Sometimes getting our children to sleep at night can seem the hardest thing to do and so draining at the end of a long day when you just want to sit down and have some quiet adult time. I so clearly remember coming home from mothers group with my first child feeling like a failure because everyone else’s child slept except mine! If you have had similar feelings, it may help to know that sleep problems are incredibly common in childhood, with about 40 per cent of primary school aged kids having some sleep problems. Sleep problems in infancy and pre-school are even more common. So you are not alone!
For toddlers and older children, the most common issues parents report are trying to get their kids: into bed and to remain in their bedroom; to fall asleep on their own; to go back to sleep in their bed if they wake overnight and; to not wake too early in the morning and go straight into their parents’ bedroom.
Here are some tips I share with families in my clinic, and that have proved very useful for my own kids.
Set up a bedtime routine and try to stick to it.
It is very important to give your child the message that the 30 minutes to one hour before bed is quiet time. It is during this time that quiet activities should be encouraged, including a warm bath, brushing their teeth, going to the toilet, having a drink, perhaps putting a water bottle next to their bed and reading a bedtime story together.
This is often a child’s most treasured time of the day when they can get our undivided attention. Hyped up games with mum or dad, who have just come home from work and may be excited to see their child, screen time, TV or loud music will over stimulate your child. Make sure there is no TV in the bedroom!
Try to work out how much sleep your child needs so that they are not going to bed too early or too late and aim for a consistent bedtime and waking time.
Older children like to know and understand how much sleep they need and what time they need to be in bed by to get enough sleep. Try to give them some control over the process. They may even like to keep a diary of their sleep.
The first step: Try to teach your child to fall asleep on their own without you.
For pre-school children, once the light is turned off, you should kiss them and walk out. If they call out or get up, take them back, reassure them and leave again. You may need to do this several times and the key is to remain calm and be very boring! Try not to get in bed and lie down next to them as they will expect this every night and it won’t teach them to fall asleep on their own. For older children, you can teach them to try and switch off their mind with breathing or relaxation exercises that they can do themselves.
What else can you do?
If nothing is working, you can use a strategy called “camping out”. This involves putting a camper bed on the floor next to your child’s bed. Once lights are out, you lie down next to your child in the camper bed – the key is not to speak to them or touch them, but just to reassure them that you are there while they fall asleep. After a few nights, move the camper bed further away from their bed until it is outside the room. You can also use a chair if this is easier. Make sure you praise your child if they are starting to fall asleep on their own. If your child is scared of the dark, a dim night-light may help. Falling asleep on their own is always easier if they have their favourite teddy or comfort toy (not you!).
For pre-school and school-aged kids, a ‘star chart’ can be great, alongside these strategies. Get your child to choose the colour of the paper, their favourite stickers (dinosaurs, ‘Frozen’ stickers) and then ask them to help make the chart with you. Place the chart somewhere where the whole family can see it, such as the fridge, so that everyone is engaged in the process. In the morning, if your child slept through the night in their own bed, they can put a sticker on the chart. I promise a small prize at the end of the first week (a smoothie, video, treat from the bakery) and a bigger prize at the end of two weeks (a book, small game, special pens etc.). Two weeks for a star chart is usually all that’s needed to kick start their new sleeping routine.
Are there any medications that can be useful?
Sometimes, if falling asleep is not helped by these behavioural measures, then a medication called melatonin may help. Melatonin is a hormone produced naturally by our brains and is controlled by our body clock. Levels naturally increase at night, about two hours before we go to sleep. Taking melatonin, as a liquid or a tablet, can help regulate your child’s sleep and wake cycle and help them to fall asleep quicker. If you think your child may benefit from melatonin supplements, speak with your GP or paediatrician.
Still nothing working?
If you are really not winning with these measures, or there are other factors contributing to your child’s sleep problems, such as anxiety, attention deficit hyperactivity disorder (ADHD) or other developmental behavioural problems, or obstructive sleep apnoea, then visit your GP or a paediatrician. You may even need to see a sleep specialist.
For more reading on sleep:
Visit these RCH Kids Health Info factsheets:
- Night waking (six to 18 months)
- Bedtime problems (preschool)
- Night terrors (night time wakings)
- Night time worries (school age children)
- Or visit http://raisingchildren.net.au/
Please note: Dr Margie is no longer monitoring this post. If you are concerned about your child, please contact your child nurse or GP for advice.