Who would want to give their children nightmares? Or night terrors? Who wants to make bedtime battles worse? Who would want to make it take longer for their children to fall asleep once they get in bed?  Who wants their kids to sleep worse when they finally do drift off? Who wants their children to be more tired and cranky during the day? Just being exposed to secondhand smoke can do all of these things, at least for some for kids, according to a study published January 18, 2010 in Pediatrics.

The researchers looked at sleep issues in kids who were already enrolled in a different study on asthma treatments. They analyzed the sleep patterns of 219 kids with asthma who were exposed to secondhand smoke versus other kids with the same severity of asthma who didn’t get the smoke exposure. The results were striking, and went beyond what they would expect just from the breathing problems we know are caused by secondhand smoke.

While this study only included children with asthma, the researchers suggest that being around smoke may affect the sleep of kids without asthma as well. I also wonder if other fumes, as from harsh household cleaners, might affect sleep as well.

Our kids deserve clean air, especially in their own homes.

• Try to keep cigarette smoke, harsh fumes, and chemical fragrances out of the home.
• Open windows when you can to let fresh air in (almost always cleaner than inside air).
• Consider a houseplant for your child’s room (can remove up to 90 percent of pollutants).

Yolton, K., Xu, Y., Khoury, J., Succop, P., Lanphear, B., Beebe, D.W., and Owens, J. “Associations Between Secondhand Smoke Exposure and Sleep Patterns in Children.” Pediatrics, online 18 Jan 2010, (doi:10.1542/peds.2009-0690).

I’m asked almost everyday by some concerned parent whether their child is sleeping enough or too much. That’s not a simple answer and varies from child to child and even from day to day.

For instance, if a child has just learned to walk she will often get more sleep because she’s getting a lot more physical activity than she did just before she began walking. When a child first learns to walk, she toddles from place to place trying out her new skills with a new burst of energy. (Note: don’t put your video camera away after she’s taken those monumental first steps! There are some never-to-be-repeated times right around the corner.)

Once she’s mastered walking, her sleep needs may decrease again. Of course when a child is ill or even fighting off an infection, he might need more sleep. And if a child (or adult) is looking forward to an exciting day ahead, the excitement and anticipationmay naturally result in less sleep the night before.

But back to the question, how much sleep does my baby need? I have general guidelines for the range of normal amount of sleep needed for each age. Keep in mind, this is a general guideline:

Average Number of Hours of Sleep Needed

Would you rather your kindergarten-age child had blood lead levels 3 times the safe limit (like children living next to a lead smelters – double the level of most kids with lead toxicity), or would your rather your child snored? The impact on the brain is about the same, according to a provocative study in the October 2004 Journal of Pediatrics.

Sleep-disordered breathing (SDB) is the name given to a spectrum of sleep breathing patterns ranging from mild snoring to obstructive sleep apnea. In this study of more than 200 children, those with SDB scored significantly worse on tests of behavior, memory, intelligence, and ADHD than did their peers – even if they only had snoring without sleep apnea.

Given the poor scores on wide variety of tests, it’s not surprising that their school performance also suffered. Thankfully, treating snoring at this age seems to improve performance. The authors suggest that 3 to 6 years old is the peak period where snoring is harmful to development, and also the peak age at which treating snoring can make a big difference in behavior and learning. Overall, about 1 in 10 children this age snore.

Is it dangerous for kids to sleep with the lights on? Lots of interesting news has been coming out of the 2004 Children with Leukemia conference in London. We’re making great progress in leukemia, but also falling behind. Even though cure rates are climbing, more children are getting leukemia than ever before – especially in western nations, where it is the most common form of childhood cancer. But we’re not sure which exposures are causing the increase.

Some studies have shown that diet plays an important role. Cured meats such as hot dogs and luncheon meats have been associated with increases in brain cancers and leukemia. Research from UC Berkeley presented at the conference suggests dramatic protection from leukemia for toddlers who get oranges, orange juice, or bananas in their diets 4 to 6 times a week before the second birthday. Research from Loyola University presented at the conference suggests that turmeric, a curry spice, might be even more effective. Curcumin, found in turmeric, is powerful at destroying cancer-causing molecules. Perhaps, turmeric is one reason that leukemia is so much less common in Asia. In India, it affects less than one child in a million.

At the conference, Professor Reiter advised parents not to allow their children to sleep with lights on, because doing so could make them more susceptible to leukemia and other cancers. He said that sleeping with the lights on should be absolutely prohibited. It is important to understand that there is no proof that there is a link between light at night and leukemia. This is speculation – but speculation that makes sense to me. We do know that light at night suppresses the body.s production of melatonin. Melatonin is a powerful protective substance. Low levels of melatonin may be one reason that night workers have higher rates of breast cancer. Perhaps one of the many reasons that cancers have increased so much since the invention of the electric light has to do with changes in our melatonin levels. Blind people, whose melatonin levels are not affected by light, have much lower rates of cancer. All other things being equal, I’d turn out the lights.

Dr. Greene’s Answer:

How exhausting! Missed sleep is tough for all of us, but yours has been long and consistent and without a failsafe solution if you just get too tired. Most young kids will return to sleep well if rocked, or cuddled, or fallen asleep with (of course, whether or not you want to do this is another issue).

Sometimes adjustments in bedtime or napping can make a difference. In some children, periods of waking can occur when a child is toilet training. In these children, taking them to the bathroom in the middle of the night can solve the problem. If a child wakes up in need of comfort, a special blanket or stuffed animal may help.

But when kids don’t sleep well in the most conducive setting, I like to have them seen at a sleep center. Thankfully, sleep is beginning to get the attention it deserves, and sleep centers are springing up in many places.

Occasionally, sleep specialists recommend medicines after other options have been explored. I am in favor of this (although I am not a fan of the Benadryl class, at least as either a medium- or long-term solution). I prefer medicines in the hypnotic class that are eliminated from the body relatively quickly. Sleep is so valuable for health (his and yours) that, in some situations, the benefits clearly outweigh the costs. Your doctor can refer him to a sleep center if necessary.