July, 2023 - Lazy Gozo

TODDLER SLEEP ISSUES? HANDLE THEM WITH THESE METHODS

You were all prepared for all those uncomfortable nights during your pregnancy, also fully on guard for those sleepless nights during babyhood. But were you prepared for toddlerhood? Also, those cold head fights, not listening, toothaches, and whatnot!

Let us first understand the stages of the development of the baby; initially, it is in the form of a fetus, and later on it develops to form an infant. After the delivery, it is known as the baby, and as the developmental stages are achieved it is known as a toddler.

In a few instances, toddlers may have their own idea or concept about their sleep schedule. They might tend to sleep only at the night. But maybe they need more than just a six-hour sleep at that age, due to the excessive energy expenditure.

At such times you need to understand that children may need sleep in between the daytime hours, or small bouts of naps which helps in reducing their crank, anger, or stubbornness.

So you might be wondering, what is the ideal sleep schedule for your toddler? or how many hours of sleep are required? Are in-between naps necessary? The answer will depend on your child’s age because, between her first and third birthdays, her nap demands and habits fluctuate significantly.

Here are some tips on how to make sure your child is getting the recommended amount of sleep each night and throughout the day, as well as a look at some sample age-based toddler sleep patterns that can help you determine whether your child’s schedule is on track.

HOW MUCH SLEEP DOES A TODDLER REQUIRE?

Usually, 10 to 11 hours of sleep combined with naps are needed for toddlers. A combination of two one- to two-hour naps throughout the day (or one longer afternoon nap as she approaches age 2) and a solid 10 to 11 1/2 hours at night will allow your child to get all those hours. Between 12 and 18 months, many children switch from two naps to one, but some don’t until they’re two.

WHAT IS THE IDEAL TIME FOR PUTTING TODDLERS TO BED?

The majority of babies do their best sleeping when they are in bed by 7:30 or 8 p.m. If you go to bed early, your child will have the chance to get the amount of sleep she requires to feel rested (especially since you can typically expect her to wake you up between 6 and 7 a.m.). Additionally, studies show that young children who go to bed before 9 p.m. typically fall asleep more quickly and wake up less frequently at night.

HOW TO CREATE A SLEEP SCHEDULE FOR TODDLERS?

Toddlers are accustomed to their routines. A calming bedtime ritual signals that it is time to start settling down and appeals to your precious pea’s need for constancy. Since it prepares her for going to bed at the same time every night, it also helps her develop healthy sleeping habits.

It’s not necessary to have a complex regimen. However, it should be regular and begin no later than 45 to 60 minutes before bedtime. A bath, literature, soft music, and cuddles are all soothing pastimes. Avoid roughhousing or energetic play because these activities are more likely to energize your child than to promote relaxation.

Even if your toddler’s sleep requirements are different from those of a baby, maintaining a schedule is still a good idea. Your toddler will have a feeling of what to expect from waking up, taking a nap, and going to bed around the same time each day, which can be reassuring and increase her readiness to comply with the schedule.

Following a routine also ensures that your sweetheart gets the proper amount of sleep, preventing her from becoming overtired and cranky throughout the day or under tired when it’s time for bed. That may lower your risk of experiencing sleep issues or complaints and assist you in avoiding those dreaded early-morning wake-ups.

1-YEAR-OLD TODDLER’S SLEEP SCHEDULE

Your 12-month-old’s schedule might be remarkably similar to how it did last month — and stay that way for a few more months — despite the fact that her age technically places her in toddlerhood territory. A 12-month-old should sleep roughly 14 hours per day, with 11 of those hours occurring at night. The final three hours should be divided into two naps during the day.

6:30 a.m.: Awake
10 a.m.: Nap
11:30 a.m.: Awake
2 p.m.: Nap
3:30 p.m.: Awake
7 p.m.: Bedtime routine
7:30 p.m.: Bedtime

15-MONTH-OLD TODDLER’S SLEEP SCHEDULE

Between 12 and 15 months, not much will change for the majority of children. You might need to move bedtime a little bit later if the afternoon nap is beginning to interfere with bedtime but your cutie isn’t ready to switch to just one nap (many babies this age aren’t).

6:30 a.m.: Awake
10 a.m.: Nap
11/11:30 a.m.: Awake
1:30/2 p.m.: Nap
3/3:30 p.m.: Awake
7/7:30 p.m.: Bedtime routine
7:30/8 p.m.: Bedtime

18-MONTH-OLD TODDLER’S SLEEP SCHEDULE

Your one-and-a-half-year-old will likely require 11 to 12 hours of sleep per night in addition to two to three hours for naps. She’ll probably be prepared at this age to go from a morning and an afternoon nap to just one midday nap, typically soon after lunch. A transition can be a significant adjustment, so it’s common for your child to act irritable as her body adjusts. She might need to be put to bed earlier than usual because she will probably be exhausted by the end of the day.

6:30 a.m.: Awake
12:30 p.m.: Nap
2:30 p.m.: Awake
6:30 p.m.: Bedtime routine
7 p.m.: Bedtime

2-YEAR-OLD’S SLEEP SCHEDULE

Two-year-olds require between 11 and 14 hours of total daily sleep. You might notice that naptime grows a bit later or shorter when your child enters her second year. She might be able to return to a somewhat later bedtime depending on how long the nap was.

6:30 a.m.: Awake
12:30 p.m.: Nap
2/2:30 p.m.: Awake
7 p.m.: Bedtime routine
7:30 p.m.: Bedtime

3-YEAR-OLS TODDLER’S SLEEP SCHEDULE

During this time toddlers generally cut out their sleep completely or may have a bout of nap during the day time. When your toddler has entered this age group usually requires 10 to 13 hours of sleep.

6:30 a.m.: Awake
1:30 p.m.: Nap or quiet time
2:30/3 p.m.: Awake
7/7:30 p.m.: Bedtime routine
7:30/8 p.m.: Bedtime

WHAT ARE THE WAYS THAT YOU CAN GET YOUR TODDLER ASLEEP?

Bedtime arguments are occasionally unavoidable when raising a toddler. However, using these techniques can help minimize opposition to nighttime and naps and get your little dreamer (more) on board.

Follow a schedule. It is more likely that your child will be weary when you tuck her into bed if she wakes up, naps, and goes to bed around the same time each day.
Have a regular schedule.

The same holds true for the activities you engage in to wind down before bed and nap, as well as how you respond to requests for one more tale, another glass of water, or getting out of bed. Your toddler will be more likely to follow the plan if she is aware of what to anticipate (and what won’t work).

Make necessary changes to your timetable. It may be time to change your toddler’s nap schedule or put her to bed a little later if she routinely acts like she isn’t sleepy at nap or bedtime or if she starts to wake up earlier than usual.

Give your consent to play. Tell her she can sing or play softly with a plush “friend” or two until she goes to sleep if she insisted she wasn’t tired. The “permission to play” card gives your child the impression that she has won, which can make it easier for her to fall asleep at night.

Keep moving throughout the day. Your child will get tired by having lots of physical playtimes and exposure to outdoor air.

Avoid using a screen. The AAP advises avoiding screens at least two hours before bedtime and preventing screen-based gadgets from being used in your child’s bedroom.

Examine sleep hygiene. A more formalized sleep training program may be wise if you’ve made previous modifications but your youngster is still refusing or regularly waking up at night.

REASONS WHY YOUR TODDLER IS NOT SLEEPING PROPERLY!

You’ve no likely already begun to learn from experience that even the best-laid plans for your toddler’s sleep can go awry. Here are a few that you might encounter frequently.

absence of a bedtime ritual. The most frequent and convenient obstacle to evening happiness must be this. Toddlers are accustomed to their routines. Even if your family’s schedule is chaotic (and who’s isn’t? ), it’s worth the bother to establish a calming, regular bedtime ritual that begins early enough to guarantee enough zzzs.

phobias and nightmares. Your toddler’s anxieties at night, whether they involve monsters under the bed or a dread of the dark, are quite real. Your instinct to reassure her with kisses and cuddles (without staying too long by her bed) is spot-on and will help your child resume her regular sleeping schedule.

illness or a trip. When you have a cold or are sleeping in an unfamiliar bed, it may be more difficult to fall asleep. In these trying times, adopt a do whatever it takes mentality to ensure that your child gets some rest. While camping or during flu season, extra hugs, kisses, and special demands are acceptable; nevertheless, try to return to the old schedule as quickly as you can to prevent these transient sleep troubles from developing into habits.

Regression in sleep. This brief sleep regression is typical among toddlers. Your greatest efforts to calm down your young child may be undone by new developmental milestones, such as learning to walk, as well as by major-to-her, minor-to-you life changes, like getting a new pet or babysitter. major life changes like having a new sibling or moving on to a new place that is not familiar to the child.

gnawing ache. Your toddler may experience teething discomfort once more as those canines, incisors, and molars erupt, which can disrupt sleep.

Your child resists giving in. A toddler’s job description is, to put it simply, to refuse almost everything. That includes time for bed! To assist your child accept when the lights go off, give her a choice between two sets of pajamas, a book you’ll read to her, and which stuffed animals will join her in bed.

Your youngster doesn’t want to be left out. Except for the bed, your little social butterfly and constant mover and shaker want to be in the center of everything.
Your young child misses you. When your child begs you to stay with her after lights down, it’s generally not a game; separation anxiety is very real.

Keep those visits brief and uninteresting, and diffuse the tension with a neutral conversation about the day and what might happen tomorrow. To avoid her wondering where you are when she wakes up and comes looking for you, try to leave the room before she falls asleep.

OSGOOD SCHATTLER DISEASE- CAUSE, SYMPTOMS, AND TREATMENT

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Osgood Schattler’s disease has many synonyms for itself like osteochondritis, tibial tubercle apophysitis, or traction apophysitis. The pain is usually experienced by the front part of the knee also known as the patella. The pain that is experienced is mostly muscular and not skeletal. Osgood Schattler’s disease is commonly found in skeletally immature athletes.

Osgoos Schattler’s disease typically shows symptoms like; tenderness around the joint, insidious pain, atraumatic and slight tenderness at patellar tendon insertion. Activities like jumping, and sprinting can aggravate the mechanical stress on the patellar tendon and increase further damage.

WHAT IS OSGOOD-SCHATTLER’S DISEASE?

In athletes with immature skeletons, Osgood Schlatter disease, also known as osteochondrosis or traction apophysitis of the tibial tubercle, is a frequent source of anterior knee pain. Sports that are frequently associated with the syndrome include:

Basketball
Volleyball
Sprinters
Gymnastics
Football

The patellar tendon insertion site at the tibial tuberosity is typically painful in patients with an atraumatic, gradual development of anterior knee discomfort. Jumping and sprinting are examples of recurrent extensor mechanism stress exercises that might cause the self-limiting syndrome.

The severity of the pain determines the course of treatment, which includes symptomatic relief with ice and NSAIDs, activity adjustment, and relative rest from aggravating activities, as well as a stretching regimen for the lower extremities to address underlying biomechanical risk factors.

Despite the benign nature of the condition, it might take a while to recover and interfere with sports. The illness gradually develops, and repetitive knee movements are frequently linked to it. Over the tibial tubercle, there is typically discomfort.

WHAT IS THE PREVALENCE OF OSGOOD-SCHATTLER’S DISEASE?

The cartilaginous tissue that makes up the patellar tendon inserts at the tibial tubercle. Ossification of the tibial tubercle occurs next, between the ages of 10 and 12 for females and 12 and 14 for boys. Osgood Schlatter’s disease manifests itself at this stage of bone development. According to the predominant idea, repeated pressure on the tubercle causes microvascular tears, fractures, and inflammation, which manifest as swelling, discomfort, and soreness.

Overuse injuries like Osgood Schlatter’s disease affect active teenage patients. The force applied by the powerful patellar tendon at its insertion into the relatively soft apophysis of the tibial tubercle results in secondary repeated strain and microtrauma.

Risk factors for the disorder include:

Male gender
Ages: male 12-15, girls 8-12
Sudden skeletal growth
Repetitive activities like jumping and sprinting

One of the most frequent causes of knee pain among skeletally immature, adolescent athletes is Osgood Schlatter disease. For males, onset occurs between ages 10 and 15 while for females, it occurs between ages 8 and 13. Males are more likely to get the syndrome than females, and athletes who compete in running and jumping sports are more likely to develop it. Osgood Schlatter’s disease affects 9.8% of teenagers between the ages of 12 and 15 (8.3% of girls and 11.4% of males). 20% to 30% of patients had bilateral symptom presentation.

PATHOPHYSIOLOGY OF OSGOOD-SCHATTLER’S DISEASE

The patellar tendon can join the tibial tubercle, which forms a secondary ossification center. Increased stress across the apophysis results from bone growth exceeding the ability of the muscle-tendon unit to expand enough to preserve previous flexibility.

As opposed to the tendon in an adult, the physis is the weakest point in the muscle-tendon-bone relationship, making it vulnerable to damage from repetitive stress. The apophyseal ossification center may soften and partially avulse with repeated contraction of the quadriceps muscle mass, especially with repeated forced knee extension as observed in sports involving running and jumping (basketball, football, gymnastics). This condition is known as osteochondritis.

The tibial tubercle develops and then closes or fuses in the order described below:

(Age 11 years) The entire tibial tubercle is made of cartilage.
Ages 11 to 14 are when apophysis forms.
Between the ages of 14 and 18, the apophysis merges with the proximal tibial epiphysis.
When a person is older than 18 years, the proximal tibial epiphysis and tibial tubercle apophysis fuse together.

HOW DOES THIS DISEASE PRESENT ITSELF?

The age group affected is between 8-year-old to 15-year-old children. This can also be caused to other age groups but it depends on the nature of the injury. Now when a child is playing the injury must have occurred once but due to healthy joint structure, the injury is not understood at an early stage.

The child typically complains of pain in the anterior or the patellar or as we can say on the front part of the knee joint. There might be pain presentation on both sides or a single side of the leg. You might notice increased swelling near the knee around the knee joint.

The pain that is felt might be insidious in nature, it may subside while the child is at rest or has stopped playing for a while. You might start noticing a bulge-like formation on the anterior part of the knee joint.

The pain aggravates after performing the following activities;

jumping
running
kneeling
squatting
direct trauma to the knee

TREATMENT FOR OSGOOD SCHATTLER’S DISEASE

Osgood Schlatter disease is diagnosed clinically, thus radiographic testing is typically not required. If the presentation is severe or unusual, plain radiographs may be utilized to rule out further diseases including a fracture, infection, or bone tumor.

An apophysis avulsion injury or other injuries following a traumatic incident may also need a radiographic assessment. The tibial tubercle is raised in Osgood-Schlatter disease, and there may be soft tissue edema, apophysis fragmentation, or calcification in the distal patellar tendon. It should be noted that these findings are not always indicative of pathology and can alternatively be interpreted as normal deviations, making clinical correlation crucial.

Although the condition eventually resolves on its own, it may last for up to two years before the apophysis fuses. Relative rest and activity reduction from the problematic activity are part of the treatment, which is determined by the intensity of the discomfort. Although there is no evidence to support it, activity limitation is useful in lessening pain.

Rest does not appear to hasten recovery. As long as the discomfort goes away with rest and does not restrict sports-related activities, patients are allowed to play sports. NSAIDs and local cold treatment are both effective painkillers. To protect the tibial tubercle from direct impact, a protective knee pad can be put over it.

In addition, hamstring stretches and quadriceps strengthening exercises can be helpful. Formal physical therapy may be required if conservative pain management does not work. A brief duration of knee immobilization may be recommended in severe, ongoing instances.

There is insufficient evidence to endorse either surgery or injectable therapy for Osgood-Schlatter’s disease. The majority of the time, symptoms are self-limiting, and the pain goes away as the apophysis closes. A swollen or conspicuous tibial tubercle may be a long-term consequence, however, in the vast majority of cases, this is asymptomatic.

An interprofessional team composed of an orthopedic surgeon, physical therapist, primary care physician, orthopedic nurse, and sports physician is the most effective way to manage Osgood Schlatter’s disease.

It may be more useful to reduce athletic participation than to stop all activity because these injuries frequently occur in extremely active adolescent patients. Instead of complete rest, it may be more effective to suggest that a patient who plays on multiple teams or participates in multiple sports during the same season drop one of those teams or sports. This will reduce the amount of activity and strain that comes from frequent and repeated participation.

Limiting activity should be decided jointly by the patient athlete and parent, taking into account both short- and long-term objectives. The degree of pain felt should ultimately dictate the choice. Osgood Schlatter can be prevented by gradually increasing their workload (less than 10% weekly), utilizing the right tools and procedures, engaging in stretching exercises to maintain flexibility in the hamstrings and quadriceps and debating against early sports specialization.

TAKEAWAY

Always pay attention even to the slightest of injuries. Some injuries may not at all need medical attention and can heal on their own, But persistent pain in a specific joint needs to be assessed and treated immediately by a medical professional.

Keep in mind all the above-mentioned symptoms and causes and get treated by your orthopedic or physiotherapist.

The long-term effects of OSD are typically not severe. Some children may develop a lump below the knee that is painless and persistent. Surgery to eliminate a bothersome lump below the knee is very uncommon.

Kneeling causes some adults who had OSD as children or teenagers discomfort. Consult your doctor if your child’s knee pain persists after the bones have stopped developing. The medical professional can look for further knee pain sources.