How can I help my child sleep better? | Boston Children’s Answers Parentcast (S2: Ep.6)

welcome to Boston Children's answers parent cast I'm your host Jennifer Arnold as a doctor and a mom I'm passionate about helping kids stay happy and healthy so join me as I chat with other Boston Children's experts to find answers for you and your family hi everyone and welcome back thanks for joining us as we get ready to talk about kids and sleep two things that don't always seem to go well together as in previous episodes we'll start things off with a question today's comes from Chris a dad to a six-month-old baby girl hi Dr Arnold

my wife and I have a six-month-old girl and sleeping has been a roller coaster since she came home from waking up half a dozen times during the night to teething issues and now most recently flipping from her back onto her belly we've experienced all of these things so far my question is what can we expect going forward in the next 6 months and more specifically when will she be able to put herself to sleep oh poor Chris that is a great question I think all parents have struggled at one point when it comes to getting

their newborn or even their teenager like me on a proper sleep schedule luckily for us we have an in-house sleep specialist who knows about all things sleep related I'm excited to introduce Our Guest expert Dr Judith Owens Dr Owens is senior fac faculty at the Center for Pediatric Sleep Disorders here at Boston Children's Hospital and a professor of Neurology at Harvard Medical School thank you so much for being here with us today it's my pleasure Jen oh thank you so before we dive into sleep um I'm curious you know you started off as a pediatrician

how did you become interested and focused in your career on sleep I think it really was a an outgrowth of my experience as a fellow in developmental behavioral pediatrics and then I also did a fellowship in child psychiatry and I realized that 80% of my patients with ADHD or Autism or depression anxiety had sleep problems and I had no training on how to deal with those so it was really on the job learning experience wow and then now you are you know you're you're part of one of the very first sleep clinics in the nation

if not the world so um you know how does one get their career to go down this path of sleep medicine well we are now fortunate enough to have sleep medicine fellowships oh wow and these fellowships are typically one year uh many of the trainees have done uh work in Pediatrics or in pulmonary medicine or in neurology and their interest has been peaked during their training like mine was and they decide to do a fellowship that's amazing well I think uh one of the things we may I may have talked to you about is that

I actually uh our kids come to the clinic here because they both have sleep challenges so I'm excited to be talking to the right person about this topic it's near and dear to my heart so with that um I want to start off with our first question I feel like you know being a a neonatologist I get asked this question all the time how much sleep is enough sleep for our children based on an extensive review VI of the existing evidence uh the American Academy of sleep medicine has published a list of sleep ranges for

different ages these recommendations are for optimal sleep for optimal functioning um for toddlers the range is 11 to 14 hours over 24 so that includes naps in the next age range which is 3 to 5y old preschoolers it's around uh 10 to 13 hours of sleep and for schoolage children 9 to 12 with school age children being defined as six year olds through 12 year olds and typically within those age ranges the younger you are the more sleep you need there is some variability from one child to another in the same age range about how

much sleep they actually need so several ways that parents can gauge that is number one does the child wake up in the morning at the time that they need to without an alarm without multiple reminders and seems well rested in a good mood ready to go number two do they show evidence of daytime sleepiness and we know that in younger children in particular that can include things like hyperactivity or acting out behaviors or mov disregulation and then the third thing which I think is really critical for everybody is when you're given an opportunity to get

more sleep you take it that really is a sign that you're not getting enough sleep on a regular basis when you sleep two or three hours later on the weekend for example I I can definitely see some things I need to be evaluating with my own kids sleep so that I can hopefully help them to ensure that they're getting the right amount sure because school performance and everything like that I imagine can be impacted if your child's not getting enough sleep absolutely it's amazing how many areas are really impacted by not only getting enough sleep

but getting sleep at the right times it's not just how much you sleep it's when you sleep that's important and if you're not sleeping at the right time then you're going to have many of the same kind consequences that insufficient sleep might cause as we're talking about the amount of sleep when to go to sleep how to you know encourage getting a good amount of sleep um why is it so important to get that good right amount of sleep well on a very basic level um there is really nothing that replaces sleep and I'll give

you an example of that there's something that was recently discovered in the brain called the glymphatic system and a essentially that seems to be a process by which accumulated toxins and also experiences and images during the day are reduced giving the brain a clean slate if you will from which to operate the following day and that lymphatic system is only working during sleep we also know that sleep affects what we call plasticity in the brain which is the ability to change structure and function according to your experiences it affects the brain's ability to repair itself

from injury or stress oh wow and so that of course is going to have a very important impact on things like cognitive function and attention and memory insufficient sleep or mistime sleep also affects essentially every system in your body so it affects your heart metabolic function so immune function so your susceptibility to getting sick is impacted as well as your response to vaccines so if you don't get enough sleep before you get a vaccination your response to that might be slowed which can be really very relevant so important I think what I'm taking away here

is that sleep does a body good all aspects of your body and your health you know I think about the hours that I spent as a resident you know working 30 hours in a shift and not sleeping and then you know I would know I'm going to get sick right because I probably when I have a lot of shifts like that in a row your body's worn down but it's really the lack of sleep that doesn't allow your immune system to to be at its best absolutely absolutely and you know another example when people aren't

sleeping well they have a lower tolerance to pain uh they're less likely to recover from painful episodes so it has the this incredibly important impact all across the board so this is really I think you know why it's important to talk about sleep and why it's important to help our kids get enough sleep so you know for teens and twins um what what is the right amount of sleep how can we help our kids get that right amount of sleep they need between 8 and 10 hours hours of sleep a night and we know that

the vast majority all over the world don't get nearly that amount of sleep but that is such a critical period for a number of reasons because for example um something called executive functions in the brain are at their highest level of development during the teenage years and these are functions like um the ability to monitor to your behavior um emotional regulation um the ability to make good decisions comp tasks right complex tasks it affects risk-taking Behavior which of course we all know is such a big issue in teenagers and so just at the time where

they're going through this important stages of brain development they're exposed to what I call a toxin of insufficient sleep the uh parents ability to influence their children's sleep starts way before the teenage years having a bedtime routine that includes reading and doesn't include electronics and then as parents really helping to emphasize to children that sleep is just as important as good nutrition and physical activity in in our family sleep has probably been one of the top topics for us because both of my kids have sleep challenges yes and part of their skeletal dysplasia is that

they have obstructive sleep apnea yes and so we had to seek help really early on you know just you can see night and day when you can tell I you know they've worn their seap they've gotten to bed on time what the next day is like compared to the days that that doesn't happen it it's a challenge I think for parents to figure out how to navigate when they were younger but it was harder just to get them to wear their CPAP now as a it's harder for me to get them to stop playing their

video games and being on their screens so back to this older population of kids and teenagers and twins um you know how can we help to encourage that good habit forming sleep Behavior without being overbearing as a parent well over yes uh and that's definitely a challenge but I think there's a carrot and a stick approach uh the stick approach is really to be vigilant about your teenager sleep habits and I talked to so many parents who are asleep well before their teenager and they really have no idea what time they're actually going to bed

and falling asleep so that's one issue being a good Mo role model in terms of sleep I think uh turning off Electronics uh so not only are they stimulating but they also emit Blue Light which is one of the most important things that actually shuts off your brain's release of melatonin and melatonin is a hormone that really is instrumental in helping you to fall asleep now I know that a lot of kids have homework that they have to use the computer for but even using things like blue light blocking glasses or apps can help with

that process not doing things in bed other than sleeping so don't do your homework work in bed don't be on your cell phone in bed don't watch TV in bed the carrot part is you are likely to be a better athlete and to be less likely to get injured and that we have data about that if you get enough sleep you're more likely to do better in school even your mood is improved so that's um sometimes can be the hook that gets kids to pay attention to the you know each every kid has different things

that are priorities for them but if you can link those priorities with the likelihood that sleep is going to make them better then that helps a lot I think yeah no I think that's the the key I definitely try to find the the you know the common ground the thing that is going to make them excited to sort of you know listen to what Mom and Dad are saying yeah absolutely and you know I think Unfortunately they get caught up in this whole Pier thing where it becomes a badge of honor of to get less

sleep you know oh I stayed up and I did an all nighter we have to change the culture to a certain extent and I think that's happening because teenagers can be your best Ally in terms of making structural changes like delaying school start times that really benefit students that dates back to the 60s when they developed teered busing systems and somebody had to go first so the logic at that time was well we'll have the older kids go first and we'll have the younger kids go last and teenagers of course have this normal shift at

puberty to a later sleep onset and wake time so it's exactly counter to what we should have done but now we have that information maybe we should we have to make the changes what what do you think would be the ideal start times for schools based on different ages well certainly for teenagers what we Advocate strongly for is 8:30 or later typically teenagers aren't really ready to fall asleep until about 11:00 and you can do the math PA if they need eight or n hours of sleep then they're not going to be able to get

up much before 7 or even 8:00 in the morning this applies to Middle Schools as well because it's so tied to puberty the this change in sleep patterns and so many middle school students are going through puberty oh as well yes so in terms of younger kids maybe somewhere between 8 and N is reasonable but right now many elementary schools start even later than that and so these kids are up and ready to go at 6:30 and you know they don't end up in their seats in class until 9:30 so that's three hours of wakefulness

and alertness that just goes to waste yes I 100% agree and I'm living that right now so you know having said that though what we're you know if if you're in a situation where your kids have a start time that may not be ideal what are some tips to help them wake up and be as alert as possible in the morning so one of the things that's very important is light exposure particularly natural light um will help to suppress your brain's release of melatonin and you want that to be the case whereas at night you

you want to have that melatonin operate ating to help you fall asleep so uh in E if it's dark in the morning or in your room turn on all the lights I am not a fan of a s alarm and I think you just get terrible sleep after you click the the alarm for another 10 minutes and then another 10 minutes and then another 10 minutes just set your alarm for the time that you actually have have to get up so you get your REM sleep in particular so rem or rapid eye movement or dream

sleep is concentrated in the last third of the night so that's another issue with teenagers because if they have to wake up too early they lose that REM sleep REM sleep is critical for Learning and especially learning of new tasks and that's what kids have to do all day long in school they need that Rim so AB absolutely so so so having said that so okay besides the fact that I am guilty of hitting this snooze and I'm going to work on this myself I'm going to use that tip with my my teen as well

um what about going to bed using will as our example what what tips do you have for helping me to help him get to bed at a good hour yes so we talked a little bit about electronic use and you know if at all possible ideally it should they should go off an hour before bedtime but at at least a half an hour before bedtime and that should also allow you to have some calm calm down time you know we we all need a period of time where we can kind of easily fall into the

process of going to sleep and I always you know wonder when when my patients say well I I'm I try to fall asleep the actual Act of falling asleep should be just a natural thing and not require work to do it so in order to allow you to be in a mindset and a physical sense ready to fall asleep just doing something whatever is relaxing for you okay so tell me about this one's concept that I've heard which is something called the forbidden zone can you tell us in our audience more about what that is

yes so it's also goes by the term the second wind phenomenon which I think most parents will say the light bulb goes off yep I know what that looks like so we all have a surge in circadian alertness the hour or so before our brains are ready to fall asleep that kind of counter surge of alertness allows us to stay up that extra hour now if you try to put a child to sped during that so-called forbidden zone it's much more likely to be difficult and you get the curtain calls I need another drink I

need another story I need another hug I have to tell you something yes you know um we all we as parents we all know the drill parents can often interpret that surge in energy as oh they're over tired when in fact it's almost the opposite that you're not over that period of time of alertness where they're then ready to fall asleep so sometimes much to the horror of parents we actually recommend a later bedtime because then you get over that period of time when they're just not ready to fall asleep it's so hard especially when

the parent wants to go to bed early exactly but we have to pay attention the tradeoff is you don't get that those curtain calls you keep them up a little longer they relax they calm down and then they fall asleep yeah and bedtime is much more pleasant it is indeed another key uh is that many teenagers for example will exercise just before bed oh yeah and so vigorous exercise actually raises your core body temperature and makes it more difficult to fall asleep and uh also not going to bed hungry having a protein uh filled snack

at bedtime is also helpful and caffeine so you know a lot of teenagers use these energy drinks and many of these energy drinks have a very high caffeine content so particularly when they're using them in the afternoon or the evening uh that's going to disrupt your ability to fall asleep and also disrupt your nighttime sleep as well yeah so so limit that caffeine you know down you need calm time no screen time and you know make sure you're not hungry little protein it's funny some of these things I've done at different ages but I have

to say with my kids I haven't been consistent so I need to also you know be consistent I think with these measures right yes consistency is the Hallmark of parenting in general right and and of course one of the hardest things to actually achieve in reality yeah 100% so I think we all can work on that well I was thinking it might be good to go back you know to our question at the top of the uh the podcast from Chris um what you know what advice do you have to help parents to get some

sleep themselves by helping to encourage good sleep habits in their baby absolutely the six-month Mark is an important one because by that time um you can start sleep training and sleep training goes under a variety of different gues uh ferberizing for example or or cry it out method um but basically the idea behind that is to have the infant falling asleep drowsy but awake okay and having the parent leave the room that avoids developing what we call Sleep onset Association in infants and older children as well whatever they need to fall asleep at the beginning

of the night and if that's parents presence for example or having a bottle or being rocked or held they will also come to need that during the night when they wake up and all of us wake up periodically through the night as a at the end of a sleep cycle now the younger you are the shorter your sleep cycle so the more often you wake up during the night so parents will come to me and say oh well you know he wakes up six or seven times a night that's normal what the problem is that

the baby needs to be picked up or shushed or whatever in order to fall back to sleep and that involves the parent getting up so that whole process of putting the child to sleep so they fall asleep independently um and that we usually don't recommend that before six months of age okay um but but at that yeah you don't want to try that too early um and um also just knowing that healthy full-term infants don't need to be fed during the night as long as they're gaining weight appropriately um so that's um kind of a

misconception that a lot of parents have yeah as long as they're growing and yes exactly thriving what about napping when to do naps how long because that's a hard thing too it is it is um so in general babies under a year of age will take two naps a day and that can sometimes last up to 18 months or so and so usually there's a sort of mid- morning nap and a mid-afternoon nap as a rule of thumb we encourage parents to have wake periods of 3 to four hours in between naps because that allow

ows the baby to build up enough of a sleep drive so that they can then fall asleep at either the second nap or particularly at bedtime so if the second nap lasts until 6 and you're trying to put the baby to sleep at 7 that's going to be a real challenge makes sense um so the other issue that comes up a lot is when do children stop napping it really amazes me how much that varies across children um so there are some two and a half year olds or threey olds that stop napping and there

are some children who are five and are still requiring a nap and there's often a transition period where they may nap some days and not others and that kind of drives parents crazy because they don't know what to expect how to plan their day um but that's kind of a a natural process now if a child in general is napping much past certainly six years old then that raises a concern about whether they're getting enough sleep at night or whether their sleep is disrupted so that that's a little bit of a red flag for parents

to pay attention to yeah so after that certain age if they're still needing naps you might need to think about why why is that the case and to seek help from from someone like you um yeah no the napping thing is really interesting because you know I skipped the whole newborn period with my kids since I brought them home at 2 and 3 will had done the napping so much longer and and and my daughter Zoe she just did not want naps after the age of three and a half and I was fighting it for

a while and then I realized okay maybe I don't need to fight this and I just have to live with the fact that nap time is over time y sh on as a parent so so it sounds like it is normal to be so variable it is for for each each child that's really great to know well I think one of the things that uh maybe all parents need to know is you know what are the warning signs that maybe something you know isn't um good with their child's sleep I'm glad you brought that up

if a child seems to be getting the amount of sleep in the general range for their age but they still seem sleepy during the day so the other pieces are very important to look for symptoms that occur more during sleep a lot of parents in interpret snoring as a sign that their child is sleeping well is sleeping deeply deeply yeah when in fact it can be and is often the primary symptom for obstructive sleep apnea particularly loud snoring and nightly snoring so other things that go along with that are frequent nasal congestion mouth breathing which

implies there's difficulty with breathing through the nose uh pauses in breathing that's very important so children who have obstructive sleep apne will snore snore snore pause and then they may snore it and kind of wake themselves up to start breathing again that's constant disruption of their normal Sleep Quality um other risk factors for sleep apnea include certain conditions that cause some narrowing of the upper Airway uh increased size of the tonsils and adenoids is probably the most common reason for sleep apnea in children but also allergies asthma a history of prematurity uh and importantly a

family history of sleep apnea is it worthwhile to Define for those that maybe haven't heard of obstructive sleep apnea what exactly it is I mean I know my kids have it because you know of the narrow midface that they have due to their skeletal dysplasia it basically is um a failure to breathe normally during sleep so there's some blockage or obstruction to breathing and that can be from anything that you know results in that narrowed Airway the brain's response to not getting enough air and enough oxygen in particular is to wake you up and say

you better start breathing again breathe harder yeah which is great but it causes this disruption in sleep and also you get these dips up and down in oxygen level all night long which we know is not good for the developing brain yeah yeah so you know it's it's interesting because we don't think of our kids as having being at risk for Sleep problems but we really do need to be mindful and looking out for those signs and symptoms and and I would also mention um particularly in the Adolescent population that obesity um can be a

risk factor for sleep apnea just as it is and adults um and as children age we see more and more of that as being the major contributor to um I'm curious if you want to share with families what to expect when they see a sleep doctor like you absolutely so uh we take a detailed history and ask about those symptoms as well as the risk factors physical exam and the gold standard really is an overnight sleep study that's done in a sleep lab um that is experienced in studying children uh our techs are working with

children with behavioral concerns with very complex medical issues uh and getting a very detailed snapshot of breathing of sleep stages so we have an EEG that's going to measure brain waves oxygen level body movements leg movements heart rate respiratory rate so we get a whole bunch of information from that one night study I have lots of I have lots of pictures of my kids with all of the gear on it's quite cute I think but they may not have thought so during the okay so going back to uh the the you know sort of the

topic at hand there is something that we haven't talked about much yet but I think is also something that a lot of parents want to know about and that's the use of melatonin um you know does Melatonin help kids sleep at night um and if if so what patients or what kids should we think about melatonin as a supplement for melatonin has become the go-to um I think for many parents and pediatricians um and it does work in many instances but there are a lot of caveats melatonin for many children is really more of a

Band-Aid and particularly if they have behavioral issues that are really contributing to the insomnia or the difficulty falling or staying asleep while they're in the Melatonin they may fall asleep faster they're probably going to continue to wake up at night and when you stop the Melatonin the problem is still going to be there so it's really the behavioral interventions in many cases that result in a much more permanent treatment so so there are specific groups of children um in which melatonin has been tested and found to be effective primarily children with autism uh and children

with attention deficit hyperactivity disorder uh they're fairly well studied all the choices that we have melatonin in general very in general is probably the safest and has the fewest side effects but it's being very much overused in this country now we really need to get some guidelines out there um and to also warn families and health care providers that there are drawbacks um one of the biggest is because melatonin is over-the-counter in the United States it's not well regulated and Studies have shown that the actual amount of melatonin is often times not remotely what it

says on the label which is alarming right and in most countries around the world melatonin is by prescription only for that reason inter so given the wild west um of melatonin out there I will recommend to families that they look for pharmaceutical grade melatonin because that's the type of melatonin that's been used in these studies so that helps give you a little bit of peace of mind that what you're giving is actually accurate the accurate dose yeah again melatonin is pretty much only for falling asleep it there's some data from Europe that suggests it might

help with staying asleep in an extended release form but I'm a bit skeptical of that I have to say and from a physiologic standpoint it doesn't really make a whole lot of sense that melatonin would help with night wakings we really don't know what the long-term effect effect of someone having been on melatonin for 5 10 years as a young person we don't think that there are major issues but the studies have not looked at those kinds of long-term side effects well and I've also heard when it comes to melatonin like you should try to

give um breaks right because over if you just give melatonin every night consistently it starts to suppress your body's own Mel tone in production is that true or is that well I I've been asked about that and I so I did some digging in the literature and there really was very little to say yes or no you think you give you know artificial melatonin it suppresses your brain's release of melatonin but that doesn't necessarily seem to be the case really the take-home message here is you've got to do the behavioral intervention because otherwise um it's

just it's really a Band-Aid yeah and we all want something easy right we want an easy fix the other thing that that bothers me is when um I hear kids say well they ask for their melatonin every night and so the idea that a six-year-old my kids did that you know has has become dependent on a pill that's exactly what I was like oh we got to stop doing this melatonin thing because I was like this is weird it's the gummy it's just the gummy part that they liked about it but I was like oh

I never intended for them to actually then tell me they needed to have their gummy before they went to that's right that's right and you know there was a a very interesting study published by the CDC that showed that the um overdoses reported to poison control centers of children and melatonin have increased astronomically suris 500 plus% you know these little gummies they taste good they look good and we all I think many parents don't you know think of it as a medication but but it is so be careful with the Melatonin is the point the

the you know to use it judiciously if you're going to try it exactly yeah so throughout the course of our conversation we've talked a little bit about research related to wake times and school times related to um you know healthy habits for bed and melatonin um is there anything from a research perspective that we haven't talked about that you'd like to share with our audience well there's tons um and you know I one of the the most gratifying parts of my career has been to see this field of Pediatric Sleep Medicine just explode one group

of studies that I oftentimes bring up with parents especially of of really young kids are these um longitudinal studies that have looked at the impact of sleep training uh in six months 12month olds 18month olds and then they look at them five years later to look at things like cognitive development attachment emotional development Behavior stress levels and these studies do not show any evidence that there are long-term negative effects of these sleep training interventions and I think that is very reassuring for parents who worry that if I don't respond to my child crying during the

night you know or I insist that they go to bed at a certain time I'm being a mean person a you know bad parent and I get that you know guilt is part of being a a parent but these longer term prospective studies have not seen any evidence that there are psychological effects if there's evidence to suggest that that's not the case then I feel better about going forward with this you're not causing other harms trying to do good in another for for another reason right that's important so so having said that for parents that

want to you know learn how to do sleep training uh with their child what resources would you recommend that they do I mean there there are a number of great books out there and I have to give a shout out to my predecessor Dr Richard Ferber of course the internet now is right the major source of information for many parents and I think because sleep training is at some level controversial um you can read a lot that says you know you're harming your child by letting them cry and you know etc etc so I think

parents come away from that feeling very confused yeah so that's one of the reasons why you know we encourage um families to seek out professionals health professionals who are trained in in guidance in guidance a lot of these interventions need support so you know you need to talk you need to have a dialogue with parents about there are several different ways you can do this so it's you never dictate you can come to a Meeting of Minds about what parents are going to be actually able to do because if you give them advice about leaving

the room or you know don't take your child in bed with you and they're just going to walk out of the office saying no way am I going to do that you want that conversation to happen before they leave yes and also you know my my family can message me anytime um once they get home and you know they talk to Dad or Grandma about what they intend to do and grandma says how you're going to let that baby cry at night um so they can reach out and get a little bit of reinforcement that

they actually yes that they're actually doing the right thing yeah well I think it really does help to talk to an expert like you because I think all of us we just want what's best for our kids um you know finally as we wrap up I thought I would um ask one of the most important questions are there any long-term consequences of not getting proper sleep well unfortunately I think the evidence is mounting that there are and that can range from things like um neurodegenerative disorders like Alzheimer's and there is data evidence to suggest that

chronic insufficiency sleep can increase the risk of dementia um we certainly know it's linked to cardiovascular consequences like high blood pressure and increased risk of heart attacks and strokes type 2 diabetes one of the things I worry about most in the Adolescent population is car accidents accidents are now the number one cause of death in adolescence in the United States and that includes M motor vehicle crashes and our our team has done some work looking at that in relationship to school start times and schools that change their start times to a later we can't say

it's cause and effect sure but is associated with less risk for car crashes interesting in those districts compared to other districts that did not change their start times where the teens are drivers exactly wow right and uh the the other is depression and and mental health problems which are also suicide is the third highest cause of death in adolescence in the US very sadly and so if we can prevent some of that by getting these kids enough sleep it's hard to imagine anybody would object to that absolutely so um you know when should parents reach

out to uh their Pediatric Sleep program the majority of the patients that I see are families with typically developing normal babies kids and teenagers um who have sleep issues insomnia uh for example um we also see lots of yeah you know typically developing healthy children who have sleep apnea as well um another uh condition sleep condition that can occur in children is called restless legs syndrome um which is characterized by by uh an urge to move particularly the legs with often times leg discomfort um that occurs primarily at bedtime in the evening hours and causes

trouble falling asleep we know kids with ADHD for example have a much higher risk for having restless legs syndrome and it's pretty generally easy to treat because it's often times caused by low iron levels and so providing iron supplementation of often times takes care of the issue uh things like sleep walking and sleep Terrors um we do see a lot of kids um with that particularly if they're frequent so their whole host run running the the gamut from infant sleep problems to sleep apnea to restless legs to narcolepsy which is a condition caused by you

know um resulting in extreme sleepiness during the day we see that whole range um of of problems wow you just listed a whole bunch of things that I think we could spend many more discussions talking about because it's it's just sleep is as you mentioned it's one of the most important things we can do for our health is to get good healthy sleep so thank you Dr Owens for your time very welcome my pleasure now onto the part of the show we're calling doctor's orders where we prescribe you with ways to make you and your

family healthier please remember that sleep is essential for the entire family and that kids who regularly get an adequate amount of sleep have improved attention Behavior learning and overall mental and physical health so do what you can to encourage and model good sleep like trying to go to bed at the same time every night removing distractions like screens and establishing a bedtime routine consistency is key the toughest part but key thanks for listening and a huge thanks to Our Guest parent Chris as well as our guest expert today Dr Judith Owens if you'd like to

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