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Childhood Insomnia and Sleep Problems

Does your child have trouble sleeping? Insomnia, bedtime fears, night terrors, and bed-wetting are common children’s sleep problems. These tips can ensure your kid gets the rest they need.

Understanding sleep problems in children

Sleep problems are common among children, especially when they’re young. Insomnia, bedtime fears, night terrors, sleepwalking, and bed-wetting can all disrupt your child’s natural sleep pattern. Some children may not feel tired at their designated bedtime while others have trouble falling asleep without a parent present. Some kids will frequently wake up in the middle of night, suddenly wide awake, and either toss and turn or come and wake up mom and dad. It can be frustrating to have your own sleep regularly disturbed and then find yourself having to rush around in the morning because your child’s late getting up, or having to deal with a fussy, moody child who’s low on sleep. But there is hope. Many childhood sleep problems are linked to daytime behavior and bedtime habits that you can work with your child to change. With a little patience and discipline, you can help your child overcome their sleep difficulties, help them fall and stay asleep—and get back on track to more restful nights of your own.

How much sleep do children need?

To function at their best, children and teens typically need more sleep than adults. The chart below outlines the recommended hours that developing kids should spend asleep. How many hours of sleep do kids need? Age group Recommended sleep time Infants (4 to 12 months) 12 to 16 hours (including naps) Toddlers (1 to 2 years) 11 to 14 hours (including naps) Children (3 to 5 years) 10 to 13 hours (including naps) Children (6 to 12 years) 9 to 12 hours Teens (13 to 18 years) 8 to 12 hours

Signs that your child isn’t getting enough sleep

Children, just like adults, have trouble controlling their moods when they’re sleep deprived. Sleep, or lack thereof, affects much of a child’s behavior and state of mind. In some cases, the symptoms of insufficient sleep can even mimic those of ADHD.

If your child isn’t getting enough sleep, they may:

Often seem cranky, irritable, or over-emotional.

Have trouble concentrating at school or at home? Has a teacher informed you of this problem.

Fall asleep while riding in the car.

Appear to struggle following conversations or seem to “space out” a lot.

Have trouble waking up or fall back asleep after you’ve gotten them up for the day.

Often become drowsy or “crash” much earlier than their regular bedtime.

If your child wakes up often in the night, or has trouble settling down, it could mean they’re struggling with insomnia, one of the biggest sleep issues among kids.

Insomnia in children

Insomnia is the inability to fall asleep or stay asleep at night, resulting in unrefreshing or non-restorative sleep. Often, the issue resolves itself over time. But if your child experiences difficulty sleeping more than three times a week for several months, and it significantly impairs their daytime functioning, it may point to insomnia or another sleep disorder.

Causes of insomnia in kids

For many children, their difficulties falling or staying asleep stem from their daytime habits or how they spend their time right before bed. Eating too much sugary food during the day, for example, or watching TV right before bed could be enough to disrupt your child’s sleep. Of course, younger children especially will have difficulty making the connection between their habits and the quality of their sleep, so you’ll have to act as a sleep detective on their behalf.

Other common reasons why your child may be experiencing sleep difficulties include

Stress. Yes, they are young, but children also experience stress—often triggered by issues at school or home. They may be struggling to keep up in class, experiencing problems with their friends, or even being bullied. At home, stress can arise from parents’ marital problems, the arrival of a new baby, or changes in their sleeping arrangements that now require them to share a bedroom with a sibling, parent, or grandparent, for example. Yes, they are young, but children also experience stress—often triggered by issues at school or home. They may be struggling to keep up in class, experiencing problems with their friends, or even being bullied. At home, stress can arise from parents’ marital problems, the arrival of a new baby, or changes in their sleeping arrangements that now require them to share a bedroom with a sibling, parent, or grandparent, for example. Caffeine. Many sodas and energy drinks contain caffeine which can keep kids awake at night. Try to limit your child’s consumption past lunchtime. Better yet, try to cut out these types of drinks as much as possible. Many sodas and energy drinks contain caffeine which can keep kids awake at night. Try to limit your child’s consumption past lunchtime. Better yet, try to cut out these types of drinks as much as possible. Side effects of medications. Some drugs, such as those used to treat attention deficit hyperactivity disorder (ADHD) and antidepressants, can also cause insomnia in children. Some drugs, such as those used to treat attention deficit hyperactivity disorder (ADHD) and antidepressants, can also cause insomnia in children. Other medical issues. It could be a sleep disorder, such as sleep apnea or restless leg syndrome, or perhaps it’s triggered by a stuffy nose from allergies, growing pains, or itchy skin from eczema. Keeping your child up-to-date on health exams can help identify any issues that could interfere with their sleep.

Insomnia and “too much time in bed”

Sometimes, a child’s insomnia may stem from having more time allotted for sleep than they need each night. In these cases, your child could fight their bedtime or wake up in the night or too early in the morning. To find an ideal bedtime, note when your child starts to become drowsy in the evening. That’s the time they should be going to bed, so start their bedtime routine about 45 minutes earlier. If they’re awake much longer, they may start to get a second wind, and then become more difficult to handle. Speak to a Therapist Now With over 25,000 licensed counselors, BetterHelp has a therapist that fits your needs. It's easy, affordable, and convenient. GET 20% OFF Online-Therapy.com is a complete toolbox of support, when you need it, on your schedule. It only takes a few minutes to sign up. GET 20% OFF Teen Counseling is an online therapy service for teens and young adults. Connect with your counselor by video, phone, or chat. GET 20% OFF

Coping with insomnia in children

While establishing good lifestyle habits can help ensure a restful night for a child of any age, it’s especially important for older children and teens. Make sure your child uses their bed only for sleep. If possible, encourage them to use their bed only for sleep and a pre-bedtime ritual (such as reading a book) rather than homework, for example. Otherwise, they’ll associate the bed with other activities rather than rest and relaxation. Similarly, don’t use your child’s bedroom for time-out or they’ll learn to associate it with punishment.

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Ensure their bedroom is comfortable. Most kids sleep best in a slightly cool room (around 65 degrees). If there’s noise from outside, using white noise from a fan or sound machine can help to mask it. Make sure your child’s bed is not overloaded with toys, as that can become distracting at bedtime. Try to keep the same sleep schedule, even on weekends. This will make it easier for your child to wake up and fall asleep naturally. Adolescents should not need to sleep much more than an hour past their usual wakeup time on the weekends. If they do, this indicates that they aren’t getting enough sleep during the week. Keep your child from going to bed too hungry or full. A light snack (such as warm milk and a banana) before bed is a good idea. However, heavy meals within an hour or two of bedtime may keep kids awake. Encourage an active lifestyle. Regular exercise prevents restlessness at night. An hour every day is the recommended amount. However, try to keep your kids from vigorous activity within three hours of bedtime. Encourage natural light exposure first thing in the morning. Opening the blinds helps your child wake up and signifies the start of the day. Pay attention to napping. Children typically need at least four hours between sleep periods before they are tired enough to doze off again. Although nap needs may vary, make sure your child is not asleep for too long or too close to bedtime. Set limits with electronics. The blue light emitted by the TV, phones, tablets, and video games can disrupt the body’s sleep/wake cycle and makes it more difficult to sleep. Turn off these devices at least one hour before bed and store them outside your child’s bedroom during sleep hours. Spend quality time together. Some kids want to stay up later because they’re craving more attention from their parents. If both parents work during the day, evenings are when they’re available. Even just asking kids about their friends or interests can go a long way. For babies, spend a few minutes singing to them, making eye contact, or interacting in a gentle way as they wind down for the night.

Coping with other childhood sleep problems

In addition to daytime habits and bedtime routines, kids often experience other obstacles to getting a good night’s sleep. Fear of the dark, bad dreams, night terrors, sleepwalking, and bed-wetting are other sleep problems that kids often struggle with. While most outgrow these problems quickly, there are plenty of ways you can address your child’s sleep problems and ensure they—and you—get a healthy night’s rest.

Bedtime fears and sleep anxiety

At some point in childhood, most children experience a fear of the dark or going to bed at night. Many young kids especially have difficulty separating what is real from what is imaginary, so while the idea of monsters under the bed may seem silly to you, it can seem very real and very frightening to your child. While it’s important to let your child express their fears without you dismissing or ridiculing them, it’s also important not to support or legitimize their worries. Instead of using “fairy dust” to get rid of monsters or waving a magic wand to scare away any ghosts, for example, you’re better off explaining to you child how their imagination can trick them into mistaking normal things, such as shadows or creaking sounds, for something frightening.

You can also:

Start by understanding their fears. Acknowledge and empathize with your child’s fears before reassuring them that their worry is separate from reality and that nothing bad is going to happen. Use a night-light to give your child extra security in their bed at night, as long as it isn’t bright enough to disturb their sleep. Let your child have a security object with them at night, such as a cuddly toy or special blanket. Having a pet in the room with them can also help to allay their fears, as long as it doesn’t disrupt their sleep. Help your child explore their bedtime fears during the day. Have them check under the bed to see that there’s nothing under there, for example. Talking about their fears during the day rather than at bedtime can also help to build up their self-confidence and make them less anxious at night. Avoid scary books, movies, or TV shows, even during the day. These will only fuel your child’s imagination and add to their fears at night. Encourage your child to stay in bed, even if they wake up in the night. You want your child to learn that their bed is a safe place so it’s better to sit with them while they go back to sleep rather than remove them from their bedroom.

Nightmares

When kids get to preschool age and a fear of the dark tends to set in, they also become more prone to nightmares. Any issues or feelings they’re working through during the day can manifest themselves in disturbing dreams at night. As well as addressing their bedtime fears and anxiety (above), it’s important to talk to your child about any changes they’re experiencing in their life. Moving home or school, parents separating, or the addition of a new sibling to the family can all fuel uncertainty in a child’s life and prompt nightmares. Whatever your child’s age or circumstances, take time each day to check in with them and stay up to date with what’s going on in their life and any issues they may be having at school or with their friends. If your child wakes you up after a nightmare, reassure them that it’s not real but don’t dwell too much on the content of the scary dream. Instead, focus on getting them ready for sleep again.

Night terrors

Night or sleep terrors are episodes of screaming, flailing, and intense fear while your child is asleep. While it can be disturbing to witness your child having night terrors, it’s not usually a cause for concern. They’re often a byproduct of stress, lack of sleep, new medication, or changes in sleep environment, and most kids outgrow them by their teenage years. Unlike nightmares, your child remains asleep and will likely have no recollection of the event the next morning.

Symptoms of night terrors

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Thrashing around in bed, kicking covers off.

Screaming in distress.

Breathing heavily and a high heart rate.

Sweating.

Sitting upright in bed.

Moving around the house (night terrors can happen in conjunction with sleepwalking).

Dealing with night terrors

Since attempting to wake your child from a night terror may cause them more distress, gently guide them back to bed or wait until they fall back asleep. You can reassure them with a pat on the back or by squeezing their hand. Most incidents don’t last for more than a few minutes. While there’s no “cure” for night terrors, you can take preventive measures to ensure your child is safe. If they move around during a sleep terror, make sure any doors leading outside the home are locked, place a safety gate at the top of the stairs, and remove any dangerous or breakable objects from the immediate vicinity. You can also help your child to deal with anything that’s fueling their stress and work to reduce tension. A relaxing bedtime routine can help, as can avoiding caffeinated drinks during the day. If the incidents take place around the same time every night, you could try waking your child up about 15-30 minutes before to see if that helps.

Sleepwalking

Sleepwalking doesn’t involve just getting out of bed; many sleepwalkers also talk, sit up in bed, or make repetitive movements such as fumbling with clothing or rubbing their eyes. Although your child’s eyes are open, they may have a glassy appearance, and since they’re still asleep, they won’t see the same way as when they’re awake. While their behavior may alarm you, your child isn’t aware of what they’re doing and most likely won’t remember it the next morning.

Causes of sleepwalking

Some influencing factors include a lack of sleep, an irregular sleep schedule, illness, stress, or certain medications. There’s usually no need to see a doctor unless the incidents are very regular, involve risky behavior, or result in your child feeling sleepy the next day. Sticking to a regular sleep schedule and making sure your child is getting enough rest is often enough to resolve most sleepwalking issues. You can also help reduce stress levels by engaging your child in relaxing activities before bedtime. Encourage your child to go to the bathroom before winding down, as a full bladder can also contribute to sleepwalking.

Sleepwalking and safety

Don’t try to wake a sleepwalker, as this might frighten them. Instead, gently guide them back to their own bed. Make sure windows and doors are locked and consider installing a safety gate outside your child’s bedroom or at the top of the stairs. Remove sharp or breakable objects from around their bed and clear out any clutter or toys that they could trip on in the night. If your child shares a room with a sibling, don’t let them sleep in the top bunk of a bunk bed. Although sleepwalking usually stops by the teen years, keep car keys away from kids who are old enough to drive.

Bed-wetting

Although able to use the bathroom correctly during the day, some young children may struggle with bladder control issues at night, which can be humiliating and stressful. Bed-wetting usually occurs in children two to four years of age. However, it can continue with school-aged children as well. If both parents wet the bed when they were young, it’s likely that their child will as well.

Other possible causes of bed-wetting include:

Your child’s bladder has not developed enough to hold urine for an entire night. Similarly, communication between their brain and bladder may not have fully formed. It is a response to stress, changes at home, a minor illness, or exhaustion. Your child is a deep sleeper and a full bladder fails to awaken them.

Your child is constipated. Full bowels put pressure on the bladder.

Your child’s body is producing too much urine at night.

Helping your child cope

Even though your child knows they’re not at fault, bed-wetting often makes them feel significant embarrassment and guilt. They may feel reluctant about sleeping over at a friend’s house or going to camp, for example. Reassure them that you don’t blame them for it and instate a ‘no-teasing’ rule in your house. If you or another family member was also a bed-wetter, it might make your child feel better to know about it. Here are some other ways to manage the situation:

Put a plastic cover over the mattress.

over the mattress. Let your child help change the sheets. Explain that this isn’t a punishment. It helps teach responsibility. Explain that this isn’t a punishment. It helps teach responsibility. Set up a reward system. Give your child stickers for “dry nights” with a small reward after a certain number. Give your child stickers for “dry nights” with a small reward after a certain number. Avoid lots of fluids before bedtime. Remind your child to use the bathroom again before bed. Remind your child to use the bathroom again before bed. Set a bed-wetting alarm. If the problem persists, consider asking your child’s doctor about an alarm. These detect wetness and will wake the child up to use the toilet. This could be helpful for deep sleepers. When to see a doctor about bed-wetting If your child has been completely toilet trained for at least six months, and then starts wetting the bed, it could point to a medical problem that requires your doctor’s attention. This is especially likely if the bed-wetting occurs along with other changes in your child, such as: Pain or a burning sensation while urinating.

Cloudy or pink bloodstains on their underwear.

Wetting their pants during the day.

Swelling of their feet or ankles.

Wetting the bed at seven years of age or older. Continued bed-wetting, especially if the child is over seven or had previously outgrown it, may also be a sign of sexual abuse.

Authors: Anne Artley, Melinda Smith, M.A., and Lawrence Robinson

References Sleep-Wake Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425787.x12_Sleep-Wake_Disorders CDC – How Much Sleep Do I Need? – Sleep and Sleep Disorders. (n.d.). Retrieved May 13, 2022, from https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html Gerber, L. (2014). Sleep deprivation in children: A growing public health concern. Nursing Management, 45(8), 22–28. https://doi.org/10.1097/01.NUMA.0000451997.95978.2f Nightmares and Night Terrors | Johns Hopkins Medicine. (n.d.). Retrieved May 13, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/nightmares-and-night-terrors Patient education: Bedwetting in children (Beyond the Basics)—UpToDate. (n.d.). Retrieved May 13, 2022, from https://www.uptodate.com/contents/bedwetting-in-children-beyond-the-basics Sleepwalking—NHS. (n.d.). Retrieved May 13, 2022, from https://www.nhs.uk/conditions/sleepwalking/

helpguide.org - Childhood Insomnia and Sleep Problems - HelpGuide.org

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