Episode 187: Aging Well Begins in Childhood--Sleep Hygiene

This is the third installment of a series of “Aging Well Begins in Childhood.” In this episode, Dr. Armstrong and Corbin Bruton tackle the importance of sleep hygiene for children; how consistent sleep practices support physical growth, cognitive development, and emotional regulation. Learn about effective bedtime routines, optimizing the sleep environment, and the impact of diet and physical activity on sleep quality. The hosts also address common misconceptions about children's sleep and offer strategies for managing naps and screen time. Tune in to discover how you can help children develop healthy sleep habits to… age well.

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Transcript

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In this third installment of our series on Aging Well Begins in Childhood, we discuss the topic of sleep hygiene for children. We explore how fostering good sleep habits early on can have a profound impact on a child's growth, development, and overall well being. We shed light on the significance of sleep hygiene and share practical tips for creating a sleep friendly environment for kids to age well. Dr. Armstrong, what is sleep hygiene and why is it important for children? Well, sleep hygiene refers to the practices and habits that promote consistent quality sleep. And for children, good sleep hygiene is crucial because it supports their physical growth. cognitive development, emotional regulation, and really their overall well being, helping them to perform better in school and to maintain better health. how does sleep hygiene affect a child's overall health and development? Well, for children, good sleep hygiene is vital because, it's going to support their growth. It's going to support their learning. You know, a kid who is better rested is going to do better in school. It's going to help with their emotional well being because The stress that comes with being under, recovered and, you know, not well rested is going to tend to make, make a kid more irritable, irritability leads to a lot more emotional disruption. So it's just going to help them function more optimally throughout the day. there's a lot of different ways. one area would be in terms of how the brain functions. When we get good sleep, the brain is better rested. It is taking information that they might have gained throughout the day. Sorting and processing much more effectively. the brain processes and organizes information that accumulates from the day consolidates that at nighttime while we're sleeping and helps kind of store that away is memories and learning. And so this really helps with the cognitive development that A child needs and helps them retain new skills and knowledge that they might be gaining as they go to school So it's better if they're studying, before a big test to study that subject right before bed and then sleep on it all that memory is consolidated. When we're trying to get optimal sleep, studying right before sleep is not going to be the most optimal because we have all that in the brain and we're a bit more restless in our sleep as we process that information. being a college professor, this is the advice I always give my students that I learned from my professors as an undergrad, get to bed early on test day, study until, say, maybe, 10 o'clock at the latest. Ideally, you're doing something more relaxing before bed. So again, practicing better sleep hygiene so that when you do go to sleep, you're gonna get better rest. Your brain is sorting through that information. It's not as stressed out over the exam, and it's going to wake up better prepared for that exam. I was always taught, and I had a professor, he was a history professor at West Virginia University, that when he went to undergrad, he went to two different universities at the same time because he couldn't take enough credits at the two different universities to major in two different majors simultaneously. So he was actually doing about 12 hours or more at each institution, on a regular basis. And so definitely had it figured out how to get the studying done. And he always taught us that if you're studying and your brain's really into it and everything's clicking, great, just keep studying. And that's when you can stay up late and get a lot of that information into your brain. If you're struggling with the information, your brain isn't able to process it. the best thing is just put it aside, go on to a different topic, or get some sleep, do something else. And I always took that to heart and it was hugely effective. And so for somebody who is studying, getting that studying done those later nights of sleep, of studying should be done in the weeks leading up to the night before the exam. And then the night before the exam, getting better sleep. ideally, And particularly we're talking about children, so we're talking about those first age kids that their sleep should be regular and they study habits should be regular. And we'll talk more about this, some of the habits we can do to improve the quality of sleep hygiene in children. But we want to make sure we are getting adequate time sleeping and processing for the brain to develop. I recommend. Having a little bit of downtime prior to sleep rather than studying right up to sleep and then going to bed and expecting to get up well rested and do well on the exam. Does that make any sense? Yeah, it does make sense. And another thing that I'm thinking of as far as memory consolidation, I'm assuming that this has to do with, for lack of a better word, like personality development as well. and, you know, I think that's why when we watch a scary movie, right before bed, our brain replays that over and over again. So you want to think about the positive stuff. That's why if you have a really great, amazing day, say you went on a hike or you were down at the lake earlier in the day, when you go to bed, you start reliving those memories. I would assume that. an individual who is a would want to have mo toward their kids are try As part of that bed, bedtime routine to help with that personality development or just have a positive experience right before bed. Does that make sense I just feel like it has a huge impact on the child's development and personality I think we're diving into the psychology of personality development as we look at brain development in general, we'll get back to some habits that facilitate better sleep hygiene. But as we look at, you know, what's kind of going on and why is it so important that it's so important. developing brains getting enough sleep is remember sleep is going to support the maturation of all these neural circuits in our brain and the formation of those new synaptic connections. And so it's essential for brain development, problem solving skills, cognitive growth, to have, you know, That adequate amount of sleep sleep is also going to help in repairing and rejuvenating itself and getting rid of some of those metabolic waste built up throughout the day. Is there stress learning all these new things in school and having new experiences and watching those scary movies and doing all those different things? We want to get rid of that metabolic waste. We want to restore Energy levels. We want time for the brain to heal itself. in a recent episode, we had Dr Patel on talking about glutathione and the importance of it is an antioxidant. We want Antioxidants like glutathione have the opportunity at night to clean up waste products within the brain, remove free radicals and allow the brain to restore and rejuvenate itself the brain regulates our emotions during sleep, and so it's going to help a lot with that. Emotional stability and resilience and managing stress and our mood levels throughout the day. Sleep supports the growth hormones that are essential for physical growth and development. the pituitary gland is part of the brain. If the brain is getting adequate recovery and rest and nutrients at night, then that's going to help us in our physical development and our growth. And so this is particularly important as we look at the early years of childhood, adolescence, up to about the age of 25 when the brain more fully matures. And so overall, sleep is going to be a very important part of our cognitive and physical development. ensuring that the brain is getting adequate sleep to be functional and recovered, and the body's getting well rested, and the child's going to be able to function more optimally. Why is having a consistent bedtime routine crucial for children? Well, consistent bedtime is going to help signal the body that it's time to wind down and prepare itself. So it's easier to fall asleep when we're more relaxed going into bedtime. And so it creates a little bit more of a sense of security and predictability for the child. it can reduce anxiety, and it's also going to improve sleep quality. this is the same for an adult as it is for a child. Having a consistent bedtime is going to help us to kind of keep those circadian rhythms in sync and sleep better so that we wake up refreshed and ready for the day I feel like that goes hand in glove with what we were talking about earlier, as far as positive experiences, right before bed. Can you share some effective bedtime routines that our listeners who are parents can implement? I'm not sure if I'm the expert on that. I had two kids and I don't know how well I did it over the years, but, From being a parent, I know that it is difficult to establish routines. Sometimes it's difficult because of our own work schedules, but what we have to look at is what can we do as a family to have a routine that's going to work for us. And so it's simply, first of all, having a routine is the most important in terms of implementing effective, sleep hygiene for our kids. And so whatever routine works well for your family could be something like having specific study times and then story time. if kids are going to watch TV at night, they have a limited amount of time. It was a lot easier when I was a kid in the 60s and 70s where children's programming on TV kind of ended before nine o'clock, And so before nine o'clock, you're done with TV. And it was time to work into your sleep patterns. if you have a kid who's going to bed about 7 30 at night, then. Okay, what are we going to do? We have dinner at a certain time, you've got your homework done, now you can have X amount of time watching TV. Now it's time to brush your teeth, get into your pajamas. I'll come up, I'll read you a story if it's a young enough child. I used to love reading Pajama Time that was one of my favorite books to read to the kids. having a reading time, depending on your faith, you might have prayer time, maybe a little bit of quiet time where the kid can read on their own or, just things that wind them down. The thing we don't want to do at bedtime is get kids all riled up. And that's one of the things I was horrible at as a parent. I'd go in and start wrestling around with the kids and toss them on the beds and getting them jumping on the beds and then they're all wound up and they couldn't get to bed. so we want to do whatever routine is going to help us to really wind them down, be consistent and get them in bed. They don't have to necessarily fall asleep at the same time. We don't have to drug our kids, give them Benadryl or something like that to fall asleep. just get them in bed, lights out. and create a sleep environment that is effective for them to get a good night's sleep and a consistent night of sleep. That also means if we're going to have a routine at bedtime, we also want to have a routine at getting up in the morning so that they're getting up consistently. And that's to help with this arcadian rhythm, right? Right. The more we can lock into a rhythmical sleep pattern, it should be the same on the weekends. I think we have trouble as adults, as well as children, allowing kids to sleep in excessively on the weekends, maybe Friday nights and Saturday nights. They're able to stay up later. That also helps to disrupt their sleeping patterns. they might get in a good routine by Friday, you know, they've worked Monday, Tuesday, Wednesday, Thursday, Friday, and they're finally getting in that routine on Friday. And then you let them stay up late. Friday night, Saturday and then Sunday, and then they go to bed at a normal time on Sunday, but their rhythms are all off because they've literally taken themselves into a different time zone. So having that consistent sleep wake cycle is going to be very important for Children. So now you mentioned, sleep environment and I am one of those people that I can sleep anywhere. I can sleep with loud noises around. I can sleep with the lights on. I can just sleep. I passed out and I can just sleep and I'm dead to the world And I've been blessed to kind of always have that ability ever since I was a little kid but for most people they don't have that luxury So how does sleep environment and i'm talking lighting noise room temperature? How does this impact a child's sleep quality? Well first, I'd be interested, what is the quality of sleep you're actually getting, even though you might be able to fall asleep at a consistent time, is that quality of sleep the same as we move from environment to environment? since we had Dr. Farrell on, I've been tracking my sleep. And I can tell you my sleep varies dramatically, even though I may go to bed at 9 o'clock and wake up at 430 consistently. my sleep scores, my quality of REM sleep and deep sleep varies from night to night, depending on some of those different activities that happen prior to my going to bed. And so that's where having a very consistent, comfortable sleep environment is going to be very important. as we talk about a comfortable sleep environment, we're talking about having a room that is cool, not cold. not hot. We definitely don't want to be hot. Nobody wants to be sweating at night. It's a lot harder to sleep. when you are really hot at night. having a consistent, comfortable temperature in the room is critical. The room should be as dark as possible. nightlights aren't necessarily the best thing for kids. we have kind of trained ourselves to use those as a crutch so that the kid feels more comfortable, but the sooner we can get The child able to sleep in a really dark room, the better it's going to be because we're aligning those circadian cycles. so getting the room as dark as possible, can be very difficult if you live, in an apartment and there's a parking lot with bright lights outside or you have a street light right outside of your bedroom. If you can shade those windows to block out as much outside light as possible. That's going to help. The room should be quiet. And that means trying to limit noises outside of the room. Because if you're in the next room with TV blaring, kids, Not gonna be able to sleep because they're kind of listening to what's going on in the tv. we don't wanna have a phone in the room. A kid should not be on their phone. They should not have a TV on in the room. a lot of people are trying to, let their kids fall asleep with the TV on. That's not the best thing to do. anything that we can do to promote a deeper. more uninterrupted sleep is going to be more effective. So reducing noise using blackout curtains, maintaining a comfortable mattress for the kid, you know, memory foam mattress, even if it's just kind of cheap mattress with a cheap memory foam pad on top is going to help enhance that child's sleep quality. kids don't typically have. sleep apnea, do they? But if they did, I would assume that has some effect on sleep quality as well. Yeah, I think we'll come back to talking more about some of the specific disruptive sleep patterns that kids might have in medical conditions. And that's things that, need to be considered and, treated by the physician. But, when we're talking in terms of just improving the quality of that sleep, one of the biggest things we need to do with children, and it's becoming a bigger issue as technology creeps more and more into our child's lives, is limit screen time prior to bed. Because that can interfere with their sleep by exposing them to blue light that disrupts the production of melatonin, so trying to limit screen use. in the hour before bedtime can really help kids fall asleep more easily and effectively. get them off the iPad, phone, television, have them read a physical book or, you know, just simply go play quietly in their room, do something more quiet and not involving blue light. Technological screens is going to be an important strategy to getting them to sleep better. Yeah, it's really interesting because there's a lot of new literature out there on the difference that blue light affects the brain and red light, how that affects the brain and the circadian rhythm. I remember growing up, as a little kid, nightlights were and then as I got older, myself and my friends, some of us would fall asleep with the TV on or the laptop playing a movie to have the quote unquote white noise. But if you look at it, that's radiating that blue light the entire time. And ironically, with all the literature out there, the demographic of individuals. That are really purchasing those blue light glasses. That's like my age bracket. I just think it's really funny because we grew up having that blue light constantly. And now we're so focused on not having that blue light. So what are some strategies to limit screen time in the evening to prevent those blue lights or just limit screen time in general? you just got to be strict and have, rules in place and the kids got to follow those rules. you got to be a parent, and parenting is not placing your kid in front of a screen so that you can do whatever you need to do. you need to develop habits within the kid. And again, I'm not saying this is an easy thing to do or that I did it perfectly as a parent, but you need to have the rules in place. and enforce those. if you have to, take away the screens. you might have a screaming kid for a while. that's where those nanny shows come in and take these disruptive kids and straighten them out. hopefully you don't get to that point, but the earlier you can. begin to limit that screen time, the easier it is for that kid to be in the habit of not having screen time. so first things first start early with limiting screen time. Have a schedule in place when they can be on their laptop iPad or their phone. Having a set time, you know, you have a set bedtime, you want to have a set time where they got to turn those screens off and. Just simply go to bed. and that's really some of the best strategies is just not allowing it in the first place, limiting it and having rules in place. You know, it's definitely not good for anybody to be falling asleep in front of a TV or a computer screen. And the fact that we need blue lights, what do we need blue lights for? Blue like glasses for if we are not going to be in front of the screen. I think it's just one of those, scams. We've got people so addicted to being on their screens and then now suddenly they have to sleep with blue glasses on or they have to, you know, where blue like glasses. on their computer to limit that. And then they're just going to turn off the computer and go to sleep. But there's still that impact of whatever you've been watching spinning around in your brain. And so just limiting screen time period is the best strategy I can come up with. Well, one thing that came to mind as far as screen time right before bed or video games, and that goes back to memory consolidation is I remember playing Sega Genesis when I was younger, if I'd turn it off and then go to bed, I would close my eyes, and I would still see it. The images that were on that little, you know, two dimensional screen that's got to have some effect not only just screen time like watching TV shows or, looking at an iPad before bed, instead of reading a book, but video games also more than likely have a, significant effect on brain development as well. Would you say? Well, it's blue screen and it is activity that your brain is having to process in order to wind itself down and then go to sleep. And so it's going to impact melatonin production and just initiating sleep. So yeah, treat it like every other screen time. The kid should not be on a computer playing video games just like they shouldn't be doing their homework on their computer immediately before bedtime. All right. So in your opinion, what role does diet play in a child's sleep hygiene? Well, I don't know if it's a matter of opinion as much as, just kind of physiological fact that a balanced diet is going to have a very positive effect on sleep quality. So, while sugary foods can help trigger us falling asleep, it was actually taught years ago by a nutritionist, if your child is having difficulty falling asleep, give them a little bit of sugar, probably to bed because you get that insulin spike and then it drops and then it's going to put them to sleep. I don't think that reasoning stands anymore. I think you're better off eating earlier in the day. having a healthier balanced diet and practicing better sleep hygiene to facilitate sleep. sugary caffeinated beverages and junk food can really disrupt sleep patterns. the more we can get our child eating a healthy balanced diet, we had a recent episode where we talked about, benefits of the Mediterranean diet for children. Children and teens. The same healthy diet that is effective for adults is going to be the same healthy diet that's going to be effective for children. Trying to limit food, at least an hour or more before bedtime is going to help facilitate getting them to sleep. Okay, now I think I know the answer to this one, but go ahead and tell our listeners. are there any specific food or drinks that we should be avoiding before bed? Well, like I said, caffeinated beverages, sugary desserts, and junk food is going to be things that we need to avoid across the day. and really rather than avoiding food, we want to encourage. healthy food consumption. so I think encouraging maybe a light snack because kids need a little bit more calories than adults do something light like yogurt or banana can be helpful. something that's going to help encourage that night's rest. And I think a lot of that might come down to experience, you know, what works well. If you notice that particular late night snacks or meals are disrupting the kid's sleep, try different foods to see what's going to work better than other foods are going to work. What about that old wives tale of like Warm glass of milk, which by the way, has always sounded disgusting to me. I don't know who's drinking warm milk, but just does not sound appealing. Oh, knock unless you've tried it. warm milk is, you know, warm milk has tryptophan in it. tryptophan is a precursor to melatonin. I'm not sure how real that benefit is, but if it's something that works to help them get to sleep, then why not? It's not going to be harmful. what we want to look at is the things that disrupt sleep more so than trying to find the magic wives tale that's going to put the kid to sleep better. You know what, one thing that I've, you know, and I'm not a parent yet, but, you know, watching my nieces and nephews, the one thing that I noticed that Really kind of puts them to bed is get them is physically active throughout the day and just burn off all of that energy. How does physical activity during the daytime influence a child's sleep pattern? And are there particular types or amounts of physical activities that are most beneficial for promoting good sleep? I think regular physical activity is. gonna make the kid more tired. They've expended energy through the day. Their body is gonna be wanting to recover from that. So they're gonna fall asleep faster. They're gonna enjoy deeper sleep, more REM sleep. So figures, physical activity, I think it's very important throughout the day just for the health and well being of the child. Whether we're talking about sleep or whatever physiological benefit exercise during the day and regular physical activity is crucial for a developing child. However, if we start looking at the proximity of vigorous exercise to bedtime, then we have some issues. And unfortunately, a lot of youth sports anymore because there's so much competition for field time and burden on kids to be participating in these sports. And we have travel teams and all this other kind of stuff that is taking away from a regular healthy routine for kids. A lot of them are ending up having practices later in the day. You know, I know somebody did club wrestling practice. You know, that was going until nine o'clock then you got to get them home and wound down for bed. They're not going to get to bed and to sleep as early as you would like. And that shifts the overall sleep pattern for the child. we want to limit vigorous exercise close to bedtime because that can be stimulating. It's best to schedule active play earlier in the day. If. practices run later in the evening. We want to push bedtime back a little give them the time to unwind and don't expect that the kid's just going to come home from practice, shower and go right to bed. It's not going to work as effectively. And so just kind of consider that going into whatever your sleep routine is going to be for the child. So what are some sleep disorders in children and how can parents recognize these signs? Well, common sleep disorders in children can include things like insomnia. Although, is it really insomnia or just again, poor sleep patterns? You mentioned earlier sleep apnea, restless leg syndrome. Those are kind of three common sleep disorders in children. I think the best way for parents to recognize is just look for signs of excessive daytime sleepiness. And you've been doing everything you can to create the right environment. the right nutrition, having the right routine prior to sleep, and the kids still not getting adequate sleep. They're not getting restorative sleep. And, you know, you're kind of checking in on him. You're saying they're tossing and turning or you're noticing is they're sleeping, that there's some breathing difficulties, whether or not being able to fall asleep. Kids coming into your room constantly. I can't sleep. Mommy, can I sleep? Can't sleep. And a lot of parents will sometimes when the kids haven't traveled sleeping, say, come into bed with us. And, you put them into bed with you and they're still not sleeping. Or you get this really loud snoring. They're having difficulty, waking up frequently throughout the night. That's something to kind of consult your healthcare provider with if you had those concerns. And, you know, when the kid's having their regular wellness visit, communicate with the physician. These are things that we're seeing in their sleep patterns. This is what we're trying to do. It's not working. Any suggestions? the physician can make that diagnosis of whether there's a sleep disorder, or whether it's just something else that's triggering them not sleeping well enough and recovering well enough. So you mentioned if they're sleepy throughout the day, that could be a sign. So it kind of raises the question, how do naps fit in to a child's sleep hygiene, you know, and what are some tips that a parent can use to balance their daytime nap with their nighttime sleep routine? the younger you are. the more beneficial naps are going to be, but they really need to be scheduled. You remember we're trying to develop these circadian rhythms. It's probably the best term to use these rhythms of wake and sleep throughout the day so that our bodies are getting adequate restoration, adequate time to grow, to develop. And so the younger we are and the faster we're growing, the more sleep that child may need. you might also find with older children that are going through growth spurts, they may need a little bit more sleep and naps might be more important. But the key is to make sure that the napping is not interfering with nighttime sleep. And so having those being more scheduled and then having a scheduled bedtime and making sure that those patterns are consistent. staying in sync with one another. if you're having too long of a nap and then they're not getting to bed easy enough, you might have to shorten that nap time or decrease the frequency of naps for younger children. for older children, balancing nap duration and timing can help ensure that they're tired enough to get a good restful night's sleep. when dealing with infants, they're going to sleep when they got to sleep. and their sleep cycles are not necessarily gonna be your sleep cycles. You know, you want to try and get them as much on a good pattern of sleep. but kids are gonna all be a little bit different. And so, you know, when we're looking at younger Children, Those naps are really going to help with their growth and development. So again, consistent nap times. We don't want to have naps that are too close to bedtime. if a kid misses a nap and it's getting closer to bedtime, Try and keep them awake. keep them active. get into that regular pre sleep bedtime routine and maybe get them to bed a little bit earlier know that they're probably going to sleep much more deeply and effectively because they're more tired for older children, adjust the nap duration and timing, to make sure it's not interfering with their nighttime sleep. You want to keep the naps a little bit shorter. Generally nap should be about 20 to 30 minutes and should be kept to be earlier in the day. Are there any misconceptions about Children's sleep that you'd like to address? Yeah, I have a list in front of me here of a few misconceptions that we often hear. Number one is that all children need the same amount of sleep. in reality, every child is different no matter what their age is. And sleep is going to vary for that same child as They age, so it's gonna be different when they're younger versus when they're a teenager. And so we just have to adjust the sleep patterns to fit that individual child. You have multiple Children. They're not all gonna have the same patterns. Some kids nap a lot better than other kids. some kids have better sleep patterns at night than their siblings might have. not all kids need the same amount of sleep. look at your Children individually and treat them as such. if a kid isn't falling asleep quickly, they're not tired. That's another misconception. I've found kind of from experience when kids are really wound up, and they're not falling asleep. Sometimes it's because they're overly stimulated and they get the most fussy and the most anxious and they're not going to fall asleep. It's not because of a lack of tiredness. It's that anxiety. It's that restlessness. It's that overstimulation that's keeping their bodies from kind of triggering the melatonin to ease them into sleep. if they're not falling asleep quickly, Look at what you what can we do to kind of wind them down calm them down a little bit better to get into their sleep Another misconception is that napping during the day will make nighttime sleep worse We just addressed that It really depends on the individual Napping can be a normal and important part of the sleep needs of different Children. Generally, the older we get, the less need we have for napping. I still need my naps on occasion, and I'm 61 years old. So deal with that. sleep problems are just a phase that Children will grow. that's again a misconception, especially when they persist. There could be other underlying problems. It's not normal to not be able to sleep. at night, right? whether a child, teen, young person or adult, we want to look at, you know, what's disrupting our sleep and trying to, again, get consistency within our sleep patterns. another misconception is that children who sleep through the night don't need as much sleep. even if a child sleeps through the night, like, you know, mentioning you said you fall asleep very easily, we still don't know that that's adequate sleep. If it's enough sleep for the child, how much sleep they need is really going to affect their nighttime and their daytime sleep. you may have kids that are going to need a little bit more napping. Even though they sleep through the night, they may not be getting enough sleep, because it's just not enough duration. You may have to extend that sleep wake cycle a little bit more. those are some of the misconceptions. I don't know if you can think of any others. not necessarily. I think you covered most of them, but what I would say is, the take home message from all of this is, although no child is the exact same, it is similar across the board, the importance of sleep hygiene and putting a kid on a strict routine and focusing on, Sleep and good rest. is going to help improve memory consolidation, brain maturity. It's going to restore and repair their body's needs and functions. It's going to help regulate their emotions. It's going to help with their overall growth and development, which, we want everyone to age well. And that's a huge, that's a huge factor of that. A good way to ensure that a child does get good sleep is to make sure that they are, not only lacking in screen time, just limiting it across the board. Make sure they get plenty of physical activities throughout the day. Make sure they're having a good strict routine. Make sure that they have lots of positivity and limit stress before bed. Make sure their diet is on par. We recommend the Mediterranean diet here on the Aging Well podcast. But similar diets, such as the Nordic diet, are also good things to have a child sleep well. And more importantly, help them age well. Thank you for listening. I hope you benefited from today's podcast. Until next time, keep aging well.