Your toddler spends his days learning at school, running on the playground, eating meals, reading books with Dad, playing in the backyard and bouncing in the tub during his bath. At last bedtime arrives; the marathon ends and his little body can rest in dreamland, right?

Not exactly. In fact, a child’s body and brain are busy during slumber preparing for another day of tasks and growth, so it’s vital that children get the proper amount of sleep.

So just how much is enough sleep for your child? Every child is unique and has unique sleep needs; however there are recommendations based on age. Newborns require about 15 to 18 hours because as they adjust to a new world, their sleep patterns are irregular the first few months. Infants 3 to 11 months need about 14 to 15 hours; toddlers require about 12 to 14 hours; preschoolers should get 11 to 13 hours; and school-age children need about 10 to 11 hours of sleep. These totals include naptime for children up to age 5.

Here are basic guidelines for sleep that I recommend you follow with your child regardless of age:

Develop a regular daily bedtime schedule, and don’t stray from it - even on weekends. Your child’s body gets used to an established rejuvenation time and will be ready for sleep.

Create a standard and enjoyable bedtime routine. Set aside 15 to 30 minutes to get your child ready to go to sleep each night. Children like a sense of predictability in their routine because it brings them comfort. A suggested routine, especially for children 10 and under, would include:

1. Take a bath.
2. Put on pajamas.
3. Brush teeth.
4. Read a story.
5. Put child in bed.
6. Say goodnight and leave.

Avoid before-bedtime sleep traps. Do not let your child eat chocolate or sugary foods or drink caffeinated beverages before bedtime. It’s also important to establish an early curfew on TV watching, video games and even vigorous play, so that children are not over-stimulated close to bedtime.

Establish a permanent "sleep-friendly" environment. Make sure your child’s bedroom is quiet, dark and at a comfortable temperature. Keep the bedtime environment the same all night.

Encourage your child to fall asleep independently. Whether an infant, toddler or older child, this is a must. I recommend accomplishing this in your child’s infancy. The older children get, the harder it will be to break their dependence on Mom or Dad for help with falling asleep, and that can affect Mom and Dad’s bedtime.

Studies show that about 37 percent of children - kindergarten through fourth grade - suffer from a sleep-related problem. Common minor ones include:

• Frequent awakening during the night. 
• Talking during sleep. 
• Difficulty falling asleep.
• Waking up crying. 
• Feeling sleepy during the day. 
• Teeth grinding and clenching. 
• Waking early.
• Bed wetting. 
• Nightmares.

Sleep problems can hinder day-to-day functions and can even contribute to illnesses by weakening a child’s immune system. However, most of the above sleep problems can be improved with an established bedtime routine. Bed wetting is normal, especially during the potty training stage, but if it continues beyond training, you should consult your pediatrician for help in eliminating bed wetting. As for nightmares, all children experience them, and they usually occur at times of transition, stress or change in routine. They happen later in the night and are remembered the next day. Fortunately, nightmares tend to go away naturally. I recommend prompting your children to talk about their nightmares and how these dreams made them feel. Reassure them that there is nothing to fear, and that you are in the next room as their protector. Reading happy stories and avoiding television immediately before bedtime are also strategies that help alleviate nightmares.

Following guidelines and routines is not always effective, and some children have more serious sleep problems. The ones to watch out for are:

1. Sleep Walking: This kind of behavior occurs most often in children age 4 through adolescence. These sleep disruptions happen during the early evening. The child is both asleep and awake at the same time and usually has no memory of the event the next day. Waking or comforting the child is usually not helpful because it prolongs the issue. Instead, be sure your child’s room and your house is safe to prevent sleep-walking accidents.
2. Night terrors: Also called sleep terrors, these episodes of screaming and agitation in the middle of the night are generally observed in children ages 4 to 8. They are probably best understood as a variation of sleep walking. Your child isn’t dreaming and won’t remember the night terror, so don’t mention it when she wakes the next morning. To prevent night terrors, awaken your child gently each night shortly after sleeping begins or just before the time you’ve observed the night terrors. Tuck her back in, tell her you love her and go back to bed. Often, this jostling of the sleep system in the brain will prevent her from having an episode.
3. Sleep Apnea: This is a serious disorder in which there are pauses in your child’s breathing rhythm while sleeping. Children with sleep apnea may snore loudly, experience restless sleep and be sleepy during the day. Enlarged tonsils or adenoids, allergies, weight problems and other medical issues may contribute to sleep apnea. 
4. Narcolepsy: These "sleep attacks" are first noticed in puberty, but may occur in children as young as 10. Children with narcolepsy experience excessive daytime sleepiness and uncontrollable sleep urges even when they are getting enough sleep. Children suspected of having narcolepsy should be diagnosed by a doctor.

Fortunately, as they mature, children usually overcome common sleep distress and even some of the more serious disorders. However, parents with ongoing concerns should contact their pediatrician or seek a sleep specialist. With a little discipline, intervention, and, if necessary, assistance from a physician, you can help achieve sweet dreams for your children - and you.

MCG Health, Inc. (d/b/a MCGHealth) is a not-for-profit corporation operating the MCGHealth Medical Center, MCGHealth Children’s Medical Center, the Georgia Radiation Therapy Center, and related outpatient facilities and services throughout the state. For more information, please visit mcghealth.org.