In September, Student Sleep Health Week is dedicated to raising awareness about the importance of healthy sleep for students of all ages to learn, grow and thrive.
This year, sleep experts engaged with the Reddit community to provide insights into fostering healthy sleep patterns in children and teens. Several sleep experts participated in an “Ask Me Anything” (AMA) session on Reddit. Seema Khosla, MD; David Kuhlmann, MD; Shalini Paruthi, MD; and Susheel Pandit Patil, MD, PhD, collectively received an impressive response of more than 1.7 thousand comments.
Continue reading to see a few questions and answers from the Reddit AMA.
How do I convince my 6-year-old to sleep through the night in her bed? She has only slept fully through the night 3-4 times in her entire life!
Shalini Paruthi, MD (SleepExpertParuthi): This might be a medical sleep disorder preventing your child from sleeping through the night, rather than a behavioral sleep problem. If your child snores, it is important to discuss with your pediatrician, a sleep physician or an ENT (ear, nose and throat) physician about possible sleep apnea, which can cause a lot of awakenings at night.
Additionally, ask to have your child’s ferritin and iron panel checked. If your child has a Ferritin < 75 or iron saturation < 20%, iron supplementation based on weight under your pediatrician’s or sleep doctor’s supervision, can significantly improve insomnia, awakenings, growing pains and restless legs syndrome in children.
Behaviorally, bedtime passes can be helpful after the above is addressed. Give your daughter a bedtime pass (foamy cutout/index card with drawings/stickers) at bedtime. She has to turn it in if she needs to talk to you or come out of her room after being tucked in. If she keeps the pass till morning, she can trade in the pass for a prize like a sticker, 5 extra minutes of tablet time or piece of chocolate (whatever you are OK with).
Why are some people more prone to insomnia? I’ve had it since I was a young child.
Susheel Pandit Patil, MD, PhD (SleepExpertPatil): There is something known as the 3 P’s for insomnia – predisposing, precipitating and perpetuating factors. Predisposing features can include genetic or familial basis or underlying health conditions. Precipitating factors include things like a health care event, stress at home or at work, etc. Perpetuating factors can include things we do that perpetuate insomnia like staying in bed when we are not sleepy.
The best long-term treatment for insomnia is cognitive behavioral therapy for insomnia. CBT-I combines behavioral strategies, such as setting a consistent sleep schedule and getting out of bed when you are struggling to sleep, with cognitive strategies, such as replacing fears about sleeplessness with more helpful expectations. Recommendations are customized to address each patient’s individual needs and symptoms. CBT-I provides customized strategies for those experiencing chronic insomnia.
What are your thoughts on melatonin?
David Kuhlmann, MD (SleepMD1): Melatonin is not an ideal sleep aid, but no sleep aid is ideal. I would focus first on figuring out why you feel like you need melatonin. I view insomnia as I view pain: It is not necessarily a symptom, but more of a disease. If you can figure out what is causing your insomnia, you may be able to treat it. And remember, 1) it is more empowering to use cognitive behavioral therapy for insomnia and 2) 10mg of melatonin could be 3 or 20mg and it may have other things in it.
Seema Khosla, MD (FargoSleepDoc): Melatonin supplements appear to be safe. There is no evidence of serious risks related to their use, but the long-term effects of melatonin are unknown. The bigger issue might be that you may be creating a ritual where you associate taking the supplement and then falling asleep. If you are having difficulties falling asleep, you may wish to consider cognitive behavioral therapy for insomnia.
Editor’s note: Last year, the AASM released a health advisory recommending that parents talk to a health care professional before giving melatonin or any supplement to children. This advisory comes amid growing reports of melatonin overdose, calls to poison control centers, and emergency room visits for children.
These responses have been edited for brevity. Visit the Reddit AMA thread to see all the questions and responses about healthy sleep in students.
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Learn more about healthy sleep in teens and healthy sleep in children.
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Authored by:
Kate Robards
