Counting Sheep


Counting Sheep


By Dr. Jonathan Halevy


*Credit to:


Family Medical Practice Viet Nam


When it comes to sleep, most of us aren’t getting enough—far less than the recommended daily dose of 8–9 hours per night. Many of us suffer from chronic sleep deprivation. While this is a serious issue in adults (for example, it increases the risk of heart disease) it is even more detrimental in children.


Chronic sleep deprivation directly affects our cognitive functions—our ability to learn, memorize and solve problems. In teenage students, this may interfere with their academic achievements. In the developing child, it may have potentially alarming consequences on their development and behavior. 


About 30% of children initially diagnosed with ADHD actually have a sleeping disorder, such as obstructive sleep apnea. Sleep deprivation and bad sleep quality can cause an inability to concentrate and pay attention; it may cause irritability and hyperactivity, which are symptoms similar to ADHD. In these cases, once the sleep problem is treated, the attention and hyperactivity symptoms resolve themselves.  


Babies need to sleep between 12–16 hours a day. This is essential for brain development and the release of growth hormone, which mainly occurs at night, during sleep. Insufficient sleep may impair the baby’s growth and development. Sleep deprivation can also cause the release of stress hormones such as cortisol, and one of its side effects is hunger. For this reason, children and adults who suffer from sleep deprivation tend to be obese. 


Babies naturally have lighter sleep and tend to wake up several times during the night and fall back to sleep. Some parents make the mistake of “intervening”, checking the baby, picking him up and trying to rock him back to sleep. This intervention interferes with the baby’s ability to fall asleep independently, and creates a habit that will be very hard to break. The next time the baby wakes up, he will expect the parent to come and “intervene” again.


Parents should not “rush” to their babies when they wake up at night. They need to wait a few minutes and then quietly and briefly make sure he is fine (no picking up, no talking or interacting) and then let him fall back to sleep by himself. 


By the age of four (pre-school age), children still need between 12 and 14 hours of sleep to stay healthy. The daily nap time at this age gradually shortens, and usually after four years old most children won’t need it anymore. Sleeping during the day may  push forward the normal sleeping time at night, and make it more difficult to fall asleep.


At age six, the amount of recommended sleep drops to between 9 and 11 hours, then falls for teenagers to between 8 and 10 and ends up at the 7 to 9 for fully-developed adults. 


Keeping a “bedtime routine” is very important for babies, children and even teenagers. Having the same routine (dinner, bath, book, milk and then sleep, for example) makes it easier for little kids to adjust and fall asleep. Any screens—televisions, smartphones or tablets—should be avoided for at least two hours before going to bed, as the light from the screens inhibit the release of melatonin, the natural sleep hormone.


In Vietnam, teenagers are under tremendous pressure to be advanced at school. This results in school-aged children having schedules that would burn out most adults. They get up at 5 o’clock in the morning to be at school at 6.30, and they don’t finish until 4 o’clock—and then their parents often send them to extra classes, such as English and Math. Once they get home, sometimes as late as 10 o’clock, they will eat supper and then do their homework. They might get to bed by midnight or even later, get only a few hours of sleep, and wake up at 5 am to another sleepless day. Parents need to know that sleep is essential for the academic success of their child. If they want him to do better in the tests, they need to make sure he sleeps better. The same way a parent will not deny his child food, he should not deny his child sleep. 


Sleep deprivation is a common cause of sleeping disorders but by no means the only one. Physical and environmental conditions may cause difficulty to fall asleep or maintain sleep. Other issues such as obstructive sleep apnea may cause poor quality sleep. Common medications like cough medicines can cause sleeping problems. Even certain foods and drinks (energy drinks, caffeine etc.) may cause a child or teenager to lose sleep.


If your child seems to be tired when he wakes up, if he has difficulties concentrating or paying attention, if he has a tendency to “doze off” during the day, if it takes him longer than 30 minutes to fall asleep at night, or if he sleeps for many hours during the weekend, then he probably suffers from a sleep disorder—and he should be properly evaluated by his pediatrician.


Dr. Jonathan Halevy



Perhaps the most well-known figure at Family Medical Practice thanks to frequently posting pediatric advice on social media, Dr. Jonathan describes his gravitation toward the discipline as soul-marking. Starting out by caring for several younger brothers and sisters while growing up in his native Israel, the pediatric ward already felt like home by the time he was a resident—and his subsequent career largely revolved around the discipline, with various excursions in intensive care and trauma & life support.


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