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"





所以,假設孩子下午小睡睡到3點半起來,比較適合的就寢時間約晚上7點半。加上施作睡眠儀式的時間(小於30分鐘),理論上晚上8點以前孩子要睡在床上。而入睡所需時間正常也小於45分鐘(30分鐘更好),所以預期會在隔天早上5點起床 (8~9pm + 9 hour= 5~6am)。


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.

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