It’s important to keep good daily habits, like getting enough sleep, now that your family is resuming a regular routine.

The COVID-19 pandemic and Singapore’s subsequent Circuit Breaker has greatly affected the way we live.

However, while the Circuit Breaker greatly restricted our lifestyles, one benefit was that children enjoyed more sleep, especially among Primary and Secondary school students. Because schools were closed, students could wake up later! I experienced this personally with my son, who is in Primary school.

However, as we transit to a “new normal”, post-Circuit Breaker, with some students having to spend alternate weeks at home and in school, it is important to establish good daily habits to promote healthy sleep. This article focuses on cultivating good sleep habits in the post-Circuit Breaker phases.

#1. Develop good sleeping habits

Remember that parents are the leaders of the family, so self-care and setting a good example for the children are very important. Adults need at least seven hours of quality sleep some even need up to nine hours a night, and this requires self-awareness.

Besides the quantity of sleep, the quality of sleep is also important. Contrary to what some people believe, snoring (whether in adults or children) is not normal as it can disrupt sleep quality and work performance. So, adults (and children) who snore should seek treatment from a sleep or ENT specialist.

Children should wake from their last nap with at least four hours or more before their desired bedtime. If not, the “sleep inertia” from the last nap would interfere with them falling asleep at bedtime.

#2. Set up nap- and bedtime routines

As the COVID-19 pandemic is causing major disruptions to our lifestyle, it is important to establish good routines that are within our control. Infants, toddlers and preschool children should get regular naps.

However, parents should note that children should wake from their last nap with at least four hours or more before their desired bedtime. If not, the “sleep inertia”^ from the last nap might prevent them from falling asleep at bedtime.

A bedtime routine is three to four soothing activities that is done consistently before bedtime. An example for a younger child may include changing to pyjamas, hugging/snuggling and singing lullabies. For an older child it may include brushing teeth, changing to pyjamas, reading bedtime stories. You should tailor a routine based on your family’s preference. This daily routine acts a signal for bedtime, especially for children who cannot yet tell the time, and also helps to relax the body for sleep. This is also a time of family bonding I personally encourage a faith-based routine, for example, my family reads the Bible and prays before bedtime.

#3. Reward positive behaviour

Reward charts help motivate children above age 2. For example, if your child goes to bed on time without fussing or stalling for time, give one sticker. Getting three stickers may earn one reward, such as time with a special toy or a family fun activity. If possible, do try to avoid offering snack foods or TV/screen time as rewards.

Start with realistic small steps and initially make it easy for your child to earn the reward. To further improve the behaviour, you may set a higher standard to earn the sticker or increase the number of stickers (such as to five stickers) needed to earn that special reward.

^ That groggy feeling when you first wake up ― it occurs because some of your brain is still in a sleep state. Sleep inertia typically lasts 15 to 30 minutes but can last up to four hours.

 

#4. Do some physical activities

Exercising in the day makes it easier to fall asleep at night. Exercise with your kids in the nearby park as we are now permitted to exercise as a family. Or do indoor exercises such as stretching and dancing. Do note, however, to avoid strenuous exercise three hours before bedtime to give your body time to calm down as late exercises might impact your sleep adversely.

#5. Spend time on things that make you happy

With mostly bad news overwhelming us daily, it is easy even for an adult to feel helpless. Even for myself and other healthcare providers, it is important to decide how much information is necessary. As life is not all about COVID-19, it is important to spend time on happier endeavours.

If you have younger children, it is best to restrict viewing of live news on TV as certain images may be scary and may trigger nightmares or fears about being in the dark at bedtime. Do use age-appropriate language to talk to younger children about COVID-19.

For older children who have access to their own news sources (usually through social media platforms), parents should spend time with them to understand what they know and feel about the situation.

For healthy sleep, it is important not to be exposed to bright light ― including light from device screens ― one to two hours before sleep as it may affect one’s ability to fall asleep.

#6. Use screen time appropriately

The American Academy of Pediatrics stipulates that children under 18 months should not have screen time, children 18 to 24 months can have video calls at parental discretion, and children aged 2 to 5 be restricted to an hour of quality screen time a day. Too much screen time may result in delayed developmental milestones especially in speech, language and social skills.

However, in these stressful times, the above guidelines may not be realistic for many families. Parents (myself included!) should not feel guilty if we aren’t able to follow them strictly, as we are also struggling to do our best for our children during this unprecedented crisis in modern history.

Nevertheless, we should still strive to set some limits, whether it is the quantity of screen time, or the choice of media our children are exposed to. Especially with young children, parents should use media together with their children and not leave them alone in front of the screen.

For healthy sleep, it is important not to be exposed to bright light ― including light from device screens ― one to two hours before sleep as it may affect one’s ability to fall asleep.

#7. Get help, if necessary

It’s okay to look for help if you/your child have tried all the above suggestions and still need assistance to enjoy a good night’s rest. For example, a healthy child that’s above 6 months old should be capable of sleeping through most of the night, so that you can rest well.

Nevertheless, frequent night wakings is common and occurs in about 25 per cent of children. Based on your family’s needs, you can sleep-train your children, so that you can get more rest.

Dr Theodric Lee, a paediatrician with a special interest in respiratory and sleep medicine, practises at Thomson Paediatric Centre (Jurong East). He consults on sleep problems and offers personalised sleep-training solutions on telemedicine platform HiDoc.

Photos: iStock

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