The information in this article comes from a discussion about children and sleep led by Richard Kravitz, MD.

Here's a sleep riddle for you: How much sleep should your child get?

Answer: As much as he or she needs.

Determining how much sleep your child needs can be tricky. While there is no magic number for the amount of sleep a child is supposed to get, rules of thumb are that he or she should fall asleep 10 to 15 minutes after getting into bed and should wake up refreshed.

When thinking about how much sleep your child should get, keep in mind that infants need more sleep than young children, and younger children need more sleep than older children.

Teens and Sleep

While many parents attribute their teen's moodiness and angst to hormones and age, research suggests that many teens are actually just sleep deprived. Most teens are not getting anywhere close to the nine to 10 hours of sleep per night that their bodies require.

Especially during the school week, teenagers are sleep deprived as they struggle to fit school, sports, jobs, and homework into their busy schedules. Schools that have taken this into account and moved their start time to a later hour have seen remarkable improvements in concentration and test scores, as well as a dramatic decline in truancy and teen-related car accidents.

While many teens look to the weekends to catch up on their sleep, this bad habit just perpetuates their work-week sleep deprivation.

In addition to simply needing more sleep, teenagers experience a dramatic shift in their sleep drives. This biochemical change causes them to want to stay up later and sleep in later.

Teenagers who can't control their sleep drives in light of this shift can develop serious sleep problems including delayed sleep phase syndrome (where the body's internal clock is constantly out of synch with the "accepted" day/night phases).

Abnormal Sleep

Be aware of some of the sleep abnormalities that your child may be facing, which can include:

• Snoring: Live by the motto: "If they snore, you've got to ask more." Snoring for children is not normal, needs to be evaluated to make sure it is just snoring and not a more serious problem such as obstructive sleep apnea.
• Obstructive sleep apnea: A child who has obstructive sleep apnea has a break in his or her breathing while asleep that is caused when the airway is obstructed due to enlarged tonsils or adenoids. Every time the child gasps for air or tosses and turns, he or she experiences a small arousal which makes for a night of poor sleep.
• Periodic limb movement or restless leg syndrome: Periodic limb movement causes a person's legs to move uncontrollably which often causes sleepers to toss and turn and accidentally wake up. Restless leg syndrome is when a person's legs get agitated when they try to sit still; this agitation intensifies as the day progresses, so this makes sleep especially hard.
• Narcolepsy: Narcolepsy is characterized by uncontrollable fits of deep sleep. Though uncommon in young children, narcolepsy often starts around junior high, so parents should be aware of this condition and watch for it in their children.

Diagnosing Sleep Problems

While doctors ultimately diagnose sleep problems, some steps you can take to see if your child has a sleep problem include:

• Get your child a physical or medical history to determine if there is an illness like asthma or allergies that is causing your child's sleep problems
• Keep a sleep log of your child's sleep patterns to aid the doctor in his diagnosis
• Participate in a sleep study administered by a sleep specialist

Treatments for Sleep Problems

Practice Good Sleep Hygiene

Simply changing your child's sleep habits and implementing good sleep hygiene can solve your child's sleep problem.

Ways to create good sleep hygiene:

• Wake your child up at the same time every morning
• Introduce bright lights to your child's mornings
• Turn off computers, television, and overhead lights when it's close to bedtime
• Implement a consistent bedtime ritual
• Give your kids 10-15 minutes to fall asleep once they're in bed
• Continue your sleep rituals on the weekends

Get a Tonsillectomy and Adenoidectomy

The most common treatment for kids with sleep apnea is a tonsillectomy or an adenoidectomy.

In both of these cases, the obstruction to the child's breathing is removed, and the sleep apnea is cured.

Use CPAP

A continuous positive airway pressure (CPAP) device treats sleep apnea by using air pressure to force the child's airways to stay open when they sleep.

Cautiously Take Medication

Giving children sleep medicine to treat sleep disorders, such as insomnia, is controversial because of the chance that they will become dependent on these medicines.

While some extreme cases may require medication to treat certain sleep disorders, behavior modification or other treatments should always be tried first.

What Can Parents Do?

• Don’t let the problems grow. Talk to your pediatrician early and often.
• Be your child’s advocate and get your questions answered. Don’t be afraid to explore different avenues until you find the help you need.
• Trust your instincts. If you feel there is a problem, seek help.
• Set a good example by getting enough sleep yourself.