According to the journal American Family Physician, about 1 in every 3 children up to the age of four has some sort of sleep problem; the most common being “night awakenings”, in which the child wakes up frequently in the night. However other problems include: night terrors (in which the child wakes up screaming and is unable to be calmed), difficulty going to sleep, and excessive sleepiness.

Why is this important?

Children who don’t get adequate sleep at night will display various behavior problems, including: irritability, hyperactivity, inattentiveness, lethargy, and aggression. These problem behaviors can be seen across different times of the day, and different settings. For example, a child who isn’t getting adequate sleep may be very violent at school (throwing toys, kicking/hitting other students), or they may be off-task, running away from the classroom during structured activities. The child may also show no problems at school, but may exhibit these problems at home, or during outings (like going to the grocery store or to the doctor’s office).

What can be done?

First step is to see a doctor and make sure there isn’t a medical explanation for any sleep problems the child may have. If the doctor says that the child is fine, then there are several options, depending on the type of sleep problem the child has:

Difficulty going to sleep:

The best way to help a child who has difficulty falling asleep or going to bed is to set up a routine. You should:

Set a regular bedtime; children between the ages of 3 and 4 should be getting at least 10 hours of sleep per night with a 1.5 hour nap during the day. Younger children need even more sleep.

Limit caffeine-children shouldn’t have any drinks or food that have caffeine in them for at least 6 hours before bedtime
Limit all activity within the last hour before bedtime. Children shouldn’t be doing any type of high activity for an hour before bedtime. Examples of high activities include running, play wrestling, jumping, bike riding, and exercising.

Keep toys, TVs, and any other distracters either out of the room or hidden at bedtime, this will make it so that the children aren’t likely to play with them rather than sleep.

Limit the amount of lighting in the child’s bedroom; when it is dark your body naturally secretes a hormone called Melatonin that causes your body to feel tired. Light inhibits the secretion of this hormone, therefore making it more difficult for a child to fall asleep or stay asleep.

Pick 5 or 6 calm activities that your child likes to do with you, and include them as part of your routine: the child may first take a bath, then brush their teeth, then do a puzzle, then read a book, then sing a song, then go to sleep. Always do the activities in the same order every night.

For other sleep issues, like night awakenings, contact the Mental Health/Special Needs Manager.

C. CAROLYN THIEDKE, M.D.
American Family Physician, 2001.

Journal of Positive Behavior Interventions, Spring 2004