Expert: David Olson, MD - 11/2/2009

Question
Hi!  I have a question about sleep and growth regarding my son, who just turned 7.  His bedtime is about 8:30 and he has to get up for school at about 7:15.  I usually have him in bed by about 8:00 and he reads for half an hour - he reads well and enjoys this.  Then about 8:30 I turn the lights out except for a nightlight on his ceiling - he gets scared without this on.  Although my husband and I are awake downstairs till about midnight, we are pretty quiet and don't disturb him.  His sister sleeps in the next room but she's asleep all night.  He likes me to lie with him till he falls asleep, but I almost never do this since I have work to do after he goes to sleep and I have to get up early - I need this time although I know he would fall asleep more quickly with me there.  
     About half to two-thirds of the time he falls asleep pretty easily.  But about 2-3 nights a week he is awake for hours before falling asleep.  He lies in bed talking, half-playing, sometimes getting out of bed to get an object, a stuffed animal, maybe getting water, etc.  On these nights he is typically awake till about 11 or even later.  Tonight is pretty extreme - it's now almost 1:00 am and he is still wide awake.  He went on a 3-mile cub scout hike today with my husband, so he should be tired!  I don't understand his extreme wakefulness, and it seems to me he definitely does not get enough sleep.  My other child sleeps easily and regularly most nights.
     Another reason I worry about this is that he is very small -about 5th percentile for weight and 25th percentile for height.  He was born at 9 lbs. but then has been small since then, and his growth curve is pretty steady so his pediatrician is not alarmed.  HOWEVER, I have read that lack of sleep can affect growth, so this greatly concerns me.  
     He had a benign enlarged lymph node removed from his neck when he was 3, and frequently has nasal congestion (he has been tested by an allergist and was not found to have any standard allergies).  Otherwise he is heathy and normal.  In terms of height, I am only 5'2" but my husband is about 5'11".    
     I would really appreciate any thoughts you have about his lack of sleep and how concerned I should be, as well as whether or not it could be related to his short stature?   Thank you very much for your time - Julie

Answer
Hi, Julie,

For lack of sleep to affect growth, this has to be considerable and unrelenting.  This is not the case with your son.  He is small because you are small.

Make sure you have good bedtime rules.  This means that things are consistent and that you virtually never allow him to fall asleep with you.  He can get up a time or two, but you shouldn't intervene at all, if possible, after you put him to bed.  Try having him read in a quiet area for about a half hour, and then put him to bed.  Reading in bed is generally a good recipe for insomnia.

Good luck, Dr. Olson