"Security, affection and trust", keys for children to sleep well - La Provincia


Regardless of age, there is something that both children and adults are affected in a fairly general way during this confinement, and that is sleep. But we are not only talking about insomnia, but also about increasing nightmares and strange dreams, more difficult for children to fall asleep by themselves, more awakenings at night ...

We talk about this with the doctor. Gonzalo Pin, pediatric doctor at the Quirónsalud hospital in Valencia, and a specialist in sleep.

Gonzalo, what can we say to parents who are worried because they are seeing that their children are having trouble falling asleep, they are having nightmares, they get up very tired the next day ...?
It is very important to convey to parents that this is normal, that it is a completely healthy and normal physiological response in children, just like in adults. When we go to bed, we go with the backpack of what we have done during the day, and we are preparing the dream throughout the day. We sleep as we live and we live as we sleep. And our way of life has completely changed, the child has lost all his social references: he no longer goes to school, he no longer plays in the park with his friends, he is no longer in the yard ... he has a series of external signals that They adapt their internal clock to the environment where they live. So now there is a mismatch between the internal clock and the signals it receives, so they are a bit disoriented. If the children had not reacted to these changes, then we should have been concerned.

If my son changes his way of sleeping or behaving during the day in the face of these changes, my son, in a healthy way, is responding to the environment. Whether he responds better or worse is another song. So is it normal for my son to sleep worse? Evidently. Is it normal for my child to be more afraid to go to bed? Obviously, because what we are transmitting, even without realizing it, is insecurity.

What role do parents have in this? Can we help our children sleep better?
For a child to sleep well it needs three things: security, a good affectivity and confidence that the world is controlled. And in this case, especially confidence and security, they are a bit disrupted. So the boy or girl is going to need their parents to give them more security and more confidence.

During these last weeks we have carried out a survey of families, and we have 12,900 responses, which are many. In this survey we asked how your children slept before confinement and how they sleep now during confinement. We are beginning to interpret all these responses, but we can already see some interesting data. For example, nightmares have increased, children who are afraid of the dark, who find it difficult to sleep alone and want to sleep in bed with someone ... This is the answer that, initially, we assumed we were going to get, and it is due to what I said before, that affectivity, trust and security have been disrupted.

Something that seems to be being fairly shared are nightmares and strange and very vivid dreams, why is this?
Of course, what happens here is that when we go to bed, as I said, we go with our backpack all day. So, that insecurity that children feel (and adults too) leads to a more restless, more superficial sleep, with more micro awakenings ... In addition, the dream of every human being has three components: one purely biological, a psychological component and a social component of the environment in which it is. All three components have to maintain a balance, a balance that is unstable and varies at each stage of the child's development. At this time, the biological part is maintained, but the psychological and social parts have been altered, so this also affects changes in the biological component.

And it is that hormones work in a certain way depending on the context, and that context has changed a lot, that's why both adults and children are having a more restless sleep, with more interruptions and nightmares, especially in those who have a family history of nightmares , night terrors, sleepwalking ... because this has a genetic load.

There are mothers and fathers who have told us that children who had already "advanced" in certain aspects have now returned, for example, to pee in bed, to complain to their parents at night ...
These regressions are absolutely normal. For example, the child who was sleepwalking and had already stopped getting up, if there is a triggering factor such as this confinement, it is more likely that this sleepwalking will reappear. And, secondly, when the human being is in a situation of insecurity, what he does is return to a situation of security, he regresses to more immature stages. So, for example, the urine control that he had achieved does not have it again.

It is important to make clear that this is normal and that what we cannot do is confuse it with a disease or a pathological problem. It is not a pathological problem, it is a response to this environmental change that, if we manage well, transmitting security and affection to the child, not having him subject to information about the pandemic all day, etc., when this situation happens, little by little, will return to normal.

If we subject children to a lot of information, we are worried all the time and continuously transmitting that concern, it is normal that they feel that insecurity.

Something that is highly recommended for older adults and children who cannot sleep is the intake of melatonin ...
Melatonin must be respected. It is a natural product, but the natural must also be respected and know what we handle. It is a neurohormone that acts at the cellular level throughout our body, not only for sleep: it is an antioxidant, it is anti-inflammatory, it has many properties. One of these properties is that it regulates circadian rhythms, but it is more important when I take melatonin, because I must take it at the circadian time that goes to the body with my body, than how much I take. And I also have to be aware that when I take melatonin or give melatonin to a child, I am giving it to his liver, his pancreas, his heart ...

It is also important that we distinguish between having sleep problems and having sleep disorders. The problems with sleep are fundamentally of daytime origin, they are educational, so the approach cannot be taking a pill or taking a few drops of melatonin, the approach is more complex.

A person should take melatonin on prescription and under medical supervision, in the short term, and as long as they are improving sleep hygiene, educational levels, rhythms, exposure to light, diet ...

There are things that are of little use when it comes to sleep, such as parsiflora or valerian, and people think they are good for a lot. But this is not the case, because for this to be effective, you have to take several hours before sleep, for several days continuously ... but not that "I take a valerian and go to sleep."

Furthermore, we have very few studies that talk about the effects of melatonin in the medium and long term when it is taken irregularly, it is a neurohormone that is very difficult to handle.

What advice do you give us to be able to have, or at least try, a restful sleep at this stage of confinement? Both us and our children, of course ...
Action routines are very important, and not just what to do, but when to do it. Children should be exposed to light, having physical activity and intellectual activity, especially in the morning. That they have regular feeding times and that dinners are a couple of hours before going to bed.

And in younger children there is one thing that is fantastic: telling stories, not just reading stories, but telling stories. The transmission of oral culture, which humanity has done for millions of years, is one of the best mechanisms to deactivate the child and facilitate sleep.

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