Whether we are talking about general health, physical, weight, mental, academic or behavioral health there is one thing that we have to start with, always:
SLEEP.
No matter the concern in the office, I start with sleep. Focus is off? Hyperactive? Increasing weight? Decreasing weight? Behavioral issues?
Tell me about your child's sleep.
Heck, start with your own. After all, I'm putting my pediatrician-hat to the side for a moment.
Tell me about your sleep last night. What did you do leading up to bedtime? When did you lay down? Turn off the lights? Close your eyes? Fall asleep? When did you awaken in the morning? Tell me about your level of refreshment when you were getting up.
I lead with a question about sleep in the vast majority of my clinical encounters as a physician. No matter if I am working with teens, younger kids, newborns (want to know about their parents' sleep!), or my time working with Marines as a general medical doc, I want to know about sleep. The same thing goes when I'm working with stressed out parents: your sleep matters!
When we don't get consistent, restful sleep, everything else gets hairy.
For example, I met a 12 year old girl this week in the office for her well visit. Growth, academics all on-point. I asked about her sleep. She is getting an estimated 6.5 hours of sleep every night. The CDC recommends that children her age get 9-12 hours of sleep per 24 hour period, and let's call it out: the vast majority of our kids aren't receiving the 9, let alone a mythical, magical 12 hours. (See this beautiful, CDC chart to find the recommended amounts of sleep for each member of your family).
The key thing to notice for this child and her family: she had no "external" signs of sleep deprivation.... yet. The most important thing to do is to address the pattern - the habit of sleep deprivation - before it becomes a problem, where the stress of chronic sleep deprivation increases cortisol, disrupts neural pathways in the brain, impacts growth and behavior and academics and...
What's getting in the way?
So often, we believe that we "don't need that much sleep." But that is because we haven't tried it. We are saying that we don't need it to justify whatever it is that is getting in the way.
As adults, we think that we will "sleep when we die." Or "when I get done with this project, I can rest.
It's all a lie, as there is always something else that comes up.
For kids, is it academics? Sports/activities? A desire to "relax" with electronics (TV, social media, scrolling)? Connecting with friends into the wee hours of the night? Or... is there fear, anxiety or safety concerns, where the child is protecting themselves by sleeping as little as they can?
We all want a simple answer: this is how you sleep more. It is both simple and complex.
1) Get curious: how much sleep are your family members getting right now?
2) What's getting in the way of regular, restful sleep?
3) What experiment can you try today, to start shifting to more, restful sleep?
In our home, we have never had TVs in bedrooms. However, it has been an ongoing practice (read: mistakes have been made) to get cell phones out of the bedroom.
I've found that setting an alarm clock when needed to awaken is much more helpful than having the "excuse" of my cellphone next to my bed, beckoning me with every light sleep cycle. It's also so refreshing to not reach for my phone first thing in the morning (isn't it crazy how automatic that habit becomes)?
I didn't realize just how "hairy" life had gotten for me in the early years of parenting. I was chronically sleep-deprived by nature of being in medical training, as a parent of 2 young kids, and with a spouse who was often gone with call schedules or deployments. I also thought that I had to keep going into the wee hours to get more things done.
After a fortuitous illness, I found myself sleeping 9 hours per night and actually feeling refreshed in the morning. Holy moly - no wonder I was so stressed when I was giving myself only 2/3 of that before.
It's not "carving out time" to sleep. It's giving myself the rest, rejuvenation and care that I need to be so much nicer, focused, functional, and quite honestly the person I want to be during the day.
What is possible for you and your family?
Check out the Family in Focus with Wendy Schofer, MD Podcast!
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