Children and Sleep Problems

Bully pulling hairConnie is a young mom who is frustrated with her nine year old son, Matt. “I know he can pull it together because he can do it at school.” Her conclusion, “He’s just choosing to misbehave.” The pattern that Connie describes is one where Matt is well-behaved at school, but when he comes home, he is impossible to manage. He is picking fights with his siblings, wants to run around instead of sitting and doing his homework, “he is defiant and won’t listen to me”, and “his temper tantrums are explosive”.

The scenario described by Connie above is one I hear all the time from parents. Nine year old Matt is well behaved at school, but once he gets home he is his mother’s worst nightmare. (Really, when it happens most days out of the week, this is not an exaggeration.) Moms usually report that teachers don’t have any complaints – “He’s quiet, well-behaved, gets his work done.” So, what’s the deal?

When parents come in wanting to discuss their children’s behavior, one of the first things I ask about is how their child is sleeping. If it’s off, it’s one of the first things we work on. Because children and sleep problems do not mix well.

Think about your own life as an adult and what you are like when you haven’t gotten the sleep you need. Not only are you physically exhausted, but you are also an emotional wreck. It takes a lot of energy and resources to keep your emotionally wrecked and exhausted self contained. When sleep deprived, we adults are easily emotional, exhausted, unfocused, unproductive, and irritable. There are very few physical and emotional resources available to live life, let alone manage relationships well and give your best at your career. Now take all this exhaustion, apply it to your sleep-deprived child and then multiply it a hundred fold.

Why multiply it? Because kids don’t have the knowledge, experience and skills that adults have acquired over a lifetime to manage their lives. Children are still learning how to do this thing called life. They have many developmental tasks they are expected to accomplish and master each day – making and keeping friends, managing and organizing educational demands, extracurricular sports, responding to adult demands, and generally having very little control over how they live their lives and spend their time.

When exhausted, most children work very hard to get through their day at school, holding back the tidal wave of all the behaviors they would rather engage in to express their exhaustion. When they come home (from holding their breath all day at school), they finally take a breath and let loose. It’s a lot like you holding back anger towards your boss all day and then, when you get home, well…you know.

A good night’s sleep can have a huge impact on how your child functions, copes with every day demands and their resilience in the face of life’s surprises. It also makes your job as a parent a little easier. A good night’s sleep is vital to your child’s mood and brain function (not to mention your sanity). Difficulties with sleep can potentially point to bigger issues – ADHD, anxiety, depression, behavioral problems, academic difficulties, and worry. It is an early first sign your child’s body uses to communicate, “Something is wrong in my world. I need your help.”

Sleep difficulties fall into five categories

Falling Asleep

Kids who fall into this category often describe that their mind “clicks in” when their head hits the pillow. Anxieties, worries and events of the day can flood their consciousness, rev them up and make it difficult to sleep. They often complain, “I can’t shut it off.” Their brain becomes a place where thoughts, feelings, ideas, memories, and imagined futures bounce uncontrollably off one another. Their brain jumps at lightning speed from one item to the next.

Staying Asleep

This sleep difficulty is characterized by multiples awakenings during the night. The repeated interruption of the sleep cycle makes it very difficult for children to achieve Mother comforting her crying little girlREM (rapid eye movement) sleep which is the restorative stage of sleep.

Early Morning Waking

In this scenario, kids wake up super early and then cannot go back to sleep. This can make for very long days and less than stellar behavior at the end of the day.

Restless Sleep

In this case, sleep is…well…restless. Kids toss and turn. They awaken to any noise in the house. They are so fitful they often awake to find the bed torn apart and covers kicked onto the floor. Sleep is not refreshing and they awaken as tired as when they went to bed.

Difficulty Waking

Difficulty waking is usually preceded by an inability to stay asleep or multiple awakenings until about 4:00 a.m. Then, they fall into “a dead sleep”, from which they have extreme difficulty rousing themselves or being roused by someone else. These are the kids that sleep through two or three alarms and family members’ attempts to get them out of bed. They are commonly irritable, even combative, when roused before they are ready. Many of them also say they are not fully alert until noon.

Strategies For A Good Night’s Sleep

Maintain a regular sleep schedule

Recent research (see the journal Pediatrics; a study involving 10,000 children) has come out that actually shows a strong connection between an irregular sleep schedule and behavioral issues in children. Thankfully, it is possible to get them on the right track by the time they are 7 – 10 years old. Phew! Kids like routine. It helps them to know what can be expected and many of them find consistent schedules quite comforting. It can be tempting to flex on a sleep schedule during weekends and holidays, but I would recommend you not. Keep things as consistent as possible.

Get their bodies moving – exercise

Exercise helps with burning extra energy as well as helping to manage depression, anxiety and ADHD. I usually recommend something that involves staggered breathing, constant movement or movement that involves a left-right contralateral movement. For example, cycling, running, and swimming. But, exercise is exercise. Get them moving in the morning or at some point during the day, so they’re not moving so much at night. Exercise can also promote deeper sleep and more time in restorative sleep.

No eating and drinking two to three hours before bedtime

This is a difficult rule to follow because kids love their snacks before bedtime. If they must eat something, keep it small and focused on carbs – milk, toast, a small bowl of cereal – whatever your child’s diet can manage. You want to give them just enough to quiet their bellies; avoid overstuffing them or they will need bathroom breaks in the middle of the night. Overfeeding will defeat the purpose. If they are asking for water at bedtime, this is a possible sign they are dehydrated and not getting enough water during the day.

Reduce nighttime distractions

Some kids are very sensitive to light and sound. Kids with ADHD are wired so they can’t not pay attention. So, eliminate as much noise and light as possible. Some options: use a white noise maker, use a clock that lights up only when a button is pressed, put up blackout curtains, use a sleep mask, or use earplugs.

Have healthy bedtime rituals

Evening rituals signal to the brain and body that it is now time to slow down and move towards sleep. It also provides kids with the opportunity to connect with caregivers. Some rituals could include: cuddle time, reading a book, turning all technology off, dimming lights, brushing teeth, changing into pajamas, getting a favorite blanket or stuffed animal, and/or saying goodnight to family members and pets.

Dress for sleep comfort

Chilly feet keep some children awake; wearing socks may help to send them into dreamland. Remove any scratchy tags from pajamas. Keep kids cool.
One tip from a client: don’t combine flannel pajamas and flannel sheets. Apparently, this combination makes it difficult for kids to turn over in bed because the fabric has a tendency to stick to itself.

family momentsHave some pre-bedtime relaxation routines

Foot rubs, visualization (imagining they are descending slowly on an escalator as they breathe deeply), breathing exercises where you can help your child focus on their breathing, and prayer (if this is a part of your life) to encourage them to entrust loved ones and concerns to God.
Another way to manage anxieties is to give kids a “parking lot” for their worries. Give them a place to put their worries so they don’t have to take them to bed. A journal where kids can write or draw their concerns works really well. Do this before their bedtime routine and store the journal in a place designated as a “safe place”.

Teach them to use self-soothing skills

Pay attention to what might give comfort to your child. Does he like wrapping himself in a blanket with only his mouth and nose exposed? (Many find it comforting to sleep this way.) Does she like it when you gently rub her back? In this case, you may want to teach your child to lightly rub her own arm as a relaxation technique. Maybe playing soft instrumental music would be soothing?

A self-soothing skill to try – teach your child to tap. One simple way of doing this is to have your child lie on their back with their arms at their sides. All they have to do is slowly tap their hands, bending up and down at their wrists in an alternating left-right pattern. This may help with promoting an automatic relaxation response in the body.

Pay attention to what works for you and your child and leave the rest. Then, be consistent.

Sweet dreams!