When your child is tired, or overtired, you're certain that it's going to be a bumpy ride. They're fussy, cranky, hungry, not hungry, and just plain difficult.... And for a parent dealing with a child who seems to have chronic sleep issues, the problem seems helpless. Today, Parents Ask expert Bonnie Zucker discusses sleep problems with children and offers tips on ways to gentley work through them.

Q: My son has had a hard time falling asleep and staying asleep. I'm worried that his sleep problems are affecting his behavior? He seems "off." Any tips?

The importance of sleep cannot be underestimated. Plain and simple, sleep is necessary for the health of your body and mind, and without good sleep, we cannot expect children to perform at their best. A strong immune system, optimal cognitive functioning, memory skills, processing speed, and many other cognitive abilities depend on quality rest. The quality, not just quantity, of sleep is also key in strengthening a child’s body and mind. Childhood sleep problems are among the top behavioral issues reported by parents.



So what can parents do? First, establish a sleep routine, including time to unwind, a ritual of getting ready for bed, and a bedtime. Ideally, children should sleep in their own bed and have the same bedtime and wake time every day, with no more than 1 hour of variance during the weekends (so, if your child’s bedtime is 9pm during the week, it shouldn’t be later than 10pm during the weekend). Once a routine is established, stick to it! Sleep is one of the easiest things to sacrifice and there needs to be a commitment to it.



Second, for children who have problems falling asleep or staying asleep, we need to take a behavior-modification approach. Here are the rules to share with your child: do nothing but sleep in your bed (e.g., no TV, no reading, no talking on the phone, no doing HW, no eating, no nothing EXCEPT sleep in your bed), for the child who complains about this, I recommend getting a bean bag for their room as a replacement to the bed for non-sleep activities; if you are not asleep after 20 minutes (by the way, it physiologically takes 8 minutes to fall asleep), then get out of bed and do a mundane activity, not too exciting- no playing video games or watching favorite movies and no screens at all (e.g., read a magazine, do a word search, play solitaire- the real version- not on the computer but with actual cards, on the floor!, put clothes away, color or draw) and once you feel sleepy, get back in bed- repeat this if you are not asleep in another 20 minutes (I assure you that after 2 weeks, you will begin to associate your bed with sleep and will be on your way to falling asleep quickly and easily upon getting in bed); smell lavender right after getting in bed (lavender has been associated with physiological relaxation); no eating or drinking for 1 hour before bed; and if worries come up, write them down (have a writing tablet and pencil next to the bed) and try do some calm breathing.  



Third, if your child continues to have sleep problems despite implementing the above, then I recommend meeting with sleep study expert to rule out a physiological problem such as sleep apnea. If your child is on stimulant medication, this may be interfering with sleep in which case I recommend talking with the prescribing physician.

 

Two great books are: Sleeping Through the Night by Jodi Mindell, Ph.D. (for younger children) and The Promise of Sleep by William Dement, M.D., Ph.D.