And Then When You Sleepy, Momma Feel so Fine: How to Help Your Child or Teen Overcome Their Insomnia
In Liberia, parents sing lullabies with lyrics like “Sleep, baby, sleep / Momma want to see you sleepy / And then when you sleepy / Momma feel so fine”. The message of these songs is very true to reality: when a young child has trouble sleeping, so do Mom and Dad.
Older children may no longer expect their parents to tuck them into bed for the night, but they, too, can have difficulty falling or staying asleep. A lack of sleep may make children grumpy, forgetful, reactive and inattentive, leading to trouble with friends and school work. When these issues occur three or more times a week, the condition is known as “insomnia disorder”.
Insomnia can develop in young children when their parents don’t give them the opportunity to calm down and relax in bed by themselves (known as “self soothing”). Children learn to fall asleep only under certain conditions; for example, when a parent is rocking them, giving them a back rub, lying in bed with them, or driving them in the car. If the child wakes up during the night, the parent must repeat the same habit to get them to fall back asleep. This type of insomnia, where the child is unable to fall asleep without these associations, is called “sleep-onset association insomnia”.
Insomnia in young children can also manifest as bedtime resistance. This is where the child keeps delaying bedtime by asking more and more questions, making more requests (“I’m thirsty, can I have a glass of water?” or “One more story!”), complaining (“I have a stomach ache”) or throwing a tantrum to force their parents to stay in their room.
When the child doesn’t want to let their parents leave the bedroom or demands the parents’ presence each time they wake up during the night, even the most nurturing parent can feel like a hostage. This is a lose-lose situation for both the parent and child.
As children grow into adolescents, their insomnia disorders develop in a different way. Changes caused by puberty delay sleep onset time. Adolescents also have long and demanding schoolwork, extracurricular activities and active social lives. They frequently shorten their sleep to squeeze all of this action into their day. This results in a delayed bedtime, shorter sleep duration and increased levels of daytime sleepiness. Some teenagers consume large quantities of caffeinated beverages like energy drinks or coffee in order to stay awake and fight the effects of their sleep deprivation. All these factors can make them more vulnerable to developing insomnia.
The intensity of school and social life can overwhelm teens, causing them to experience high levels of stress that manifest as increased arousal at all times (arousal being the scientific term for a physiological response to stress). As a result, adolescents can have a hard time disengaging from the day’s stressors at bedtime, making it difficult for them to fall asleep.
In an effort to reduce their stress levels, some teenagers use tobacco or play video games in the hour before bedtime. Unfortunately, these habits have an opposite effect: they increase rather than decrease arousal. Too much arousal at bedtime, called “hyperarousal”, makes it difficult to fall and stay asleep. This triggers the onset of an insomnia disorder.
Once insomnia has been triggered, it’s hard to turn it off. The same habits that created the insomnia are now perpetuating it, making it snowball into a chronic disorder.Persistent insomnia in children or teens is associated with poor physical and mental health, depression, anxiety, poor school performance, bad behavior, emotional dysregulation and suicidal ideation.
The Good News: Insomnia in Babies, Children and Adolescents Can Be Treated
Behavioral Sleep Specialists or Clinical Psychologists are licensed professionals who are trained to use behavioral or cognitive strategies to help children and teens improve their sleep.
For babies and children, parents hold the key to healthy sleep. Behavioral sleep specialists facilitate changes in children’s sleep habits by helping parents change some of the ways they respond to their children at bedtime and during the night. They guide parents in creating night routines and selecting bedtimes and encourage parents to teach their child to self-soothe in order to fall asleep and stay asleep independently. Behavioral therapists can also help the child overcome nighttime fears or worries about sleep.
Treating Insomnia in Teenagers
Therapists working with adolescents will help them identify and eliminate behaviors that contribute to hyperarousal at bedtime in order to “undo” insomnia triggers. Therapists can also teach how to relax at bedtime by using techniques like guided or mindfulness meditation. These behavioral interventions can lead to significant improvements in the sleep and mental health of children and teens.
Things You Can Do to Teach Your Baby or Child to Fall and Stay Asleep:
- Help to create a consistent sleep routine. A sleep routine is a series of short activities your child does in the same sequence each night a]s they prepare for bed. Repeating the same sleep routine every night creates an association between these activities and sleep, which helps the child get in the right mindset to fall asleep.
- Keep consistent bedtimes, wake-up times and nap times (if your child is napping) to help them develop a healthy rhythm.
- Place your child in bed when they’re drowsy, but still awake, and leave the room. This will help your child develop the ability to self-soothe.
Things Adolescents Can Do to Fall and Stay Asleep:
- Maintain a consistent bedtime and wake up time throughout the week.
- Adjust light exposure throughout the day. Get 30 minutes of sunlight exposure before 1:00 PM. Avoid using electronics before bedtime to reduce blue light exposure, or use blue light filtering glasses and turn on the night shift feature on your devices.
- Get some physical activity in during the day but avoid exercise or other overly stimulating activities before bedtime.
- Use calming activities at bedtime such as meditation or relaxation exercises.
- Keep your bed for sleep only. It’s better to do homework in a different place
- Make sure your bedroom is cool, dark and quiet.
- Avoid caffeinated products at least 3-4 hours before bedtime and big meals like dinner any closer than 2-3 hours before bedtime.
By putting these healthy practices into place, your child will be one step closer to getting a good night’s sleep, and you’ll be able to rest easy.
A word of warning: Some individuals who offer their services for evaluation or treatment of sleep disorders (such as “coaches” or “child sleep consultants”) may not hold a professional license to practice as a healthcare provider. For more information, see the position statement from the Society of Behavioral Sleep Medicine.
A clinical psychologist must be fully licensed for independent practice and have documentation of training. You can find certified CBT Diplomates at the Academy of Cognitive and Behavioral Therapies.
“Sleepyhead, close your eyes, mother’s right here beside you; now sound asleep until morning light.”
Reut Gruber is a scientist, psychologist and sleep expert. She is an associate professor in the department of psychiatry at McGill University and director of the Attention, Behaviour and Sleep lab at the Douglas Mental Health University Institute; Diplomate of the American Academy of Cognitive Therapy (ACT) USA; Licensed Psychologist, l’Ordre des Psychologues du Québec (OPQ), QC, Canada
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