开学了，如何让孩子睡得更好？

睡眠质量的好坏直接影响儿童生长发育、学习记忆、心理行为等。帮助儿童形成一个好的睡眠，并对儿童的睡眠问题进行早评估、早诊断和早治疗，具有重要意义。

转眼间，寒假结束了，家里的小朋友都要开启上学时间了，对儿童而言，睡眠质量的好坏直接影响生长发育、学习记忆、心理行为等。儿童期的睡眠问题还可能会持续到成年期，导致高血压、糖尿病等慢性疾病发生。因此，帮助儿童形成一个好的睡眠，并对儿童的睡眠问题进行早评估、早诊断和早治疗，具有重要意义。如何帮助孩子们调整睡眠作息，有个良好的睡眠呢？

一招教您简单初步评估儿童睡眠情况

评估孩子24小时总的睡眠时间：

各年龄阶段儿童有不同的睡眠推荐时间。如果睡眠时间少于推荐时间，提示有睡眠问题。

入睡/就寝问题：孩子入睡需多长时间？

入睡潜伏期＞20min，提示有睡眠问题。

睡眠中问题：孩子睡眠中会经常醒来、打鼾、呼吸困难或其他问题吗？

夜醒＞20min，提示有睡眠问题。

如果您初筛发现有儿童睡眠问题

需进行进一步科学评估

如果您初步评估发现孩子疑似存在睡眠问题，建议家长携带儿童到医院就诊并进行专业评估。采用儿童睡眠相关量表和儿童睡眠评估工具进行评估。

儿童睡眠评估常用量表：包括睡眠日记、儿童睡眠障碍量表、儿童睡眠习惯问卷、简明婴儿睡眠问卷等。

儿童睡眠评估工具：包括多导睡眠监测和体动记录仪。

多导睡眠监测（PSG）是评价睡眠相关呼吸障碍的金标准和疗效评价的客观指标。

体动记录仪通过记录手腕随时间的活动频次测量受试者睡眠昼夜节律活动相关参数，包括总睡眠时间、睡眠效率、总清醒时间、清醒时间百分比、觉醒次数、入睡潜伏期等。

如何帮助孩子睡得更好？

■ 给孩子良好的睡眠环境和睡床

卧室每天通风，空气清新、温湿度适宜（建议室温23℃左右，湿度40%-70%左右）；如有孩子需要灯光伴睡，可在卧室准备一盏小夜灯，但睡后家长应熄灯；不要在卧室放置电视、电话、电脑、游戏机等电子游戏设备。儿童青少年每天的电子屏幕暴露时间应限制在2小时内。

同房分床睡：婴儿宜睡在自己婴儿床里，与父母同一房间。幼儿期可逐渐从婴儿床过渡到小床。

分房分床睡：有条件的家庭宜让儿童单独一个房间睡觉。

■ 培养规律的作息时间和睡前活动

3-5月龄时，儿童睡眠开始逐渐规律，家长应给孩子培养固定就寝时间，一般不晚于21:00，但也不提倡过早上床。

每天睡前可安排3-4项睡前活动，如盥洗、如厕、讲故事等。研究发现，在睡前1-2小时进行持续10分钟的温水沐浴、足浴或淋浴，能够缩短入睡潜伏期并提高睡眠效率和质量。低龄儿童，可以先洗澡，讲故事，然后睡觉，这个常规能帮助幼小的孩子感觉准备好睡觉。对大一点的学龄儿童可以睡前半小时阅读或者和孩子一起安静地聊一聊白天发生的事，然后让他自己一个人安静放松，随后关灯睡觉。每天晚上的睡前活动内容基本保持一致，固定有序，温馨适度，时间控制在半小时内，每天晚上在同一时间开始有规律的就寝常规能帮助孩子形成好的睡觉模式。

■ 养成良好的入睡方式

自我平静是儿童学会从觉醒状态转为睡眠状态的基本前提。培养儿童独立入睡的能力，在儿童瞌睡但未睡着时单独放置在小床睡眠，不要抱睡、摇睡、奶睡；将喂奶或进食与睡眠分开，至少在幼儿睡前1h喂奶。可适当允许儿童抱安慰物入睡。儿童哭闹时父母先耐心等待几分钟，再进房间短暂待在其身边1-2min后立即离开，重新等候，并逐步延长等候时间，帮助儿童学会独自入睡和顺利完成整个夜晚连续睡眠。

■ 逐步提前孩子的入睡时间

如果在假期里孩子的入睡和起床时间被推迟了，那么在开学之前的2周就可以开始逐步调整以适应新学期的节奏。最简单的方法是设定一个能保证足够睡眠的就寝时间和起床时间，然后每隔2-3个晚上将就寝时间和起床时间提前15分钟，直到达到之前制定的睡眠时间表。

■ 合理的进食和运动有助于睡眠健康

每天摄入牛奶、鱼、樱桃、猕猴桃等食物，能够改善睡眠，且不会改变饮食模式。“吃、睡、动”三种行为是孩子的生物钟节律的重要组成部分。让孩子每天在合理的晚餐时间好好完成一顿适量而且满意的晚餐，不宜吃得过饱或者不吃。睡前太饿或太饱都可能会使孩子更容易惊醒或入睡困难。睡前3小时应尽量少吃或者不吃东西。不要在傍晚或晚上让孩子摄入有刺激性的食物，例如：巧克力、可乐、运动饮料、茶和咖啡等。

加强体育锻炼：儿童青少年应每天进行累计≥60分钟的中高等强度身体活动，例如体操、骑车、跑步、足球、篮球等。但应避免在睡前2小时内进行运动。

■ 定时提前唤醒孩子

对有睡眠问题的儿童，事先做好睡眠日记，然后在儿童常规夜醒前15-20min，轻拍唤醒儿童，再让其重新入睡，从而使常规夜醒不再出现。

■ 加强带养人的睡眠知识教育

婴幼儿睡眠卫生习惯的培养主要在于带养人。加强对带养人有关科学喂养及睡眠知识的健康教育，消除带养人的焦虑，并与带养人共同制定睡眠计划是帮助婴儿建立正常睡眠模式的关键，而且家庭督导睡眠卫生习惯培养能够明显促进婴儿的体格发育和身心发展。

培养孩子养成规律的睡眠习惯，是个长期且需要坚持的过程。不要轻易地改变孩子的睡眠作息时间，节假日、外出旅游也要尽量保持固定、规律的睡眠作息。需要通过良好的睡眠来缓解疲劳，保证孩子次日能够精神百倍地投入学习和生活中。

来源丨福建医科大学附属协和医院

（文中部分图片来源于网络）

*“医学界”力求所发表内容专业、可靠，但不对内容的准确性做出承诺；请相关各方在采用或以此作为决策依据时另行核查。

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