Pediatric Sleep and Rest Norms: Nursing Implications and Parental Guidance

Pediatric Sleep and Rest Norms Nursing Implications/Parental Guidance
INFANT: 16-20 hour/day
  • 3 months: nocturnal pattern
  • 6 months: 1-2 naps, with 12 hours at night
  • 12 months: 1 nap, with 12 hours at night
  • No set schedule can be predetermined.
  • If waking at night after age 3 months, investigate hunger as a probable cause.
  • Monitor behavior to determine sleep needs: alert and active? Growing, developing? Routine fairly well established
TODDLER: 12-14 hour/night
  • “Dawdles” at bedtime.
  • Dependency on security object.
  • May ask to sleep with bottle.
  • May rebel against going to sleep.
  • Set firm, realistic limits
  • Place favorite blanket or toy in crib/bed.
  • Avoid “bottle mouth syndrome” (caries).
  • Establish bedtime “ritual”.
PRESCHOOL 10-12 hour/night
  • Gives up afternoon nap.
  • Difficulty falling asleep/nighttime waking.
  • Fear of dark.
  • Enuresis.
  • May begin to have nightmares.
  • Provide “quiet time” in place of nap;
  • May regress in behavior when tired.
  • Avoid overstimulation in evening.
  • Leave night-light on, door open.
  • Occasional accidents are normal.
  • Comfort child but leave in own bed.
SCHOOL-AGE: 8-12 hour/night
  • Nightmares common.
  • Awakens early in morning.
  • May not be aware he or she is tired.
  • Likes to stay up late.
  • Slumber parties.
  • Comfort child but leave in own bed.
  • Important that child play/relax after school.
  • Remind about bedtime.
  • “Privilege” of later bedtime can be “awarded" as child gets older.
  • Permit, as good opportunity to socialize.
ADOLESCENT: 10-14 hour/night
  • Need for sleep increases greatly.
  • May complain of excessive fatigue.
  • Needs vary greatly among individuals.
  • Rapid growth rate.
  • Related to rapid growth and overall increased activity.