Sleep Problems in Children and How to Cope with Them
Sleep is essential to a child’s’ health. Learning how to sleep soundly is a normal part of development. It is typical for children to wake during the night. However, returning to sleep may be difficult at times for children. Children who get little sleep are more likely to have behavioral problems, be prone to general moodiness, and have difficulties living up to their potential. Having a child that is not getting restful sleep or enough sleep can put significant stress on the family. Fortunately, many of the common sleep problems that children have are easily remedied after they are identified.
Sleep Onset Association
It is normal for a person to awaken during the night. Most often adults do not have a recollection of waking up and return to sleep with out a problem. On the other hand, when children wake during the night, it is common for them to become upset or frightened and to cry out for help. As a parent, ones first response is to go to the child and comfort them. Many parents feel the need to help their child return to sleep by rocking, feeding, holding, or lying down with their child. Doing this continually will teach a child that in order to fall asleep or return to sleep they need this attention. Over a period of time, a child may not be able to fall asleep with out being comforted. It can be a difficult learning process, but children need to learn how to take comfort in their bed environment with out a parent present. Having a favorite stuffed animal or a blanket in the crib or bed can help them feel more secure and relaxed.
If this sounds like your child, the child may have a sleep-onset association disorder. A parent must be aware that their child or baby can learn how to sleep on their own. To correct this problem, children must learn how to sleep at all times including nap times, on their own. Most parents find it easier to begin the teaching process at bedtime, but for others nap time may work better. When a parent starts teaching their child how to sleep with out people’s assistance, the child will most likely cry in frustration. Don’t worry, this is not abandoning or ignoring the child. If the child is an infant, be sure they are safe and not wet, hungry or sick. Counting the minutes when a child cries can be heartbreaking and nerve wracking for parents. Teaching a child how to sleep on his or her own is often more upsetting for the parents than it is for their child. The technique described in the following paragraphs will help one teach their child how to fall asleep. This technique combines reassurance and encouragement from the parents and limits the feelings of fright or abandonment a child might feel.
When a child is sleepy, but still awake, place them in their crib or bed. After saying “goodnight” turn out the lights (a night light is acceptable), and leave the room. If the child begins to cry or call for attention, and they are still doing so after 2 minutes, return to their room. Do not turn on the lights or take the child out of bed; do not give into requests like more juice, another story or to be held. Instead comfort them with soothing words and a quiet voice. One can also place their hand on their child to show them they are safe and reassure them. Do not linger in the room for more than 2 minutes at the most. If the child continues to cry or begins to cry again, a parent can reenter the room; however, this time wait a little longer before returning. If a parent needs to go back to their child’s room a few more times before they fall asleep, wait longer each time before reentering the room.
Following a consistent schedule like this will teach children they can sleep on their own. Consistency is the key! Be sure that other caretakers, like babysitters, are aware of the rules and follow the same plan. A parent should see improvement after 3 nights of this routine. If a child does not respond this quickly, that ok. It is entirely normal for some children to need more time making the transition to sleeping on their own.
Many parents find this to be a very frustrating learning period with their children. Often many will give in because they do not want their child to “suffer’. Giving in will delay a child’s progress in learning how to sleep on their own. Stick to the routine and a child will learn how to sleep soundly with out anyone’s assistance.
Night Time Eating and Drinking
A nighttime eating and drinking disorder is most common in babies or toddlers. Feeding an infant at night is a normal part of child rearing; however, by 5 or 6 months of age, a child should not need more than 8 ounces of fluid during the night. If a child is drinking more than 8 ounces of fluid per night at this age, he or she is probably taking in more fluid than is necessary. A quick way to find out to if ones child is over feeding at night is to feel their diaper when checking on them. If it is wet every time they wake during the night, chances are they are over feeding.
Feeding becomes excessive when the child cannot fall asleep with out being fed or drinking something first. A child that develops an association with feeding during the night will wake up hungry even though they are not in need of sustenance. The same children will have problems returning to sleep with out eating or drinking something first. These children have learned to associate feeding with sleep. A parents’ responsibility in this situation is to help their child learn to eat a more appropriate time of the day.
The best way to teach a child to eat at other times during the day is through a gradual reduction in the number of feedings if a parent is nursing. On the other hand if a child is bottle fed, a parent can reduce the amount offered to the child for a nighttime feeding. If a child is used to nursing every hour and a half or so, wait an extra half an hour before nursing them. The next night, wait an additional half an hour before nursing. Every night wait an additional half hour before feedings until the unnecessary night feedings are eliminated. The same reduction technique works if a child is bottle-fed. Try reducing the amount of fluid one offers their child by 1 ounce every night. Both of these techniques will take about 1 or 2 weeks to eliminate excessive nighttime eating.
This nighttime sleep problem is very typical for children from toddler age through kinder garden age. Limit-setting issues usually begin about 2 years of age. Signs of this issue could be a child stalling when it is time for bed with requests such as asking for one more story or they may flat out refuse to go to bed. Limit setting problems can occur at bedtime, naptime or if a child wakes during the night. Children can get quite creative in their requests before bedtime, maybe they need a tissue, another glass of water or they have to “tell you something really important”; these crafty tactics are used to postpone their bedtime. For an older child that sleeps in a bed instead of a crib, they may get out of bed or leave their room instead of asking for things.
It is important to set limits and to be firm about bedtime. Even if a child seems alert and full of energy at bedtime, it is a parent’s role to determine their child’s bedtime, not for the child to decide. If a parent adheres to the limits they have determined and will not give into their child’s requests; the requests will diminish over time. If a child understands that their parent is serious when they say “No, it’s time for bed.” and that limit is reinforced, the child’s requests will become fewer and fewer over time.
For an older child that has their own bed and can easily get out of it at night, keeping them in their room may be an issue. Many parents use a gate to block off the bedroom doorway. This way they are able to hear their child if there is a real emergency and the child is able to feel near their parents. If your child has figured out how to climb over the gate or remove it, you may need to get a better gate or use two; some parents stack one gate on top the other. Other parents may begin shutting the bedroom door at this point. If a child is old enough some parents may choose the tactic of a warning system. If their child will not stay in bed, they shut the door and tell their child they will be happy to open the door if the child will remain in bed. Shutting the door is not supposed to be a punishment; instead it is a deterrent system to keep the child in bed. Often many children do not like this option because they enjoy the security of feeling near their parents or like light from the hallway as a nightlight. A reward system also works well for older children. One strategy may be creating a chart with gold stars; a new star can be given as a reward for every night their child stays in bed. This can be an excellent way for a child to take pride in their progress of sleeping with out commotion.
If the child becomes upset at the prospect of shutting the door or having a gate in place, a parent can reassure their child that everything is ok. Do not enter the child’s bedroom though. Instead, if a gate is in place or their door is open, stand on the other side of the gate but of sight of the child. Speak to them in a calm and soothing voice. Reassure them that everything is all right and that if the child needs them a parent will be near by. During this learning process, if a gate is in place, it is typical for a child to fall asleep on the floor near it. If the bedroom door is closed a similar approach can be used. Stand on the other side of the door and speak to them using the same calm and soothing voice. As a child learns their parents are resolute about them remaining in bed and the child develops their own comfort level, they will gradually begin to sleep in the bed. As long as their parents consistently stick to the guidelines set in place this learning process will work. It is important for parents to realize that limit setting is essential in a child’s development whether it is during the night in regards to sleep or during the day in association with other requests.
It is important for every parent to know that a child with sleep problems is not a reflection of bad parenting nor is it a sign of something physically or mentally wrong with their child. If a parent believes, their child has sleep problems there are many resources available. A child’s pediatrician is a wonderful person to ask for information or advice about sleeping issues; they may also be able to supply a parent with more resources or information about sleep problems.
Tips for a Good Night of Sleep
There are a few things every parent can do to ensure a healthy sleep routine for their child.
- Create a relaxing bedtime environment
- Follow a consistent routine
- Spend one on one time with you child before they go to bed. Television or video games are not a good substitute.
- Screen TV programs and video games for age appropriate material.
- Avoid letting your child fall asleep with a bottle or while nursing, being held or rocked.
- Avoid products with stimulants in them before bedtime like caffeine, chocolate, some cold medicines or decongestants.