Young Children

There are a limited number of studies that address normal sleep architecture in young children; however, one trend that appears to be consistent is that sleep amounts decrease as a child gets older. The reduction cannot be attributed solely to physiologic requirements, because cultural environments and social changes also influence changing sleep characteristics in young children. Total sleep time decreases by 2 hours from age 2 to age 5 (13 hours to 11) (Roffward et al., 1966). Socially, the decrease in time asleep may be a result of decreased daytime napping, as most children discontinue napping between 3 and 5 years old (Jenni and Carskadon, 2000). Other social and cultural factors that begin to influence sleep include how, with whom, and where children sleep and the introduction of school time routines (Jenni and O’Connor, 2005).

Physiologically, it has been suggested that by the time children enter school (typically 6 years old) they begin to manifest circadian sleep phase preferences—a tendency to be a “night owl” or “morning bird” (Jenni and Carskadon, 2000). Older children, however, are significantly more likely to experience challenges in initiating and maintaining sleep than younger children. In addition, older children are more likely to have nightmares, which usually disrupt sleep, making it discontinuous (Beltramini and Hertzig, 1983). One study found that children appear to have longer REM sleep latencies than adolescents and consequently spend a greater percentage of sleep time in stages 3 and 4 (Gaudreau et al., 2001).

Adolescents

A complex and bidirectional relationship exists between pubertal development and sleep. Studies underscore the importance of using pubertal stage, rather than chronologic age as the metric in understanding sleep, as has been found for other physiologic parameters in the second decade of life. It has been determined that adolescents require 9 to 10 hours of sleep each night (Carskadon et al., 1993; Mercer et al., 1998), though few adolescents obtain adequate sleep. In the United States, the average total sleep time in a sample of eighth-grade students was found to be 7.9 hours (Wolfson et al., 2003). Over a quarter of high school and college students were found to be sleep deprived (Wolfson and Carskadon, 1998).

SWS and sleep latency time progressively declines with advancing pubertal development (Carskadon et al., 1980); however, time spent in stage 2 increases (Carskadon, 1982). These changes are likely in part due to pubertal and hormonal changes that accompany the onset of puberty (Karacan et al., 1975). For instance, at midpuberty, there is significantly greater daytime sleepiness than at earlier stages of puberty. Afternoon



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