I Can't Sleep: Child insomnia

Your seven-year-old comes into your room at 2 a.m. and she’s wide awake. You walk her back to her room, and tuck her in, where she tosses and turns for an hour before drifting off. Or maybe you read to her and turn out the light at 8 p.m., but when you head to bed at 10:30, you discover she’s still awake.

Insomnia is one of the most common problems paediatricians see, says Michelle Ponti, medical director for the London-Middlesex Children’s Aid Society in Ontario.

Insomnia may manifest as difficulty falling asleep or staying asleep, or waking very early. But to be considered true insomnia, there has to be a daytime consequence, such as sleepiness, irritability and trouble concentrating, says paediatric neurologist Shelly Weiss, who specializes in sleep disorders at Toronto’s Hospital for Sick Children and is the author of Better Sleep for Your Baby & Child. “It’s important for parents to look at the big picture when it comes to addressing sleep issues,” says Weiss. Here are some things to consider:

Set consistent routines A predictable bedtime routine signals the body and brain that it’s time for sleep, says Weiss. But it’s important to tailor the routine to the child. If your daughter is raring to go after a bath, save bathing for the morning.

Promote winding down While lots of exercise in the day is important to sleeping well at night, too much right before bedtime can rev kids up so they can’t settle down. Similarly, too much excitement can sabotage sleep, whether it’s a video game or that Captain Underpants book that has him rolling on the bed in hysterics.

Pinpoint anxiety Sometimes fears and worries keep kids awake: tomorrow’s class presentation, an altercation on the playground or an imagined car crash as his dad drives to work. Developmentally, kids this age have active imaginations, a deepening moral awareness and the knowledge that bad things sometimes happen. “Children certainly do have concerns that can impact sleep,” says Weiss. If your child seems preoccupied or worried, being able to talk about what’s on his mind will probably allow him to rest. Moving house, changing schools, the arrival of a new baby or parental separation can also cause sleep troubles, says Ponti.

Curb caffeine This sleep thief is an ingredient in colas and other pops, some energy drinks and chocolate.

Teach settling tricks “We all wake up at night, but some children can’t put themselves back to sleep without a parent’s intervention,” says Weiss. “There are many families where the children do sleep with parents or siblings and I’m not saying children need to learn to fall asleep alone,” she adds. It’s only a problem if the parents want to change it.

How do you do that? Weiss says the same strategies parents use to encourage younger children to fall asleep alone still apply. First, rule out the causes listed above, and make sure you have a consistent bedtime routine. Spend a few minutes with your child as he settles, then leave while he is awake so that he learns to fall asleep on his own. You can also talk about the problem: “Why do you think you’re having trouble? What do you think would help?”

Finally, says Weiss, it’s important to recognize that some children simply need less sleep than their peers. (Experts say that 10 to 11 hours a day is average.) If a child doesn’t fall asleep until way past bedtime or rises with the birds, but still has lots of energy during the day, then his sleep needs are probably being met.

However, if your little night owl seems overly tired, see a doctor. Conditions such as recurring ear infections, nighttime asthma or eczema or other problems can make sleep difficult.