Sleep in Toddlers and Young Children

In toddlers and children, sleep is incredibly important, with sleep requirements remaining much higher than those in adults.  Toddlers (1-3 years) require approximately 12-15 hours and will usually have at least one nap of between 1 and 3 hours duration each day.  As the child grows up, the quantity of sleep needed gradually decreases to approximately 10-11 hours at age 12.  Most children stop needing a daytime nap at around 5 years of age.  Whilst everyone yearns for a magic number for optimal sleep length for children, the reality is that everyone is different and this includes different sleep requirements!

Importance of Sleep

It is during sleep that consolidation of memory, learning and growth of the brain and body occur.  Accordingly, disruption to sleep during childhood can result in a range of problems including poor school performance and behavioural problems.  While an adult is likely to experience excessive daytime sleepiness following disrupted sleep, in children it is much more common to see hyperactivity as a result of poor sleep.  In fact, commonly, sleep problems in children are misdiagnosed as attention deficit hyperactivity disorder as the daytime symptoms are very similar.  As children get older, poor sleep can also manifest as moodiness and learning difficulties or problems at school.

Sleep Problems and Disorders

In childhood, the most common sleep disorder is sleep disordered breathing which includes a spectrum of disorders ranging from simple snoring up to obstructive sleep apnoea, where the child’s airway becomes blocked during sleep resulting in periodic episodes of cessation of breathing followed a big breakthrough breath and arousal from sleep.  This condition is particularly common in pre-school aged children (3-5 years old) as large tonsils and adenoids at this age result in a relative narrowing of the upper airway.  The negative effects of this condition can include excessive daytime sleepiness or hyperactivity as well as behavioural and learning problems.  There is also some evidence to suggest that sleep disordered breathing in childhood can have effects on the cardiovascular system resulting in the development of high blood pressure.  If you are concerned about your child’s breathing during sleep, ask your doctor for advice.

Another group of sleep disorders which occur commonly in toddlers and young children are parasomnias which include all the abnormal things that can occur around sleep that do not fall under the category of sleep disordered breathing.  These include night terrors, nightmares and sleep walking, all of which occur commonly in children due to their immaturity, peaking in the pre-school age group (3-5 years).  Parasomnias in children are usually benign and do not signify any underlying disorder with most parasomnias disappearing as the child matures.

Furthermore, as children get older it becomes more difficult to maintain proper sleep hygiene as technology, games and television become a distraction from sleep.  Extra-curricular and school activities put pressure on the time available for sleep and caffeine begins to be consumed.  Therefore, it is important to begin emphasising the importance of healthy sleep habits at a young age before bad sleep practices become bad sleep habits.

Tips to Improve Sleep

Toddlers:

  • Maintain a regular bedtime and a soothing bedtime routine
  • Encourage the use of a safety object such as a toy or blanket
  • Set bedtime limits that are consistent, clearly communicated and enforced
  • Create a comfortable bedroom environment which is dark, cool and quiet – include a night-light if the child is fearful

Children: 

  • Create bedtime rules and enforce them consistently – evidence suggests that the regularity of sleep is just as important as the duration (i.e. going to bed at the same time each night)
  • Educate school-aged children about the importance of healthy sleep habits
  • Ensure the bedroom is free of technology including TV’s, computers and games
  • Avoid caffeine
  • If sleep walking is a problem ensure the sleep environment is safe i.e. bedroom on the ground floor, lock doors to outside


With children spending up to 50% of their lives asleep, ensuring healthy sleep can help to keep your child healthy, happy and performing at their best!