Children's Hospital Colorado

Insufficient Sleep

What is insufficient sleep?

The amount of sleep a child needs falls within a range, much like adults. Any particular kid may be a long sleeper, requiring more sleep, or a short sleeper, who requires less sleep than his or her peers. 

Sleep needs also change with age. These are typical ranges for kids by age, in a day or 24-hour period:

  • Newborns (0 to 2 months): 11 to18 hours every 24 hours
  • Infants (2 to12 months): 11 to 17 hours every 24 hours
  • Toddlers (1 to 3 years): 12 to 14 hours every 24 hours
  • Preschoolers (3 to 5 years): 11 to13 hours every 24 hours
  • School-Aged Children (6 to12 years): 10 to 11 hours each night
  • Adolescents (13 to18 years): about 9 hours each night

A helpful clue to figure out how much sleep a child gets every night is asking parents about their own sleep habits. Sufficient sleep is enough sleep to wake up in the morning and feel refreshed throughout the day.

Insufficient sleep can cause a number of problems, including decreased brain development and learning problems, weight management and growth issues, increased illnesses and more frequent negative emotions.

What causes insufficient sleep?

There can be many causes of insufficient sleep, including medical problems, mental health issues, and bad sleep hygiene habits. Some examples of medical conditions that contribute to poor sleep are: obstructive sleep apnea, periodic limb movements, excess movement when sleeping and acid reflux.

Insomnia often causes insufficient sleep and unrefreshing sleep. Insomnia is the inability to fall asleep in a reasonable amount of time, or getting “stuck” awake during the night. Depression, anxiety, trauma, life changes, hormonal fluctuations, poor sleep habits and an “overly active mind” can all contribute to insomnia. Insomnia can occur at any age, but is most commonly seen in adolescents and adults. 

Night awakening problems are frequently seen in babies and younger children. Parents often describe the condition as a baby who won’t stop crying during the night or a child who won’t stay in bed throughout the night. These extended waking periods and disruptions in sleep often reduce the amount of sleep both the child and other family members can get during the night. Night awakening is often caused because a child or baby has not learned to “self-sooth” back to sleep after the natural waking we all have throughout the night.

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What are the signs and symptoms of insufficient sleep?

  • Problems paying attention
  • Hyperactivity and impulsiveness (especially in younger children)
  • Low energy
  • Poor mood regulation (often upset and "moody")
  • Decreased social skills
  • Falling asleep at school and sleeping during short car rides
  • Taking naps when no longer of a napping age
  • Hard to get out of bed in the morning
  • Complaining of being tired
  • Reports that it takes too long to go to sleep or can’t stay asleep

What tests are used to diagnose insufficient sleep?

In order to determine a child’s baseline sleep patterns, doctors often request that a family keep a “sleep log” to record their child’s bedtimes, wake times and night waking.

Another way to assess a patient’s amount of sleep is to have the patient wear an “actigraphy watch,” usually for a week while sleeping normally at home. This device looks like a wristwatch, but instead of telling time, it records the patient’s movement, how much sleep occurs, how long it takes to fall asleep, how much time is spent awake throughout the night and the amount of light in the room.

In some cases, our doctors may recommend an overnight sleep study if they suspect that sleep disordered breathing or excessive movement may be decreasing sleep. Healthcare providers may also order blood tests to see if a thyroid problem or acid reflux is causing less sleep.

How do providers at Children’s Hospital Colorado make a diagnosis?

The most important part of diagnosing insufficient sleep is talking with the family to get a thorough sleep history. This conversation usually takes place with a physician or nurse practitioner specializing in assessing and treating sleep disorders. Your child’s medical providers may also recommend further evaluations to fully explore all possible reasons for insufficient sleep.

How is insufficient sleep treated?

Families often also work with the sleep team’s psychologist to resolve insufficient sleep. While this may involve more than one visit, it is often resolved with two or three visits and phone consultations. The psychologist helps families learn new habits and behaviors that support improved sleep. In most cases, an important part of increasing sleep is improving sleep habits, which health care providers call “sleep hygiene.”The first step in treating insufficient sleep is making sure that any medical problems that could reduce sleep are properly diagnosed and treated. This begins with a visit to the sleep clinic with a physician or a nurse practitioner specializing in sleep treatments. After an exam, these providers will suggest possible treatments and may recommend additional tests or procedures. 

Children with insomnia regularly learn cognitive behavioral therapy (CBT) tools which help them to more effectively relax and mentally refocus as a way of inviting sleep. Treating night awakenings involves training infants and children to learn to sooth themselves back to sleep after their natural waking during the night. In all cases, our sleep psychologist offers support for families interested in making sleep changes because we recognize that teaching and learning new skills and behaviors is often challenging for our patients and families.   

Why choose Children’s Hospital Colorado for your child’s insufficient sleep?

The Children’s Colorado Sleep Team is an excellent resource for treating insufficient sleep for children and adolescents. Our providers are known internationally for their expertise in sleep research and sleep treatments. The team is made up of sleep specialists trained in different aspects of sleep treatments, including: sleep physicians who specialize in children’s breathing and ear-nose-and throat problems, a sleep-specialized psychologist, two sleep-specialized nurse practitioners, a sleep-specialized respiratory therapist and a dedicated sleep nurse. 

We often coordinate care with other specialists and primary care physicians involved in each family’s treatment. Most importantly, we have very caring staff members who are willing to listen to families and go the extra mile to improve your child’s sleep and optimize his or her development. 

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