Bedtime and Sleep Problems

Anyone who has children has experienced them having sleep problems at one point in time.  There are children who have persistent and severe sleep problems.  The following are some examples of sleep issues that indicate parents should seek advice:

1. Parents lying with their child nearly every night to help him fall asleep.

2. Child coming into parents’ room at night and either sleeping with them or a parent returning to the child’s room to sleep with them.

3. Parents who sleep on their child’s floor so their child will sleep better.

4. Child who gets up numerous times after bedtime.

5. Nightmares or night terrors.

6. Bedwetting.

7. Anxiety at bedtime.

8. Child waking up most nights or several times per night.

9. Parents are experiencing fatigue because their child has sleep difficulties.

Assessment of the Problem

It is important to identify potential sources or contributing factors to the bedtime problem.  A good place to start would be to ask the following questions:

1. Has the problem been long-standing?

2. Does your child have restless sleep?

3. Does your child have leg pains, back pains or body pains?

4. Do they snore?

5. Does your child seem tired during the day?

6. Is your family experiencing recent family stressors?

7. Does your child have caffeine or snacks a couple of hours before bed?

8. How are the parents responding to the problem?

9. Are medications affecting sleep?

If you answer yes to any of the above questions or feel that you are at a loss for how to manage your child’s problems, talk with your child’s pediatrician.

Potential Reasons

The first thing we do when a child has sleep disturbances is rule-out medical reasons.  We refer to a sleep specialist if we hear that the child has restless sleep, snores, seems to display an excessive amount of fatigue after what appears to be a full night’s sleep, or has body aches, such as leg or back pain.

If medical reasons are ruled-out, then we work closely with families to establish a good bedtime routine (if they don’t have one), tailor specific strategies for the child and family decrease bedtime problems.  Most importantly (and we can’t emphasize this next point enough), we work with the parents to manage how they might actually be reinforcing their child’s sleep problem.  As psychologists, we are not there with the parents when they are putting their children to bed, so we serve as their “coach.”   The way the parents respond to their child when these sleep problems are actually happening greatly determines the success of improving their child’s sleep.  Many disorders have associated sleep problems.  ADHD, depression and anxiety can all affect sleep so, as psychologists, our strategies are tailored to the child’s specific issues.  Our goal is to minimize the effects of these disorders on the child’s sleep.

Talk to your pediatrician first to rule-out medical reasons for a sleep problem.  Once you have done this, seek out a child psychologist experienced in sleep problems in children.  Afterall, a rested child means rested parents—and that’s important for everyone’s mental health!