body rocking are frequent. By one year, sleep time av-
erages twelve hours distributed into a long sleep peri-
od at night and two daytime naps.
Across early childhood, daytime naps gradually
disappear, resulting in decreased daily sleep. By age
four, children sleep about eleven hours per day and
many have given up napping. Not only do pre-
schoolers sleep less than infants, they also fall asleep
differently. Young children are often reluctant to go
to sleep, and bedtime rituals may take on a predict-
able pattern with children who have been tucked in
perhaps requesting a drink of water or another good-
night kiss. Children over the age of three are also
more likely than younger children to depend on a fa-
vorite blanket or teddy bear to help them fall asleep.
By six to ten years of age, children are generally
‘‘good sleepers,’’ sleeping soundly for about ten hours
at night and staying alert during the day. But as they
approach puberty, sleep patterns undergo further
change. Studies in the United States, Europe, and
elsewhere reveal an increasing tendency among ado-
lescents to sleep less, to go to bed later, to develop dif-
ferent patterns of sleep on weekends and weeknights,
and to report increased daytime sleepiness. But con-
trary to popular belief, adolescents do not necessarily
need less sleep. Although optimal sleep time for ado-
lescents is about nine hours per night, most adoles-
cents average less than eight hours. This is
unfortunate because inadequate sleep is associated
with poor school performance, mood and behavioral
problems, and increased risk for automobile acci-
dents.
A study of school-age children in Israel showed
that sleep habits identified in adolescents may be
drifting down to younger ages. In addition, girls in
the study slept more and moved less in sleep than
boys, a finding that has also been observed in new-
borns. Overall, however, researchers have found rela-
tively few gender differences in sleeping patterns.
Sleep Requirements
It is not clear how much sleep is optimal for chil-
dren because most studies have been based on small
samples. Until developmental norms are established
for large representative samples of children and ado-
lescents, parents may need to monitor their child’s
behavior. A child who has difficulty waking in the
morning, or is consistently sleepy, irritable, and inat-
tentive during the day, may not be getting enough
sleep.
Sleep Disorders
Two general categories of sleep disorders are rec-
ognized. Dyssomnias are problems with the initiation
or maintenance of sleep, or with sleep that is ineffi-
cient. These include common sleep timing problems
such as frequent night wakings and difficulty falling
asleep at night or difficulty waking in the morning.
Dyssomnias also include relatively rare problems such
as obstructive sleep apnea (associated with enlarged
tonsils and adenoids) and narcolepsy (sudden day-
time sleep attacks).
Parasomnias occur during sleep but are not asso-
ciated with insomnia or excessive sleepiness. Com-
mon parasomnias in children include head banging
or rocking (exhibited by about 58% of children) and
nightmares (most commonly of being attacked, fall-
ing, or dying). Nightmares are not the same as the
rarer sleep terrors, a disorder in which a child, al-
though asleep, appears to be awake and terrified. In
sleep terrors, the child is screaming and incoherent
with a glassy-eyed stare, profuse sweating, and rapid
heart rate and respirations. The child is difficult to
rouse and calm, and in the morning retains no mem-
ory of the episode. Both nightmares and sleep terrors
occur during the transition from NREM sleep to REM
sleep. They generally resolve with age. Other para-
somnias are teeth grinding (bruxism), sleepwalking,
and sleep talking. Bed-wetting (enuresis) is also con-
sidered a parasomnia if it continues after the age of
five in the absence of physical or psychiatric patholo-
gy.Dreaming
Children’s dreams have often been described as
bizarre and fantastical in nature. Early theories of
children’s emotional development (e.g., psychoana-
lytic theory, which maintained that dreams are wish
fulfillments) contributed to this view. But how dreams
are studied may also play a role. Dreams reported
after they occur may have been recalled because they
were bizarre. David Foulkes showed in laboratory
studies that if children were awakened during REM
sleep and asked to describe their dreams, a different
picture emerged. Although some dreams contained
bizarre elements, children generally dreamed about
familiar people, settings, and actions. In addition,
dreams changed with age. It was not until about age
eight or nine that dream reports began to include
narratives that featured activity by dream characters
with the self as a participant. Foulkes concluded that
dreaming in children is linked to general intellectual
development with dream construction dependent on
abstract, representational thought.
In general, empirical research on children’s
dreams has been sparse. While knowledge of many as-
pects of sleeping in childhood has grown since the
1950s, relatively little is known about the intriguing
topic of children’s dreams.SLEEPING 371