he has to do - and I think I will take up that strategy as my next post. Thank you again for this feedback - because just as important that we get our children to sleep stress is not optimal.

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  3. I really enjoyed reading this article. I am a licensed child care provider in Chesapeake, Virginia. I have been taking care of children for well over 11 years and have just made the connection between lack of sleep in young pre-schoolers aged 2-5 years. Many of the children I take care of have parents that are on Active Duty in the military. Many of these children do not have strict schedules for them to be in bed by a certain time at night. On average, I think many of these children do not get put into bed until 11pm or later and by then, many of these children are awaken at 5am or earlier to be taken to daycare. Right now the children I take care of are between 2-5 years old and they all fall into the same lack of sleep cycle pattern that I have been researching on. To help them overcome their sleep depreviation when they arrive at my home usually between 4am-6:30am, I will already have their sleeping cots put down. The school is warm but not too hot and all natural light is shut off which makes my school pretty dark. I insist that these children go back to sleep after they arrive at my home. I ususally do not wake them until 9:00am or 9:15am. I can usually tell if they are extremely exhausted because they will sleep through the housekeeping chores I do while they rest. Since I do not wake them until 9:00am, they are great spirits to eat breakfast and can sit through reading, exercise time and circle time activities without one tantrum, or crying spell. I do not worry too much about letting them sleep again during the afternoon because everyone seems to be alert and ready for learning. I truly believe that letting them go back to sleep instead of insisting that they remain awake during the early am is helping them achieve to their potential. Again, thanks for writing this article!

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