Healthy sleep

Sleep is essential for growth, immunity, learning and memory and is important for helping a child heal and recover. Healthy sleep means a good quantity and quality of sleep, with regular sleep routines.

What happens if my child doesn’t get enough sleep?

A child who does not get enough healthy sleep may experience difficulties with concentration, memory, regulating their emotions, organising tasks and creative thinking. These children may be easily distracted, irritable, disruptive or generally hyperactive and restless. A lack of healthy sleep has been linked to mental health problems, poor growth, excessive weight gain, and reduced school performance.

How much sleep does a child need?

Infants from birth to three months of age have a wide variation in sleep duration and patterns; infants in this age group generally sleep 14 to 17 hours daily (including naps). It is important to remember that these figures are a guide only and that each child will have their own individual sleep requirement. Children with a development disorder may need an amount of sleep appropriate for their developmental age rather than their actual age.

Napping

From birth to two months of age, the length of one period of sleep can vary from 30 minutes to three to four hours. This is throughout the day and night. From about two months onwards, babies start to sleep for longer periods, particularly at night, as they start to develop their internal day/night (circadian) rhythm. This rhythm favours sleep at night and being more awake in the day. From about six months, babies have their longest sleeps at night and can typically sleep for a period of up to six hours or more at night. From two months to 12 months, the number of daytime naps reduces typically from three to four naps, down to two naps. Morning naps usually stop between 12 and 18 months. It is normal for children to have a daytime nap until three to five years of age. Consistent daytime naps after five years of age are not normal.

Good sleep habits

Have a regular sleep pattern. Your child should keep regular times for going to bed and waking up. These times should be the same or similar on weekends and holidays. The 24-hour body clock that controls sleepiness and wakefulness works best if there is a regular sleep routine.

Have a consistent pre-bedtime routine. This will help your child settle and prepare for sleep. It may include reading quietly, a warm bath or a warm milk drink. Avoid exercise or stimulating play in the hour before bedtime.

Limit access to electronic devices (including TV, smart-phones, tablets and computer games) and bright light exposure in the one to two hours prior to bedtime. Exposure to bright light or the LED light from electronic devices can reduce the evening levels of the sleep promoting hormone, melatonin, making it more difficult to fall asleep. Electronic devices should remain out of the bedroom where possible.

Ensure the sleeping environment is quiet, dark and comfortable. Children should sleep in their own bed. If a night light is required, a red light is preferred. If background sound is required, soothing, gentle music is preferred. The bedroom should be used for sleep only and not study or play if possible.

Daytime exercise and natural light exposure may improve sleep at night. Children who are inactive through the day and/or are not exposed to natural sunlight, particularly early in the morning, may have difficulty falling asleep at night.

Limit caffeine intake. Caffeine is a stimulant that prevents sleep. Caffeine is present in tea, coffee, chocolate, energy drinks and some soft drinks. Caffeine is best avoided in children and certainly should be avoided after midday to avoid interfering with sleep.

Self-settling

It is important that babies learn to go to sleep in their cot by themselves at the start of the night, so they are more able to self-soothe themselves back to sleep. Children wake at night partly because they’re worried about being separated from their parents. This is normal. Children need to overcome this worry as a step towards becoming more independent sleepers. If your child is routinely waking in the night, they should be returned to bed with minimal parental attention. This can be difficult to enforce and emotionally challenging, but it is important that parents remain firm and consistent. Praising your child in the morning for staying in bed at night can help reinforce the good behaviour.

When to seek help

See your GP if your child:

• is sleeping too much or too little.
• has difficulty falling asleep or wakes frequently at night.
• has symptoms of inadequate sleep which may include poor school performance, difficulty with attention and concentration, behavioural problems, hyperactive or restless behaviour, or unusual daytime tiredness including regular daytime naps after five years of age.
• snores loudly, pauses while breathing or has difficulty with breathing during sleep.
• moves or behaves in way that concerns  you while they sleep.

In an emergency, call Triple Zero (000) and ask for an ambulance.

If you're not sure whether to go to an emergency department, call 13 HEALTH (13 43 25 84) and speak to a registered nurse.

More information

• Responsive settling video series
• Sleep and Settling help for babies and toddlers – Raising children
• Sleep fact sheets – Sleep Health Foundation
• The period of purple crying – National Center on Shaken Baby Syndrome

Developed by Respiratory and Sleep Medicine, Queensland Children’s Hospital. We acknowledge the input of consumers and carers.

Resource ID: FS347. Reviewed: June 2019.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.