Naps: Does a routine of rest really matter? | by Lisa Marshall

Posted on Sun, Nov 4, 2012

Anyone who has been around toddlers and preschoolers much can tell you: Just one missed nap can turn a “little angel” into an intolerable grouch. But new research suggests it may do much more than that, blunting their capacity for joy, heightening their anxiety, and diminishing their tendency to ask for help when they need it. If prolonged, local sleep researchers and medical specialist say, sleep deprivation can ultimately stunt a child’s emotional growth and lead to behavioral, cognitive, and physical problems. The bottom line: Naps matter, perhaps more than we realize.

“The toddler and preschool years are a critical time for the development of emotion regulation, language, fine motor skills, and cognitive control processes. But it is also the point when a lot of kids stop napping,” says Monique LeBourgeois, PhD, director of University of Colorado’s Sleep and Development Laboratory and author of some of the first-ever studies exploring the impact of sleep on young children. “It’s a vulnerable window for them to start missing out on much-needed sleep.”

Dr. Noah Makovsky, a pediatrician with Stapleton Pediatrics, says that while every child’s sleep requirements are different, he generally recommends that children 18 months to 3 years old get 12 hours per night plus a 90-minute or longer nap per day. Between the ages of 3 and 5, they should still sleep 12 hours per night. While many parents give in to resistant kids or hectic schedules and phase out or eliminate a daytime snooze for their child after age 3, they often still need them well after their 3rd, and sometimes 4th birthday, he says.

Dr. Jessica Litwin, a sleep medicine specialist with Presbyterian/St. Luke’s Medical Center, notes that when children sleep it gives the brain a chance to “fine tune” neural connections and “consolidate knowledge” gleaned during wake-time. It’s also the time that the body secretes critical hormones which influence growth, metabolism, appetite and energy levels.

Some studies show that during a nap, levels of the stress hormone cortisol fall, enabling a child to awaken calm and – ironically – go to bed easier later.

“Some families think it will make children sleep better at night if they withdraw daytime naps, but it can actually make things worse,” says Litwin.

As LeBourgeois’ latest study points out, missing just one nap can have an impact.

The study, published in the Journal of Sleep Research, looked at healthy children who typically got at least 12.5 hours of sleep in a 24 hour period, including one afternoon nap. One day, they were videotaped after their nap. Another day they were taped after missing it. Each time, they were asked to work on an easy puzzle with all nine pieces available, then another puzzle which, unbeknownst to them, included a mismatched piece.

Researchers coded their facial expressions, tracking emotions like excitement, anxiety, joy, disgust, shame, and confusion, and compared reactions on nap days with no-nap days. The differences were stark: Nap-deprived toddlers not only reacted to the unsolvable puzzle with more stress and anxiety, but they also seemed to experience less joy when they solved the intact puzzle, instead exhibiting a flat response akin to someone suffering from depression.

The nap-deprived children, when working on the unsolvable puzzle, were also less likely to figure out there was a problem and ask for help.

While missing one nap is no tragedy, consistently facing the world while sleepy may prompt a child to miss out on joy, get overly frustrated, and shy away from interaction with others, putting them at risk for “lifelong, mood-related problems” Le Bourgeois says.

“For toddlers, daytime naps are one way of making sure their sleep tanks are set to full each day.”

Here’s how to get your toddler to take one:

Be consistent: “You cannot force anyone to go to sleep,” says Makovsky. “But what you can do is set up a routine and an environment that facilitates it.”

Try to time your child’s nap around the same time every day. Create a routine – perhaps lunch, followed by a change into pajamas, and a 15-minute story. Then pull the shades, close the door, and try to keep siblings and other distractions away.

While, in an ideal world, this would all happen at home at every day, it doesn’t have to. If you’re at a friend’s house at naptime, find a quiet room and follow your routine there.

“Lack of routine is the number one thing that keeps kids from taking naps,” Makovsky says. “People are too open about how their day is going to go and just assume that kids will go to bed when they determine it is time. That doesn’t work.”

Follow your daycare’s routine: Makovsky often hears from parents whose children nap great at daycare but horrible at home. That’s probably because they’ve settled into the routine there. Find out what time they nap at childcare, where, and what they do beforehand and try to mimic it.

Keep car naps to a minimum: While many children will fall asleep in the car seat as soon as the wheels start moving, the quality and length of their sleep is likely to be far less than in their crib or bed. Meanwhile, a short nap in the car can sabotage a quality nap at home.

Set limits and offer praise: You wouldn’t allow your child to put his or her hand on the stove. So why would you allow your child to refuse a nap that is critical for his or her health? “Just like you would set limits around other things that are important to your child’s health, you need to set limits around naps,” says Litwin. Make it clear that there will be consequences, like a “time out”, if Junior crawls out of the crib or throws a fit. On the flip side, offer praise – perhaps a sticker on a wall calendar – if he or she takes a nap without argument.

Know your child: While some kids need to nap until they are 5, others can healthily do away with them at 3. If your child is hyperactive, moody, or showing a sudden shift in behavior, you may have cut nap time out too soon.

Settle for downtime: Even if naptime is officially behind you, young children can still benefit from an hour of down time each day, says Makovsky. Pull the door close, provide them with some books, and set a timer for when they come out. They may even nod off before it goes off.



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