Sleep thieves

Is your child being robbed of precious slumber? Here's help for older kids' common nighttime woes

Johnny McGregor*, six, is not what you would call a sound sleeper. The youngster from Timberlea, NS, rarely makes it through the night without something waking him. Nightmares, night terrors and bedwetting all contribute to his chronic lack of shut-eye. Not surprisingly, the less time Johnny spends in the land of nod, the crankier and more irritable he is. “The nights he does manage to sleep right through, he’s like a different child,” say his mother, Rebecca*. “He wakes up happy and he doesn’t complain about going to school.”

When your child was a toddler and you struggled to get her to sleep through the night, you probably thought, “I can’t wait until she’s older and this won’t be a problem.” Unfortunately, that’s not always the case: Older kids can also have their share of nighttime issues.

Sleep problems are a major roadblock on the path to dreamland and can affect more than your child’s disposition. The proper amount and quality of sleep are also important for his overall health, says Shelly Weiss, an associate professor in the department of paediatrics at the University of Toronto and author of Better Sleep for Your Baby and Child. If junior isn’t clocking enough zzz’s, he’s at greater risk of having learning and behaviour problems, including difficulty concentrating, poor school performance and hyperactivity. And chances are if he’s tossing, turning and waking up irritable, you are too.

Here’s how to identify some of the more common sleep thieves and prevent them from stealing your child’s slumber.

Bedwetting

This sleep thief delivers a double whammy — besides waking your child at night, bedwetting (or enuresis) can make him afraid of dozing off in case he has an accident. Children who wet the bed tend to be very deep sleepers with small bladders; they don’t awaken to the signal of needing to pee until it’s too late. Since children naturally have less deep sleep as they get older, most bedwetters outgrow the problem, usually between the ages of six and 10. Bedwetting tends to run in families and affects boys more than girls.

Sleep aid

Limit junior’s fluids before bedtime and make sure he empties his bladder before lights out. Punishments should be avoided, advises Weiss, since wetting the bed is not something children have control over. If your child is really bothered by bedwetting and it’s affecting his self-esteem, there are treatment options your doctor can suggest, including alarm devices and medications. For more on bedwetting, see Five things you don’t need to worry about.

Nightmares

Scary dreams are a normal part of child development and just about anything can trigger one, from a seemingly innocuous children’s cartoon to a stressful event at school. Nightmares peak between the ages of three and six, when children have difficulty distinguishing fantasy from reality.

Sleep aid When your child wakes up terrified, reassure her that she’s safe and that you’re there to protect her. Most bogeymen can be banished with a night light, gentle reassurance and a favourite teddy bear. Ask her to describe what frightened her and explain that it’s a bad dream, not real. Sit with your child until she’s calm and drifting back to sleep. Try not to bring her into bed with you, since the extra attention may prolong the waking as well as lead to her wanting to sleep with you on other nights too, advises Weiss.

Night terrors

After witnessing her five-year-old’s first night terror, Toronto mom Jane Slater* felt somewhat terrorized herself. “He was kicking and flailing his body around and yelling no, no!” she says. “When I tried to snap him out of it, it just made it worse.”

Night terrors (or sleep terrors) occur when a child partially wakes as he moves from deep sleep into a lighter snoozing stage. They’re most common between the ages of two and six, but can continue into adolescence. Stress, fatigue, a full bladder or loud noises can all trigger night terrors, and there’s often a family history. Your child may bolt up in bed with his eyes wide open and speak incoherently, or scream and look frightened or confused. Night terrors can last anywhere from five to 30 minutes — then children return easily to sleep and don’t remember anything the next morning.

Sleep aid

While it’s instinctive to want to wake your child, it’s not that easy to do and he may become more agitated. Speak soothingly to him instead (“It’s OK, you’re safe and in your own bed”) until he drifts back to sleep. Restraining may also increase his distress, so watch from a distance to make sure he’s safe. To prevent night terrors, try to pinpoint any obvious sources of stress and keep him from getting overtired.

Childhood insomnia

If your child takes more than 20 to 25 minutes to fall asleep and has trouble staying asleep, she could have a sleep problem, says Penny Corkum, a Halifax child psychologist who researches sleep in school-aged children. Insomnia can be caused by many things, including poor sleep habits, too much caffeine and other physical problems such as sleep apnea. Worries about school, friendships and disasters from TV news (such as floods or tornadoes) can also cause kids to toss and turn at night.

Sleep aid Teach your child how to relax. A relaxation CD could be helpful “It’s something children can do on their own,” says Corkum. Review your child’s sleep practices and schedule, and try tracking the problem by keeping a sleep diary to see if there is any obvious reason she’s spending her nights counting sheep. If the insomnia problem is ongoing, speak to your child’s doctor.

*Names changed by request.

Sleepwalking

Connor Freeman, five, frequently sleepwalks through the living room while his parents are watching TV. “He walks around in circles, bumping into things and giggling hysterically until we guide him to the bathroom and back to bed,” says his mom, Tara. These partial awakenings are most common in children aged four to 12 and typically occur one to two hours after they fall asleep. Make sure your house is safe for your child’s nocturnal wanderings (you might want to tie a bell to his bedroom door so you know when he’s up), and gently steer him back to bed without waking him.

Sleep aid Connor tends to sleepwalk when he’s overtired “if we’re out visiting family later than usual, for example,” says his mom. “Stress and a change of routine make it worse too.” Talk to your health care provider if your child has symptoms of other sleep disorders such as obstructive sleep apnea, which may increase the arousals.

Snoring and obstructive sleep apnea

If your child has a habit of snoring loudly and regularly, she could have obstructive sleep apnea (OSA), especially if snoring is accompanied by gasping, snorting or pauses in breathing. While large adenoids and tonsils are the most common cause, there are also cases of obesity-related OSA due to the growing number of overweight kids, says Shai Marcu, a paediatrician at Youthdale Child and Adolescent Sleep Centre in Toronto. Left untreated, OSA can lead to increased behavioural problems, such as hyperactivity, that are often misdiagnosed as attention deficit disorder.

Sleep aid If you suspect your child has OSA, make a cassette of her sleep noises to take to her doctor. Surgery may be recommended to remove tonsils and adenoids.

Delayed sleep phase syndrome

What this means, basically, is that your 14-year-old doesn’t start yawning until midnight. Parents often joke that their teen is ready to party at around the same time they’re ready for bed. Blame it on biology, says Marcu. Melatonin, the “put your pyjamas on” hormone that promotes sleepiness, peaks at later hours in teenagers than in the rest of us. “That explains why many teens find it so hard to get up for school, love sleeping in on weekends and just aren’t tired when we think they should be,” says Marcu. As a result, 80 percent of adolescents aren’t getting the recommended nine hours’ sleep. Other factors exacerbate the problem, including too much caffeine, too many extracurricular activities and too much technology in the bedroom. “We see more and more teens who are moody, depressed, anxious and irritable because they aren’t getting enough sleep,” says Marcu.

Sleep aid Try letting your teen choose a bedtime at an hour when it’s easy and natural for him to fall asleep (11 p.m., for example), then start ticking it back 15 minutes each night until he gradually resets his biological clock. Open the blinds in the morning so he’s exposed to bright light and make sure he doesn’t skip breakfast. While some teens take over-the-counter melatonin, the experts are still cautious about its use in children. Melatonin is a powerful chemical that affects the reproductive system if given before or during puberty, says Marcu.

When to worry

In her book, Better Sleep for Your Baby and Child, Shelly Weiss advises seeing your doctor if your child develops these symptoms:

• fatigue, even though she seems to be getting adequate sleep
• onset of night terrors or sleepwalking after the age of six or seven
• a sudden need for a regular nap
• loud snoring, pauses in breathing, extreme restlessness at night

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