My last post provided guidelines for establishing bedtime routines for your children, with an emphasis on consistency. Consistency is the key to helping ensure that everyone gets a good night’s sleep. When your child gets into a consistent sleep routine, he or she will be at less risk for emotional, behavioral, and learning problems. Additionally, you – the parent – will feel more refreshed during the day and enjoy a better overall family life.

What if my child has more serious sleep problems? Some children and teenagers suffer from sleep disruptions and have difficulty following a good sleep diet. These disorders may include:

• Insomnia
• Nightmares
• Sleepwalking
• Night Terrors
• Other sleep disturbances caused by hormonal changes and stress in adolescence

Let’s explore these more serious sleep problems in greater detail.

Primary insomnia occurs when your child has difficulty falling or staying asleep without any known underlying medical condition. This may be due to poor sleep patterns or erratic sleep schedules. Usually the establishment of a good sleep routine is sufficient to reduce or eliminate primary insomnia. Emphasize calming activities in the hour or so before bedtime, avoid giving your child caffeinated food or drinks before bedtime, and provide for plenty of exercise during the day. If these techniques do not help, consult your child’s pediatrician to rule out any underlying medical conditions that my interfere with sleep. A mental health professional may be sought out as well.

Nightmares are disturbing and/or frightening dreams. As many as half of all children may suffer from nightmares; however, they are most common in preschool and elementary grade children and tend to lessen over time. Nightmares may begin around age 2, peak in the 4 to 6-age range, and then slowly diminish, although they can occur in all ages. What causes nightmares? Stress, traumatic events, scary TV programs, violent video games or movies, vivid imaginations, fear (such as fear of the dark), and even some medications can all trigger nightmares. When your child experiences a nightmare, calm her down and repeat a shortened version of her bedtime routine to help her back to sleep. A nightlight in the bedroom may help a frightened child, or a shared storybook for those who have frequent nightmares.

Sleepwalking occurs during deep sleep, often 1 to 2 hours after initially falling asleep. Episodes can range from simply sitting up in bed to actually getting up and walking around the house, down stairs, or even outside. It can be very difficult to wake a sleepwalking child. When awakened, he may seem confused and usually will have no memory of the event. Comfort your child after an episode of sleepwalking and then return him to his bed. Sleepwalking usually stops in late childhood, although a few continue to sleepwalk into adulthood.

Night Terrors are episodes during which the child screams, seems disoriented and anxious, does not recognize parents, but at the same time appears wide awake. They usually occur between ages 3 and 8, and often 3 hours into the sleep period. Night terrors typically end by age 12. I often refer to them as “Parent Terrors” because it can be very scary to be awakened by a screaming, anxious child who may not recognize you. While children who have night terrors seem to be awake, they are not consciously awake, and may fight the parent who is trying to calm them. When the night terror eventually ends, often after 10-15 minutes, the child will return to sleep and have no memory of this terrifying event. Although parents are usually frightened (and I have personally experienced this!), there is little or no impact on the child. Hold your child gently until the episode ends and then return him/her to bed. Night terrors are NOT a sign that your child is troubled or emotionally disturbed.

Teenagers usually outgrow nightmares, sleepwalking, and night terrors; however, other sleep disturbances caused by hormonal changes and stress in adolescence may crop up.  Changes in sleep cycles can be triggered by puberty, hormonal fluctuations typical to adolescents, and the stresses of growing up in a complex society. Most teens do NOT get enough sleep at night, nor do they fall asleep quickly when they lie down for the night. Teens begin their days with school early in the morning. Extracurricular activities, such as jobs, homework, athletics and other social events often work against teens, preventing them from getting an adequate number of hours of sleep. Parents can intervene by reducing stress, encouraging adequate exercise, eliminating caffeine and energy drinks in the evening and removing distractions from their bedrooms.

If you believe your child has any of these serious sleep issues, a sleep diary may be helpful. Record the number of hours your child sleeps, how many times he/she wakes during the night, what happened before the child fell asleep, and any parental intervention taken during the disruption. Your child’s pediatrician should be consulted for serious sleep problems. The sleep diary information will be a useful tool to determine if your child has a sleep disorder.

Does your child or teen have sleep disturbances?  Please share your interventions or frustrations. I’d love to hear from you.