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