實戰篇：4步驟搞定孩子睡眠作息
作者：黃正憲醫師
門診有時候會被問到孩子睡多久是適當的？要怎麼調整作息呢？所以今天就舉個例子來跟大家討論一下哦
例子：8個月大的健康小孩要怎麼睡？
1.決定整天睡眠所需要的時間
根據建議這個年齡層的孩子整天睡眠總時長為12到16小時。
2.計算白天小睡所需的時間
按照下圖，可以發現8個月大的孩子，白天小睡會有2次，1次在上午10~12點，長度約1~2小時；另1次小睡在下午2點左右，長度約0.5~1小時。所以白天小睡總時間長度約為1.5~3小時。
3.決定就寢時間
因此，夜晚總睡眠長度為 12-3= 9 小時(當然也可以睡得更多一點)
對照下圖，大部分這年齡層的孩子是在晚上6點過後準備睡覺；所以家長要選擇出一個適當的就寢時間。
因為西方國家的孩子普遍早睡，但亞洲國家卻比較晚睡。此外，如果下午的小睡睡得比較晚，孩子起床之後沒有足夠"放電"活動，也會造成睡不著的。因此在正常狀況之下，我個人建議比較合的就寢時間是
"至少要距離下午小睡起床時間4小時以上"
4.夜間醒來可接受的次數
4個月以上的健康孩子，夜醒超過5分鐘以上的次數，按照美國睡眠基金會的建議是小於等於1次。但是臨床上可以放寬到2~3次，因為愈小的孩子，夜晚可能需要餵奶的次數是比較高的。但是超過3次以上孩子就真地比較可能有睡眠問題。
所以，家長可以發現如果按照這個作息時間表，孩子會在早上6點起床，活動4小時之後，就會剛剛銜接上我們早上10點的第1次的小睡哦！
提醒事項
- 孩子不是機器，建議利用 app或睡眠日誌等先記錄1周的孩子作息，才比較正確和容易調整睡眠作息。此外，隨著孩子的成長，睡眠需求也會有所改變，請家長一定要動態調整。
- 睡眠儀式很重要，可以幫助孩子早點入睡和增加睡眠時間長度。如果沒有睡眠儀式的話，可以從現在開始作起哦。
=========English version, translated by ChatGpt====
Author: Dr. ChengHsien Huang
In my clinic, I am often asked, "How long should a child sleep, and how can I adjust their routine?" Today, let's discuss this with an example.
Example: How should an 8-month-old healthy child sleep?
1. Determine the total amount of sleep needed in a day
For this age group, it's recommended that children sleep a total of 12 to 16 hours a day.
2. Calculate the time needed for daytime naps
As the diagram shows, an 8-month-old child usually has two naps: one from 10 AM to 12 PM, lasting about 1-2 hours, and another around 2 PM, lasting about 0.5-1 hour. Therefore, the total duration of daytime naps is about 1.5-3 hours.
3. Decide on bedtime
Consequently, the total nighttime sleep duration would be 12 - 3 = 9 hours (although it can be longer). Most children in this age group prepare for bed after 6 PM; therefore, parents should choose an appropriate bedtime.
Children in Western countries generally go to bed earlier than those in Asian countries. Moreover, if a child's afternoon nap ends late and they don't have enough physical activity afterwards, they may struggle to fall asleep. Therefore, under normal circumstances, I recommend a bedtime at least 4 hours after the afternoon nap.
For instance, if the child wakes up from the afternoon nap at 3:30 PM, an appropriate bedtime would be around 7:30 PM. Including the bedtime routine (less than 30 minutes), the child should be in bed by 8 PM. The time taken to fall asleep should normally be less than 45 minutes (30 minutes is better), so the child is expected to wake up around 5 AM the next day (8-9 PM + 9 hours = 5-6 AM).
4. Acceptable number of nighttime awakenings
For healthy children over 4 months, the number of awakenings lasting more than 5 minutes should be no more than once, as per the American Sleep Foundation's recommendation. Clinically, this can be relaxed to 2-3 times, as younger children may need to feed more often at night. However, more than three awakenings suggest a potential sleep problem.
Thus, following this schedule, the child would wake up at 6 AM and, after being active for 4 hours, would just be ready for the first nap at 10 AM!
Reminders:
- Children are not machines. It is recommended to use an app or sleep diary to record a child’s routine for a week before accurately and easily adjusting their sleep schedule. Additionally, as children grow, their sleep needs change, so parents must dynamically adjust.
- Sleep rituals are important as they can help children fall asleep earlier and increase the length of sleep. If you don't have a sleep ritual, consider starting one now.
