What time does the child have to go to bed?

baby sleeping on big pumpkin
A good night's sleep is very important to all of us, but especially for children. My son, Alex, is 17 months old and has a very regular life. He goes to bed at 8 o'clock every night and usually wakes up at 7:30 in the morning. Coupled with one or two sleep during the day, he can sleep for 12 hours a day and meet the recommended standards. But the toddler who is just a toddler in my upstairs jumps up and down every night, and most of the time I have to sleep at least 10pm. Many Chinese parents told me that their children only slept at 9:00, 10:00 or 11:00 - which was much later than my American colleagues and other paediatrician colleagues. This phenomenon may not be universal, but behind the significant differences in this sleep pattern, what are the reasons behind it, and more importantly, which way is healthier for children?

A study published in 2005 supported my personal observations, pointing out that Chinese children not only fall asleep later than American children but also get up earlier. This comparative study shows that Chinese primary school students sleep less than an hour (9.25 hours vs. 10.2 hours) than their American counterparts; what is even more worrying is that Chinese children still complain that they feel very sleepy during the day. The main problem is not when your child goes to bed: what's more important is their overall sleep length per day (including daytime naps, but most children over the age of five no longer take a nap). Sleep studies have confirmed that preschool children need 11-12 hours of sleep a day, while school-age children need at least 10 hours of sleep, and adolescents are 9-10 hours (infants need 16-18 hours, adults 7-8 hours). If your five-year-old child goes to bed at 9:30 in the evening, gets up at 6:30 in the morning, and is no longer taking a nap, then 9 hours of sleep a day is not enough for their long-term health.

Not enough to sleep at night, naturally will be sleepy during the day, which is also a major problem of lack of sleep. A series of studies published in 2013 on Chinese children showed that lack of awareness and daytime sleepiness can lead to poor student performance at school. In this study, most of the children slept from 9:00 to 9:30 pm, and almost all children got up at 7 in the morning, so many children missed half an hour to an hour of sleep every day. This doesn't look too serious, but like any debt, sleep debts have to be paid sooner or later, and it's not enough to make up for this debt by simply sleeping on weekends. The lack of awareness problems can lead to problems with attention time, enthusiasm for learning, and test scores. The researchers speculate that the anterior cortex, which is responsible for attention, creative activity, positivity, and abstract reasoning, is particularly susceptible to poor sleep. They, therefore, conclude that in Chinese society, children still have to invest a lot of time in their studies in the absence of sleep, and our findings provide a warning fable for this.

Good news can be seen from the same study: even if the school time is delayed by half an hour, it can significantly prolong the sleep time of students and improve their sleepiness during the day. The researchers conducted an intervention study at six elementary schools in Shanghai, delaying class time from 7:30 am to 8:00 or 8:30, which allowed students to sleep for nearly an hour – and more importantly, they were not very good. Complaining that I was sleepy during class. This is consistent with the results of various studies in other parts of the world, and also provides a theoretical basis for the ongoing movement in the United States. This paediatrician-led campaign initiative delayed school hours until 8:30 am. Just making this adjustment will allow the child to sleep a little longer and possibly improve their performance.

In addition to school performance, poor sleep can also increase the risk of overweight and obesity among children (and adults). In 2007, a meta-analysis of 36 studies across the globe showed a strong independent association between short sleep time and weight gain in children, and this association continued into adulthood. In Anhui Province, a study of 500 adolescent twins showed a link between lack of consciousness and weight gain. In 2010-2011, a study involving more than 4,000 children in rural areas of northeast China found that obese children were more likely to have insufficient sleep (less than seven and a half hours with a nap). Although this does not constitute a causal relationship, the connection between the two is still worrying. The cause of overweight may be a physiological factor, as studies have shown that lack of sleep can alter the hormone secretion that controls appetite. Lack of sensation leads to decreased levels of leptin secretion and increased levels of ghrelin, which increases our instinctive hunger reflex. Given that the proportion of obese children in China is growing at an alarming rate, I feel that all parents should at least consider the child's sleep problems.

I can't manage the noisy children upstairs, but in our own home, I am very happy that we let Alex develop a good sleep habit, and even if necessary, he goes to bed at 8:30 or 9:00. We can also guarantee that he gets enough to sleep every day so that he can stick to his pre-puberty. In addition, when we choose a school, it will definitely be a plus point for children to get up later.

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