Dear Dr. Medoff,
We have been having a lot of difficulty with our ten-year-old son lately concerning bedtime. He has trouble falling asleep and staying asleep. Then he is so difficult to wake up in the morning, and is often cranky throughout the day. What should we do? From, L.J.
Getting the right amount of sleep is important for all of us, adults and children alike. Sleep has many restorative properties, both physically and mentally. In children, sleep contributes to physical growth, as certain growth hormones are released during the hours of sleep. Children who are well-rested are better able to pay attention in school and exhibit better moods, which contributes to their ability to play cooperatively and develop social skills. As you are also surely already aware, children who do not sleep well disrupt the sleeping patterns of their parents, which can lead to overall family tension and stress.
There may be many causes for sleep difficulties, which often work together to prevent getting a good night’s sleep. Make sure to take a look at the variety of issues mentioned below, and adjust as many variables as you can to produce a good night’s sleep for your child.
- Limit your child’s intake of caffeine throughout the day, and try to cut it out entirely in the afternoon and evening. Be aware of hidden sources of caffeine by paying close attention to food labels.
- Monitor what your child eats just prior to bedtime. Having a heavy meal and going to bed hungry can both interfere with sleep. Make sure that dinner comes a few hours before bedtime. Ask your child if he is hungry an hour before bedtime, and if so, feed him a small portion of a light, healthy snack.
- Make sure that your child is active during the day. If he does not get a lot of exercise on his own, exercise as a family, such as taking a walk together before dinner. Try to avoid heavy exercise within 3-4 hours of bedtime.
- Older children should avoid naps that last longer than 15-20 minutes.
- Stay away from any kind of overstimulation in the evening, such as violent or exciting television, movies, or video games. Try to get difficult homework done in the afternoon, and attempt to avoid subjects that could lead to fighting in the evening. Limit evening internet use, which could also get your child overexcited or anxious. Instead, watch calmer movies and television, or better yet, read with your child.
- Establish a regular bedtime that you stick to every night, including on the weekends. Start a bedtime ritual that you will perform at the same time every night. Consider incorporating relaxing activities, such as taking a warm bath, playing classical music, or doing breathing exercises and muscle relaxation.
- Talk to your child about his bed and his room. Are the mattress and pillows too soft or too hard? Are the textures of the blanket and sheets too scratchy? Is the room too hot or too cold? Too noisy or eerily quiet? Too bright or too dark?
- Let your child have some leeway in terms of bedtime rules if he can’t fall asleep. For example, if he cannot fall asleep a half-hour past bedtime, he can get up and read in a chair for 20 minutes, and then try to fall asleep again.
- Make sure your child clearly associates the bed only with sleeping. He should avoid using the bed for any other activities, such as doing homework. Another way to encourage mental separation is to make sure that your child has specific clothes that are only worn for sleeping.
- Difficulty falling asleep is often associated with either common childhood fears or parental authority issues. To combat both, definitely soothe an upset child, but stick firmly to limits. For example, you can tell your child in a calm, but confident voice, “You can have one drink of water, and then you need to get back in bed. I will stay for five minutes, and then I know you’ll be okay on your own.” Follow through with what you say.
- Do not give your child over-the-counter sleep medication. If the problem persists, talk to your pediatrician. Keep notes on when your child tends to have problems, and what was going on the day before and the day after the sleep disturbance. Share these notes with your child’s physician.
Lisa Medoff, Ph.D holds a B.A. in psychology, a master's degree in school counseling, and a Ph.D. in child and adolescent development. Although she’s worked with all types of children, for the past eight years, she has worked with students with special needs, such as ADHD, learning disabilities, depression and anxiety. She has taught courses in psychology and child/adolescent development at Stanford University, Santa Clara University, San Jose State University, and DeAnza College. She currently works as a resilience consultant for the non-profit Cleo Eulau Center, helping teachers at a low-performing elementary school understand issues of connectedness, special needs, and cultural sensitivity in order to build resilience in their students.