children and sleep Archives

Nearly every parent struggles to get their infant on a sleep schedule that works – and allows the parents to be functional – but what about children who aren’t good sleepers as they age? And what about neurodiverse children who don’t sleep well?

We met one mom on a mission to make life easier for the rest of us.

Meet Melisa Moore, PhD, a clinical psychologist who is board certified in behavioral sleep medicine. In her Los Angeles practice, she works with children, teens and young adults for a variety of sleep and mood issues, and she specializes in neurodiversity. So much so that Melisa wrote a book: The Good Sleep Guide for Neurodivergent Kids. It’s due out in March, which happens to be National Sleep Awareness Month.

We asked Melisa to share her experience, her expertise and what prompted her to write the book?

L.A. Parent: What exactly is sleep medicine?

Melisa: Sleep medicine is a medical specialty focused on understanding and improving sleep. It helps identify and treat common sleep problems in children and adults, such as insomnia (trouble falling or staying asleep) and obstructive sleep apnea (pauses in breathing during sleep). What makes sleep medicine unique is that it brings together a team of doctors, psychologists, nurses, respiratory therapists and others who work together to support your child and your family.

Sleep medicine isn’t just about diagnosing sleep disorders, it’s about helping families build healthy sleep habits so children can grow, learn and thrive – and parents can get the rest they need too.

L.A. Parent: How did you develop your interest and expertise in this field?

Melisa: When I was a graduate student, I loved working with teenagers and wanted to focus my research on something that truly affected their health and day-to-day lives. I quickly realized that sleep touches almost every part of adolescent life. As I became more immersed in the field, I saw firsthand how improving sleep could make a real difference not just for children and teens, but for their entire families. That’s what drew me to sleep medicine and continues to motivate my work today.

L.A. Parent: When, and how, did you realize your son needed help to become a good sleeper?

Melisa: My son was a good sleeper when he was younger, but around kindergarten age I started noticing things about his sleep that felt different. For months at a time, he would wake up at 4 a.m., wide awake and perfectly happy. Other times, if he got a new toy or learned something exciting, his mind just wouldn’t slow down and it could take hours for him to fall asleep. Experiences like these helped me understand how differently children’s brains can respond to sleep and how important it is to look beyond “typical” sleep advice.

L.A. Parent: How did your son respond?

Melisa: To be honest, it was a lot of trial and error. Some things helped and some didn’t. What did help and still does, was a combination of strategies: Setting his bedtime closer to when he was actually able to fall asleep (which meant a later bedtime), teaching him quiet, calming ways to help distract his busy brain, gently reminding him every 15 minutes or so that it was time for sleep and using a melatonin supplement.

L.A. Parent: What do you want parents to get out of the book?

Melisa: First, my hope is that having science-based, comprehensive sleep information specifically focused on neurodiversity helps families get better sleep. Just as importantly, I want parents to feel less alone.

I’m in about the best possible position to help my own neurodivergent son sleep well – I do this work professionally, I know many experts I can turn to and I have access to the latest research. And still, sleep has been genuinely challenging for our family.

Melisa Moore, PhD, is a clinical psychologist who is board certified in behavioral sleep medicine.

That experience has reinforced something I want every parent to hear: If your neurodivergent child struggles with sleep, it’s not because you’re doing something wrong. This is hard. Your child’s brain works differently, and sleep can be more complicated.

The good news is that there’s almost always something else to try, whether it’s a new strategy, a different approach, or even a small tweak that makes a big difference. Our understanding of neurodiversity and sleep is always evolving, and that means new ideas and tools are becoming available all the time.

Melisa Moore, PhD, is the author of “The Good Sleep Guide for Neurodivergent Kids,” which is available at Barnes & Noble, Bookshop.org and Amazon. Melissa will be doing two free author talks/book signings: March 6 at 7 p.m. at Vroman’s Bookstore in Pasadena, and March 10 at 6:30 p.m. at Diesel Bookstore in Santa Monica. A clinical psychologist board certified in behavioral sleep medicine, she currently works for the Sleep Center at Rady Children’s Health San Diego helping to develop their behavioral sleep medicine program. She also has a practice in the Los Angeles area working with children, teens and young adults across the country for a variety of sleep and mood issues, specializing in neurodiversity. Visit her online at http://www.DrMelisaMoore.com.

Doctors advise avoiding screens for at least an hour before bedtime.

Back-to-school season ushers in earlier alarms, busier schedules, homework, after-school activities and that old familiar battle: bedtime.

The question is: Should getting our kids to sleep really be a nightly battle? After all, how much shut-eye do they actually need?

We reached out to Brittany N. Middleton, M.D., FAAP, who is medical director of pediatrics at Huntington Hospital, to answer some of our questions.

How important is sleep for kids, tweens and teens?

Brittany N. Middleton, M.D., FAAP
PHOTO COURTESY HUNTINGTON HOSPITAL

Sleep is incredibly important for children of all ages (all people, really!). We have a circadian rhythm in which melatonin, a hormone that helps us sleep, is released when it is dark and not released when we are exposed to daylight. During sleep, our bodies and minds are in a crucial recovery state. Insufficient and poor-quality sleep can cause problems with mood, behavior, learning, attention and physical health. Irritability, tiredness, hyperactivity and poor school performance may all be signs of poor sleep. Too much sleep has been linked to diabetes, obesity and mental health problems. Parent surveys have shown that sleep problems may affect 25-50% of preschoolers and up to 40% of adolescents. The more common complaints include insomnia, daytime sleepiness, snoring and things like nightmares, sleepwalking and bedwetting.

Should kids have a bedtime? And what do you recommend that time be? How about tweens and teens?

Yes, kids should have a bedtime. Children thrive with some structure in place, and a consistent bedtime — even on weekends — is a healthy sleep practice. The bedtime will depend on the age of the child. No two kids are the same, so within the range suggested, the parent will have to identify how many hours are ideal for their child and set their bedtime accordingly. The bedtime will depend on the desired morning wake-up time and consider any daytime naps the child will take. Newborn and young infant sleep is unique, as they do not have established circadian rhythms, require significant help from the caregiver to sleep and naturally have frequent night waking. Adolescents have a naturally delayed circadian rhythm — a naturally later bedtime — that can make it difficult to get enough sleep with early school start times and other social and academic demands, so adhering to a routine is even more important in this age range.

General sleep requirements by age:

Ages 4-12 months: 12-16 hours (including naps)
Ages 1-2 years: 11-14 hours (including naps)
Ages 3-5 years: 10-13 hours (including naps)
Ages 6-12 years: 9-12 hours
Ages 13-18 years: 8-10 hours

How can parents help transition kids from a summertime sleep schedule, which can be more flexible, back to the school year schedule?

The most important and effective thing you can do is set an earlier bedtime. If there is a large time gap between the current bedtime and the desired bedtime, walk the bedtime back by 15 minutes every few nights until you arrive at the desired bedtime. Pay attention to how much sleep your child has gotten when they act and feel well rested and try to match their regular sleep duration with that. A nap can help restore some of the sleep debt, but regular napping in a child who does not usually nap can interfere with night sleep, so an earlier bedtime is a more appropriate long-term solution.

What can parents do to improve their kids’ quality of sleep?

Set a bedtime that allows them to sleep within the recommended time range for their age, ideally even on weekends. This is the most important thing you can do.
A bedtime routine can help them “take off the day” and wind down for bed. It should be relaxing, not stimulating, long or complicated. This prepares the body and mind for sleep and, eventually, their body will know that sleep is coming based on the sequence of events. In younger children, bath, brushing teeth, book and then bed is a common bedtime routine. In older children, the routine can include things like journaling, stretching or a body-scan meditation to relax the body and mind.
Avoid screens for an hour before bedtime.
Avoid stimulants like caffeine (including chocolate) several hours before bedtime.
Foster good physical and emotional health. For example, be physically active and teach processing of emotions and coping strategies.
Assess the sleep environment for excess light, temperature extremes and excess noise.
Consistently enforce limits on bedtimes and bedtime routines. Offer positive reinforcement for compliance.

What’s one thing you wish all parents knew about sleep?

With the abundance of screens, demanding school schedules, extracurricular and other social activities, you will likely have to take a more active role in making sure your child gets enough sleep. Each child is different, so tune into your child as you assess and make changes. Speak with your pediatrician for specific strategies to improve your individual child’s sleep and to help identify causes of poor sleep that might require medical intervention.

Sleep Advice for Neurodivergent Kids

Should You Battle Over Bedtime?

L.A. Parent