Childhood Insomnia

In an era of ever-present video and constant texting and snapchatting, many parents are trying to figure out how to deal with childhood insomnia.

Here is a quick guide for busy parents of things to think about and things to do if your child is having trouble getting to sleep or getting enough sleep.

Consider possible causes –

• Stress. Kids, just like adults can suffer from stress. Show interest in your child’s life and build trust so they feel comfortable sharing their worries with you. How are things going at school. Online bullying (cyberbullying) is an increasingly common problem for pre-teens and teenagers.  Is everything under your own roof running smoothly (ie, is there arguing, fighting between siblings, marital or financial problems; has there been a death in the family, a recent job change; has the family recently moved)? Children worry more than you might think and excess worry and stress can lead to insomnia.
• Use of caffeine or other stimulants. Even some clear sodas (Mountain Dew) and most energy drinks have caffeine.
• Medical, psychiatric and other sleep disorders. Uncontrolled nighttime asthma, a stuffy nose from allergies or itchy skin from eczema can get in the way of good sleep. Also, depression and anxiety, which may show up without clear signs and symptoms, can be a cause of disturbed sleep.

What else to do?

• Sleep hygiene habits. Restrict time spent in bed to just sleeping (no reading, doing homework or watching TV in bed); maintaining a regular sleep schedule (going to bed and waking up at the same time each day including weekends and holidays); avoiding caffeinated products 4-6 hours before bedtime (caffeinated products include coffee, tea, colas, some non-cola pops, energy drinks, and chocolates); and establishing a bedtime routine that does not include stimulating activities within an hour of bedtime (such as TV watching, electronic gaming, heavy homework, or computer gaming).
• Comfortable sleep environment. Make sure your child’s bedroom is quiet, calm, comfortable (< 75 degrees F), and dark (a nightlight is acceptable for children afraid of a dark bedroom).
• Teach children how to relax. We love Calm.com and there are several guides for mindfulness and relaxation specifically for children on the Calm apps.
• Set bedtime so that enough sleep is possible. Set bedtime so that your child gets his or her usual amount of sleep (Children between the ages of 6 and 12 need about 10 to 11 hours of sleep each night; teens need about 9 hours of sleep each night.)
• Get up out of bed if your child can’t get to sleep. If your child can’t get to sleep in a half an hour, it is better to get up and do something calming in relatively low light for 15-20 minutes (for example reading or listening to calming music), rather than lying in bed and tossing and turning. After staying out of bed for 20-30 minutes or so, they may return and attempt to sleep. If after a 15-20 minute attempt there is no success, they should get up again and try the relaxing activity again. Repeat the cycle as necessary.
• Consider cognitive behavioral therapy. Specialists in behavioral and cognitive therapy can work with the child and family to establish regular sleep rhythms. CBT for insomnia is very helpful and can have long term benefits.
• For kids who have trouble getting to sleep and tend to wake up late. Circadian rhythm disorders can occur in children as in adults. If you have a childhood “owl” trying to function in a world of early rising “larks” a recent article suggests that a combination of nighttime melatonin and early morning bright light may help to reset circadian rhythms. Light therapy consisting of daily bright blue light exposure during 30 minutes between 6:00 and 8:00 am and 3 mg of immediate release melatonin at 7:00 pm. The melatonin treatment was more effective than the light therapy alone and only those receiving melatonin treatment had more total sleep time.

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