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6 Things I Wish All Parents Knew About Sleep

Posted by Dr. Claire McCarthy  May 31, 2013 07:49 AM

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Thumbnail image for sleep.jpgAccording to a study just released, the number of hours kids sleep at night is more affected by genetics than by bedtime or how quiet or dark it is. While daytime naps can be affected and changed by messing with the environment, nighttime sleep is a more wired thing.

This doesn’t surprise me at all, actually. For years I’ve been hearing from parents about how much their children sleep, and there is remarkable variation. Some kids sleep a lot at night and a lot during the day too, while others truly barely sleep at all—and yet, for the most part, they seem to get the sleep they need. It’s hard to explain this variation to parents, who understandably think that all kids of a certain age must need roughly the same amount of sleep.

That’s just one of the conversations I seem to have again and again about sleep. When I read the study I thought: this would be a great opportunity to write a blog about the things I wish all parents knew about sleep. So here they are:

Every child needs a different amount of sleep, as the study points out. It depends on age, to some extent, but it also depends on genetics, what they do during the day and all sorts of factors we don’t understand yet. So instead of counting hours, look at your kid. Are they generally tired or cranky during the day? If so, they may need more sleep. If they are healthy, act rested, have enough energy, get along with others (and are doing okay in school if they go to school), they are probably getting enough sleep.

Calming routines before bedtime are a good idea.  Nobody can go from active, exciting or stimulating things to being fast asleep right away. Yet lots of families try to make their children do just that…and wonder why it doesn’t work. Video games are not a good plan—a recent study suggests that any video (including TV) may not be a good plan, not just because it can get kids riled up, but because the blue light emitted messes up melatonin and our body's sleep cycles. My general advice to parents: start winding down at least an hour (an hour and a half is better) before bed. Do a bath or shower. Turn off the screens. Read books or do other quiet activities. It helps.

Routines in general are good. I once had a mother complain that her child wouldn’t go to sleep on school nights—but on further questioning, it turned out that on weekends the whole family stayed up very late (to at least midnight) doing things together. I suggested that they try to keep the child’s bedtime more or less consistent even on weekends, and the sleep problems went away. I'm not saying you have to be a slave to routines--flexibility is important in parenthood and life--but having a regular bedtime (and a regular waking time) can help kids get enough sleep.

Safe sleep is important for babies. Everybody approaches sleep a bit differently (and I am personally a sleep softie), but there are a few things that all parents should know about safe sleep for babies:

  • The safest place for a baby to sleep is in the parents' room, but in their own sleep space.
  • The safest position for a baby to sleep is on his or her back (we used to say back or side, but now we say just back).
  • Mattresses should be firm. No waterbeds or featherbeds, and sleeping on a couch is a bad idea too.
  • Bedding should be kept to a minimum. Cooler is better for preventing SIDS, and babies can smother or get tangled in extra bedding.
  • There should be nothing extra in the sleep space--no crib bumpers, pillows or stuffed animals.

Snoring is bad. A little bit here and there with a cold or when the child is really tired is probably okay, but any regular snoring should be reported to your doctor--especially if the child seems to have trouble breathing. It can lead to health, behavioral and learning problems.

Most sleep problems can be fixed (or at least helped). Genetics may play a role, but that doesn't mean that there's nothing you can do if your child's sleep routine is wreaking havoc with everyone's sleep. Even the study found that at 18 months the genetic influence wasn't quite as strong, giving parents and caregivers a possible window of opportunity to make changes. So talk to your doctor if exhaustion is common at your house. Your doctor may have ideas, or may refer you to a specialist (at Boston Children's we have a Center for Pediatric Sleep Disorders to help families). Really--it is possible for all of you to get enough sleep.

I don't really mind having these conversations again and again with families. After all, sleep is important for health, and my job as a doctor is to keep my patients healthy. So talk to your doctor if you have any questions about sleep; we are here to help.


Is there something you'd like me to write about? Leave me a message on my Facebook page--and "like" the page for links to all my MD Mama blogs as well as my blogs on Thriving and Huffington Post. 

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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