“Help, My Child Won’t Sleep!” – Treating Insomnia in Children

Joshua August 31, 2016 10 Comments

There’s no denying it — this world of fast-paced communication, highly accessible media, and ubiquitous applications represents both opportunities and pitfalls for the kids?of today. No wonder treating insomnia in ?children appears to be so difficult! But, as with everything, we must return to first principles and?think about is how these things influence our children from a developmental perspective, and also how they will serve to shape their experiences into the future. With the million distractions that exist, how do you handle your kids today when it comes to proper sleep hygiene? Do you have a schedule in place? Do they know how to respect your boundaries? Or do they frequently and routinely ignore the limits that are set and subsequently have issues?falling asleep? This post will?speak to causes of insomnia in children and also possible means of treatment that can be employed in order to reverse the potential harmful effects of same.

What is Insomnia?

Essentially, insomnia is an inability to fall asleep or even to stay asleep for sustainable periods of time.?As a direct result, sufferers of insomnia experience non-restorative sleep which can leadto a host of other debilitating effects. We all know that?children, especially younger ones, require a greater quantity of sleep than adults on a daily basis. Infants can sleep up to 16 hours in a single day while children 2 years and older only require 12. It is important to remember that the formative years, that is between ages 0 & 7 represent the stage within which most of the social, cognitive and psychological traits in?children tend to solidify. As a result we must all ensure that our kids get the best sleep possible so that they can perform optimally and effectively in all their pursuits.

Symptoms of Childhood Insomnia

Insomnia can manifest itself in many different ways for kids. The primary indicator is of course difficulty falling asleep and staying asleep. In some cases, kids may also the awaken way too early. In my previous posts regarding some of the high-level effects of sleep deprivation, it’s pretty easy to see that very similar side effects occur in children despite the fact that adults have a higher tolerance for sleep debt. Children may exhibit drowsiness and lethargy throughout the day along with memory problems and attention span issues. Irritability, hyperactivity and aggression?in the form of unusual temper tantrums are also marked changes in behavior that company childhood insomnia. Naturally this can lead to poor performance in school and a lack of?social adjustment.?This also puts undue pressure on parents as well so we should not forget that these problems do not occur only in isolation.

Causes of Childhood Insomnia

Insomnia can be caused by both behavioral and medical issues. We’re going to look at each in turn, starting with the behavioral which incidentally is the more common of the two.

Behavioral causes of insomnia

Behavioral insomnia reflects what happens when children are not taught proper sleep practices. In that way it resembles poor sleep hygiene common in adults who themselves may ignore sleeping opportunities in favor of other pursuits (much to their own detriment). There are two major types of behavioral insomnia: sleep-onset association and limit-setting.

Sleep onset Association

This specific type of behavioral insomnia arises?as a result of a conditioned expectation. What does that mean exactly? Basically that the child has come to expect the parent’s presence before falling asleep. In new parents this may be a common mistake. Oftentimes parents will cuddle with their children, rock them, sing to them or even lie down?with them in order to make sure that they fall asleep. While this may not sound like a bad thing it does have possibly serious implications. The child may come to associate the presence of the parent with the activity of sleep — an occurrence that is detrimental to both parties. It is important to recall that most children do wake up up to 5 times per night therefore if having a parent present is a precondition to sleep then either Mommy or Daddy must be awake as well! Obviously this can lead to?a lot of frayed nerves on the part of the parents.

Limit-setting

In a very real sense limit-setting insomnia is almost the opposite of sleep-onset association insomnia. Where sleep association insomnia stems from consistent but incorrect?conditioning, limit-setting insomnia actually comes from a lack of reinforcement of proper?sleep hygiene and parental authority. Children in and of themselves do not understand how much sleep they actually require on a daily basis and thus?are likely to think that they may be “missing out”?on?additional play time or entertainment. Some may even become excessively?stubborn or very opinionated about the times at which they should be allowed to fall asleep, and try to hide from or delay the process as long as possible! A subset of?parents unfortunately given to these behavioural displays, only to have their children develop poor sleep practices. Demands around bedtime are not uncommon in this particular class of insomnia, and may include things like food, attention or perhaps just additional time to play. Many kids who are afflicted with this will try to push their parents with ever more increasing demands and there must come a time, if this behaviour is to be curtailed, that parents take a stand.

Possible medical causes of childhood insomnia

Incidences of medically caused insomnia and rather?rare but definitely possible. In most cases this is due to treatment for other disorders for which the onset of insomnia may be purely incidental. Children that have challenges with depression, autism, ADHD or Asperger’s may take medication which bring about?insomnia as a side effect.

Treatment Strategies for Childhood Insomnia

By and large many of the treatment strategies available for childhood insomnia involve setting adequate expectations with children and enforcing a rhythmic approach to the matter of sleep. Parents need to take a very strong and positive role in monitoring the sleep patterns of their children so as to make sure that their health and well-being are safe and protected with the highest priority. Let’s enumerate a few of those strategies below (which incidentally are very close to general tips for good sleep):

• Control the Sleep Environment?- Ensure that your child’s sleep environment is conducive to sleep. This includes such things as making sure that the bed is comfortable and that the lighting and temperature are suitable. Also delay discussions relating to?any stressful topics so as to prevent anxiety from interfering with their child sleep. We often forget that children are just as prone to stress as adults (if not more so).

 

• Set an appropriate bedtime – For this strategy to be effective,?it is important to understand the average amount of sleep that may be required by your child. Infants need around 12 hours whereas children between the ages of 6 and 12 may?require around 10. Teens can get by with 8?or 9?hours. Once you have a handle on your child’s sleep requirements, do be sure to enforce a bedtime hour consistent with their needs.

 

• Practice relaxation techniques with your child?- This is fairly effective because it?teaches your child to create a bedtime ritual…a set of practices?that allow the body to know that it is time to wind down in preparation for sleep. This can go from deep breathing exercises to very specific activities such as brushing teeth and?reading bedtime stories. Once more consistency is paramount?so that children understand that sleep is the next logical activity to follow. Dissociate yourself from your child’s sleeping pattern as in the case of sleep onset insomnia. Parents must find a way to ensure that their child does not maintain an expectation of their presence in order for sleep to ensue. Some people think that this may be cruel?since at times the child may actually cry without the presence of the parent but inevitably this can only be beneficial to both parties. For one thing it frees the child from the seemingly definite belief that a parent must be in proximity for them to sleep and also frees parents from the need to provide soothing for their kids in all cases before bed. Self soothing is not a crime and the earlier that children understand this the better it will be.

 

• Being firm with children?- In limit-setting instances unreasonable demands must not be accommodated. That’s right, that means no food or snacks or extra time with those gadgets or TV. Facilitating those requests will only send a signal to the child that stubbornness has its own payoff.

 

• “Unplugging” your child -?This may be considered controversial for some parents but?is actually a very serious recommendation. Mobile devices such as phones and tablets, and also TVs (in fact anything with a colour emitting screen) are known to emit blue light which serves to stimulate the body into believing that daytime is still in effect. In such instances the onset of sleep is delayed and children end up?going to bed off their circadian rhythms and possibly experiencing sleep hangovers in the morning. It is important to cease?interaction with devices with screens at least an hour before bed so that your child can become settled into their ritual prior to falling to sleep.

 

• Behavioral and cognitive therapy?- Sometimes kids need a little help on the psychological side in order to develop proper sleep hygiene. It is usually best to pursue this as an early alternative to any options involving medication since these tend not to be recommended for children and adolescents. Getting a referral to a sleep specialist is usually a great place to start this kind of intervention which is likely to have more sustainable effects as the child grows older.

By following the above, it’s likely that children suffering from childhood insomnia will find themselves regaining their energy on a daily basis. For parents, there is nothing like the security of their child’s welfare.

Did you or your child ever experience insomnia in any form? What were your coping mechanisms? Drop me a line below, I would love to hear from you!

Sleep well until next time.

?–
Josh.