Sleep Problems in Children
Sleep Problems in Children
A child can have a healthful sleep pattern sleeping alone, sharing a room with other siblings or parents, or sleeping in the same bed with someone. Any of these choices for sleeping can work. If sleep problems are going on, you may see these signs.
- Too much time is spent "helping" the child fall asleep.
- Your child wakes up over and over again during the night.
- Your child's behavior and mood are affected by poor sleep.
- Parents lose sleep as a result of the child's nighttime patterns.
- Poor sleep is causing the parent-child relationship to suffer.
What can you do to correct a problem?
- Ensure that there is a constant bedtime routine which involves choices which calm and comfort your child. Knowing a time limit for the bedtime routine will help you and your child to stick to the routine. Giving in to extra requests for more juice or one more story will teach a child that the bedtime can be postponed. This will likely lead to increased fussing, anxiety, and tension.
- Avoid letting the child fall asleep with a bottle or while nursing, being held or rocked.
- Don't let your child be exposed to programs or games on the TV or computer which contain things that are too scary.
- Avoid caffeine.
- Create a relaxing setting at bedtime which includes time spent with a parent. Don't replace that time with television or videos at sleep time.
Sleep-onset association disorder. Your child closely connects falling asleep with something else (being nursed, rocked or held while going to sleep, car rides, etc.). When the action, person, or object is missing, the child is unable to sleep and may awaken in the night to have help with falling asleep.
Teach your child to fall asleep in ways which do not require a response from you.
For children six months to three years old
Place your drowsy child in the bed after a quiet bedtime or nap routine. Say goodnight and leave the room, making sure to allow a little light into the room. Only return to the room keeping to the following schedule. Do not stay longer than two minutes. The schedule may be modified with more or less time spent at each time point depending on how the child is doing.
For older children (over three years old)
|Nighttime eating and drinking disorder. This is often a problem for infants and young children. Nighttime feedings while the child is a few months old or even one nightly feeding after age six to seven months can fall into this problem area.||
To end the habit of nighttime feedings, start by slowly cutting back the number of feedings. For an infant feeding every hour-and-a-half at night, the parent should wait two hours between feedings the first night, then two-and-a-half hours the second night. Increase the time in between feedings until all feedings are gone. The process may take one to two weeks. If bottle feeding, you can also try giving one ounce less per night at each feeding.
|Limit-setting problems. A child who stalls or makes it hard for a parent to leave, refusing to go to bed may have a limit-setting problem. Children can get very creative with their requests. One more hug, a drink of water, needing a light turned on or off, needing "to tell you something important…", etc.||
Parents should understand the importance of limit-setting during the day or night. For an older child who is getting out of the bed, a gate can be placed in the doorway or the door can be closed until you are sure she is staying in her room. A gate is preferred. For safety, two gates can be used if the child has learned to crawl over a single gate. If using the door method, you can tell her you will gladly open the door again when she stops trying to leave her bedroom. You will want to follow through with your warning, although early on, close it for just a few seconds moving slowly to a closed door for up to three minutes. The purpose is to teach her a new way to fall asleep, not to scare her. Use a calm, kind but firm voice when teaching how it will work.
Other suggestions include using a checking method where the parent promises to come back to the room after several minutes and check that the child is still in bed. This could be repeated several times at bedtime until the child falls asleep with the parent waiting longer and longer time periods between times of checking. The final suggestion is a “bedtime pass” in which a child is given 1 to 3 “passes” that they can use for their requests such as a drink of water, hug, and so forth. If the child does not use all of the passes on a given night, then a small reward is provided in the morning. Positive reinforcement with a sticker chart or a small reward in the morning can be very helpful with any of the above methods
A child who sleeps well will fall asleep easily and wake rarely during the night. She is more likely to be cheerful during the day. The better the child sleeps, the happier the entire family is likely to be. Most sleep problems do not reflect poor parenting, nor do they mean that there is something wrong with your child. If you have tried these methods, and your child still has problems with sleep, or if you have questions, consult your child's clinic.
If sleep problems persist even after speaking with your child’s doctor, consider further evaluation with a pediatric sleep doctor. Wisconsin Sleep clinic at 6001 Research Park Boulevard (www.wisconsinsleep.org) has sleep medicine specialists. A referral from your child’s doctor is recommended before consultation.
The Spanish version of this Health Facts for You is #6438.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 10/21/2011
Copyright © 10/21/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6214
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