Sleep Requirements by Age

Infant (0–1y)

Requirement: 15 hr

• SIDS Risk Reduction Strategies

• ABC: Alone, on Back, in Crib

• Appropriate bedding

• Encourage breastfeeding and tummy time

Toddler (1–3y)

Requirement: 12 hr

Preschooler (3–6y)

Requirement: 12 hr

• Common sleep disturbances: Nightmares, night terrors

• Nightmare interventions: Stay with child; Offer comfort

• Night terror interventions: Do not intervene; Observe for safety

What are the symptoms of a nightmare?

• Wake up crying or feeling afraid

• Difficulty falling back to sleep

• Child is AWAKE

What are the interventions for a nightmare?

• Check on the child as quickly as possible

• Assess the room environment to identify if there are shapes, shadows, noise, or other stimulus that is frightening to the child (and remove if possible)

• Reassure them of your presence and that you will not let anything harm them

• Remind the child that dreams are not real, although it may have felt real

• Permit a soft light in the room, if desired

• Once the child is calm, encourage them to go back to
  sleep

What are the symptoms of a night terror?

• Uncontrollably crying

• Sweating, shaking, or breathing fast

• Terrified , confused, “glassy-eyed” appearance

• Thrashing, kicking, screaming

• Not recognizing caregiver / blank stare

• May try to push you away

• Children ARE NOT AWAKE during a Night Terror

• Children will NOT remember a Night Terror

What are the interventions for a night terror?

• Keep the child SAFE, and prevent injury

• Stay calm; Night terrors are often more frightening for the parent than the child

• Do not try to wake the child

• Monitor the child until the episode resolves

School age (6–12y)

Requirement: 9.25–11 hr

• Nocturnal enuresis

What are the interventions for nocturnal enuresis?

• Educate parents that bedwetting is not bad behavior, and should not scold, shame, or threaten a child

• Provide emotional support to child and relieve feelings of shame and guilt

• Encourage regular daily bowel movements

• Restrict or eliminate fluids after evening meal

• Avoid caffeinated or sugary beverages after 4pm

• Purposeful interruption of sleep to void

• Create a conditioned reflex to wake when voiding (bed wetting alarms)

Adolescent (12–19y)

Requirement: 6–8 hr

As a nurse, how do you promote healthy sleep patterns in the pediatric patient population?

• Stick to a routine

• Be active during the day

• Avoid overscheduling

• Monitor screen time

• Create a sleep-supportive safe bedroom and home environment

What are the screen time recommendations per age group?

• Under 18mo: No screen time

• 18–24mo: Do not leave unsupervised with media

• 2y and older: 1 hr of screen time each day

How can families create a sleep-supportive safe bedroom and home environment?

• Wind down, down time

• No screen time for at least 1 hr before bed time

• Keep all screens/devices away from sleep areas

• Separate sleep areas from play areas

• Dim lights

• Control room temperature