Helping your child sleep through the night

Is your child having trouble sleeping at night? One of these issues could be the cause.

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Almost every night, five-year-old Holden gets up in the wee hours and makes a beeline for his parents’ bed. If his mom, Allison Colpitts, walks Holden back to his room, he’ll boomerang back, so she lets him stay. But Holden’s fidgeting has Dad retreating to his son’s room.

The Colpitts are far from alone. It’s not uncommon for school-age kids to require sleep training. Close to 40 percent of kids will have some kind of sleep-related problem before age 18, says Valerie Kirk, medical director of the Paediatric Sleep Service at Alberta Children’s Hospital. “Sleep problem” is a broad term that includes any issue related to falling or staying asleep that impacts the child or family.

According to the Canadian Sleep Society, 40 percent of young children are sleep deprived. Lack of sleep can affect a child’s growth, development, learning and behaviour. But finding solutions is a process that takes time, says Michelle Ponti, a paediatrician in London, Ont. Experts recommend starting with good “sleep hygiene”: keeping a consistent and calming bedtime routine, with a room that’s primed for sleep—cool temperature, comfortable bedding and a soft night light.

If you’re still having issues, here’s how you can deal with the top four sleep problems.

Bedtime refusal
These kids are masters of the curtain call, popping out of bed to ask for one more glass of water, hug, etc. Ponti sometimes suggests a “visual schedule” that shows pictures of the nighttime routine, such as toothbrush, toilet, story, sleep. “The child can be responsible for checking off the list; it makes it a lot easier for everybody to follow,” she says. Kids this age have the ability to reason; parents must set the expectations (lights out at 8 p.m.), verbalize the consequences and follow through.

Nighttime awakenings
Like Holden, some kids wake up one or more times each night and are unable to go back to sleep on their own. They often have a “sleep association disorder,” says Kirk: They’ve developed a set of criteria that must be met to get to dreamland, like having a parent lie with them or seeing the hall light on. Kirk says kids this age respond well to positive reinforcement, so try using a sticker chart with a reward earned only when your kid successfully stays in bed for a set number of nights. The prize shouldn’t be material; instead, make it something special that involves spending time with a parent. And be firm: “There has to be a cost for messing up,” Kirk says.

Bedtime Anxiety
Some kids have nighttime phobias—it could be fear of the dark, something scary they’ve seen or a general uneasiness about sleeping alone. While some kids may be seeking attention, says Ponti, if fear is the culprit, “we have to teach that child the difference between fantasy and reality, and help them work through those fears.” For example, notes Kirk, using a “monster spray” tells a child the monster must be real. Instead, reassure them that they’re safe and nothing is in the house except family members. Ponti adds that parents can work with kids to practise calming breathing strategies, positive imagery or brave thoughts like, “I’m a big boy.”

Parasomnia
These sleep disorders are characterized by unusual movements, behaviours, emotions or dreams, such as sleepwalking or night terrors where a child thrashes or cries out. Sleepwalking starts to be more common at this age and tends to occur when a kid is overtired, stressed and/or excited, says Kirk, adding it’s usually pretty easy to lead them back to bed. But night terrors or confusional arousals—where a kid is half-awake, agitated and incoherent—can become chronic. Kirk suggests parents note the timing of these events so they can go in prior to the arousal and gently shake their kid. “You’re not trying to get them up. You’re just shifting their sleep stage and bringing them out of a deep sleep,” she says. After three or four weeks of pre-emptive rousing, the terrors or confusional arousals should stop.

Did you know?
Sleep apnea isn’t very common, affecting only two to four percent of kids, but it’s a serious issue. If your kid snores or you notice obvious pauses in breathing, talk to your doctor about a referral to a sleep specialist. Bottom line: “Parental concern about something is enough to make an appointment,” says Alberta Children’s Hospital’s Valerie Kirk.

A version of this article appeared in our May 2015 issue with the headline, “Problem sleepers,” p.64.

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