When I was in graduate school, I wanted to write my thesis on the sleep needs of young children. My main hypothesis would have been that the daytime sleep needs of young children are individual, and a long nap is not suitable for every child. From reading global studies, it became clear that nearly 60 percent of children aged four and older do not take naps, and it is no longer necessary for their bodies (1). It becomes important for the child to get a long and quality night's sleep as they grow. These studies were already almost 30 years old (2; 3; 4).

When I started researching the daily schedules of kindergartens in Western countries and wrote to several kindergartens in Norway and Sweden, I realized that my question seemed strange to them. This is understandable, because in Scandinavia, European countries, America, Australia and even Asia, children over the age of four do not take daytime naps. In these kindergartens, where the child's day lasts from eight in the morning to half-past one, children aged four and older already have school-like activities.

Only in countries like ours, which were part of the Soviet Union, and in all other former Soviet republics, was there a strict two to two-and-a-half-hour nap rule. An excerpt from my master's thesis: "According to the old Soviet Estonian regulation, kindergartens had to provide all children aged 3-7 with a daytime rest" (Paragraph 28, Soviet Teacher No. 11, 1950). The regulation did not specify the length of the nap, although it is known that during Soviet times, children had to stay in bed for an average of 2-2.5 hours. Currently, according to the Preschool Child Care Institutions Act, the daily schedule is determined by the director of the institution.

It is not entirely clear who established this strict schedule at that time. In any case, it was not based on any scientific research. The logic suggests that parents needed to work. Children have never been a priority in our cultural space and still are not. Parents worked long hours, picked up their children only around 7 p.m. and thanked heaven for the children's afternoon nap – otherwise, they wouldn't have been able to put them to bed on time.

At the same time, we know that many children did not actually sleep during their naps and just laid in bed. Back then, they were not even allowed to take a stuffed animal to bed. Many children cried into their pillows and chewed on the sheets. In Estonia, there are still cases where the same strict rules are in place. Did you know that in our kindergartens, there are still teachers who make the child face the wall to fall asleep? Did you know, or perhaps have heard from your child, how sometimes a teacher sets conditions for the child to fall asleep? For example, saying: "If you don't fall asleep, then..."

Four years of mandatory sleep pattern disruptions

I have been actively working with children's sleep disorders for nearly ten years. Now, I work as a supervisor at children's hospitals in both Tartu and Tallinn. What has my practice shown? It confirms scientific studies: children for whom long afternoon naps are not suitable experience restless sleep at night (5; 6).

Most commonly, I encounter night terrors. Night terrors are quite typical, occurring in 5 percent of preschool and early elementary school children. Often, they are related to the child's development and growth and are a normal phenomenon that eventually disappears. During night terrors, the child is generally unresponsive because these episodes typically occur during the N3 (deep sleep) stage. Generally, night terrors may occur episodically for a few months and then disappear (7; 8).

However, children who have come to me have experienced night terrors for years. This is not normal. If a child's daily schedule is adjusted to place the nap at the correct time or to limit it, the night episodes either disappear or significantly decrease. This is logical because a child or even an adult who takes excessively long naps for their age will eventually develop sleep debt.

The worst part of the situation is that most children stop napping by the age of three, but in kindergarten, they are required to nap until the age of seven. Such a child lives with an irregular sleep rhythm for four years. On weekends, they do not nap, but during the week they do, significantly affecting the length of their nighttime sleep.

Adults who sleep irregularly, with six hours on weekdays and seven to eight hours on weekends, are also in sleep deprivation or sleep debt. What does sleep debt lead to? In short, many adverse effects. It should be noted that these individuals have higher levels of the stress hormone cortisol, which remains elevated even at night, consuming the body's resources.

Additionally, it is important to note that restless sleep is more common in children who breathe through their mouths. This is quite logical because their bodies are also stressed, and their brains do not receive enough filtered oxygen. Sleep studies show micro-awakenings in their brains, which disrupt sleep quality. Many children who breathe through their mouths also experience night terrors because they are in sleep debt and under stress (9; 10).

Children who do not breathe well at night are indeed more tired. They may sleep well but tire quickly. I can say that every third child at my practice has a breathing problem. For them, exceptions sometimes need to be made, allowing them to nap during the day. Otherwise, they simply cannot cope until their breathing problem is resolved.

Quiet activities out of bed

I am thoroughly familiar with the issues faced by both kindergarten teachers and parents. There aren't enough teachers, and resources are lacking, while parents cite long workdays as their reason. What should we do then? Wait for teachers' salaries to increase? For our parents to work less? I don't agree with this approach: our country will not achieve this anytime soon. It is essential that we start from the very beginning, our future – the children.

The chancellor of justice has received numerous complaints from kindergartens where children are not allowed to engage in quiet activities. This is the core of the problem: "the choice between sleep and other quiet activities" (excerpt from Paragraph 4 of the Health Protection Requirements regulation). In Estonian kindergartens, this means that if a child does not sleep, they lie down and play with their thoughts or, at best, with their stuffed animal. Or they spend two hours looking at a book.

Even in so-called lenient kindergartens, which claim they do not force children to nap and offer a choice, there is still an internal rule that the child must stay in bed for 30 minutes to an hour. This is called forced napping. Imagine having to lie down at a specific time for five consecutive days without being allowed to get out of bed. An observer is in the next room. The ability to rest voluntarily is very different from a situation where there is always an observer or monitor present.

This leads to the next problem. Many children come to consultations because they have been forced to sleep at inappropriate times, both at kindergarten and at home. If a child has taken a nap that is too long and too late, it becomes challenging to get them to bed at the correct time. Parents resort to various tricks to get their child to fall asleep.

In our system, the typical schedule for children who take afternoon naps includes a bedtime routine starting at 10 p.m., with the child falling asleep around 10:30 p.m. If the child does not take a nap, it is entirely possible for them to fall asleep 8:00-9:00 p.m. Yes, there are parents who strive for their child's good sleep. Yes, there are parents who know nothing about sleep routines or creating a conducive sleep environment. Nevertheless, it is encouraging that more and more parents are becoming aware that young and preschool children need a calm evening and parents at home.

If our child, at the age of three to four, gets the recommended amount of 11-12 hours of nighttime sleep, they should not experience severe daytime sleepiness. They may need some downtime but not deep sleep. Many parents want their child to take daytime naps. The reason given is the child's quick fatigue during the day. In such cases, the child's sleep schedule should be reviewed, and it should be ensured that they do not have any sleep disorders: apnea, mouth breathing, restless legs, severe night terrors, childhood insomnia, fears, anxiety, poor sleep hygiene such as excessive screen time, noisy or disruptive environment. Children with special needs may also tire more quickly during the day, but this is not always the case.

It is crucial to address these issues and create a supportive environment for our children's sleep needs. This means allowing for flexibility in kindergarten schedules and recognizing the individual sleep needs of each child. By doing so, we can help ensure that our children grow up healthy and well-rested, ready to face the challenges of the day.

Ideal nap or quiet activity times in Estonian kindergartens

• Groups aged 3-4. Nap time 12:30-2:00 p.m. OR quiet activity. The latter takes place out of bed and under the teacher's supervision or if there is a group of children capable of playing quietly by themselves. Examples include drawing, puzzles, crafts, supervised meditation, listening to music etc.
• Groups aged 4-5. Quiet activities 12:30-13:30 p.m. No beds for sleeping, while there are mats for children who need to sleep because of special needs.
• Kindergarten day should start at 8:30 a.m. and end at 4:30 p.m.
• More time should be spent outside. In many countries, educational activities take place 9 a.m. to 12 p.m. which is followed by free time. It is also possible to learn 9-11 a.m. and do simpler exercises again at 3-4 p.m.

Sleeping problems of schoolchildren

The biggest concern for school-aged children is early wake-up times and the early start of the school day. In America, several states have shifted the start of the school day to 8:30 or 9:00 a.m. Sleep medicine tells us that children's sleep onset shifts to later starting from ages 11-12 and remains delayed until they are 18-20 years old. Therefore, even with good sleep hygiene and no dependencies, children cannot fall asleep very early (11). The average wake-up time for our schoolchildren is around 6:45 a.m.

Why do people have to wake up so early? Of course, to work and to work a lot. This attitude originated during the Industrial Revolution, when long workdays required efficient rest. Before this, people's sleep patterns were more flexible and often more cyclic.

If you ask a room full of people if they wake up at 6-7 a.m. on their days off, only a few hands will go up. Most people sleep in until at least 8-10 a.m., which is actually normal. Thus, the natural sleep rhythm for most people is much later: falling asleep between 10 p.m. and 1 a.m. and waking up 8-9 a.m.

Smart devices should be off limits until teenage years

Screen time reduction is the next item on the list. When I ask in lectures how old a child should be to get a smartphone, many suggest children aged five to seven. In fact, children are allowed to have a smartphone from the age of 12/13-16. Yes, at that age, a child can have their own smartphone. Before that, we can occasionally give them screen time, but even that is rather prohibited (13).

Children can still watch television, but in a limited manner. Computer games and other activities behind screens should be limited and controlled. A smart device (phone, tablet, TV) should be out of the child's sight for as long as possible. Certainly, these should not be given to a child in early childhood, i.e., during the first three years of life.

Schools that have made their institution smartphone-free for children later, for instance, from the 6th-7th grade, or vice versa, banned smartphones in elementary school but allowed them in middle school, are in a bind. Therefore, if you want to be smartphone-free and truly help and support the child, schools need to be smartphone-free from the very beginning. This means from the 1st grade to the 12th grade.

A smart device should not be taken to school, or if it is brought, it should be handed over to a supervisor upon arrival at school. There are a few schools in Estonia that have done this and they are doing well. Those who have allowed it partially, struggle daily with children's tantrums, anger and misunderstandings.

It is also extremely important that at least one recess takes place outdoors. Yes, this is possible. Our children need light, especially in Estonia. Being in the light also improves our sleep rhythm a bit. Every ray of light is necessary to stimulate the suprachiasmatic nucleus.

Finally, the most important point: why give children homework? A child is at school for six to eight hours and still has to study at home. Has the teaching methodology become outdated? We go to school to learn, and if necessary, we review what we have learned before an assessment. If a child did not understand what the teacher explained, they should have a sufficiently safe environment to let the teacher know they did not understand and need extra help. This could be offered to them right after school or on a specific day at school.

There is no need for a child to go home and struggle with their homework, where parents also don't know what the child is learning or how they should master it. Let's make it so that we don't give children homework. Believe me, when I have talked about this in schools, everyone is in favor: both parents and teachers. Children, of course, applaud this.

Do mom and dad care about their screens or me?

Now for the biggest problem. It is the use of smart devices in the home environment and by parents. When we have children, we aim to provide them with a secure and safe environment. Parents should remain calm, have more time, fewer obligations, excellent cooperation with their loved ones and an open mind.

When a child is born, they need food and sleep, to be warm, and most importantly, to be noticed – to receive attention, praise and recognition. A child needs this for their entire life. While we don't need to cuddle our child until they are a hundred years old, a small amount of physical contact every day is sufficient: it is a security element.

Children are often behind screens because they are lonely. They might not have playmates or parents to spend time with. It is often the parents who start offering screens to two- or three-year-olds: "But look at this... Wait, I'll put this on..." etc. This is like a punishment for the child.

It is difficult to see a parent with a screen in front of them while being with an infant in a restaurant. However, more studies are now emerging on this topic. It is quite frightening that when the child is not on the screen and you are, it is very confusing for the child. It is quite logical that an infant needs contact as they grow. By the time they are a toddler, they have already formed the opinion that the phone is more important and valuable to mom and dad than they are (14).

We now come to the fact that money is needed to live, and parents generally earn it by working. How does the state support and contribute to the lives of parents so that they can be with and raise their children? You can think about this further yourself. I will add just one supportive thought: parents could have workdays from 9.-10 a.m. to 4 p.m. Is this the case anywhere else? Yes, it is. It would be nice to take your child to school at a normal time or pick them up from preschool at 4 p.m.

School schedules

• Start of school day 9:00-10:00 a.m. End of school day 15:00-16:00 p.m.
• Mandatory outdoor recess: at least one and for at least 30 minutes.
• Smart devices should be banned for grades 1 through 12. (Jury still out on high school)
• Students should not be given homework on a daily basis. Information should only be reviewed for tests/assessments. If a child needs help understanding the material, this should be offered after the school day.

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