Self-help Articles

by by J.C. Blader, Ph.D., H. S. Koplewicz, MD, H. Abilkoff, Ph.D.
& C. A. Foley, MD

Sleep problems of elementary school children are more complex in today's media-rich world. Researchers from the Long Island Jewish Medical Center in New Hyde Park, New York are presenting the results of a survey of the parents of 987 children age 5 to 12 about their children's sleeping habits and insomnia.

The most common problem reported by the parents was bedtime resistance. Other common problems were delays in falling asleep after going to bed, difficulty staying asleep, difficulty waking up in the morning and child complaining of fatigue.

While the researchers note that conventional wisdom holds bedtime struggles among school-age children "result mainly from deficiencies in limit-setting practices," their data suggest that for a significant subgroup of "bedtime-resistant" children, there may be more going on than rebelliousness. "These children differ from those with bedtime resistance alone by more anxiety- related features such as fearfulness, night waking, need for caregiver proximity and fatigue complaints and early histories of disrupted sleep."

The bottom line, the researchers say, is that while consistent, parent-enforced bedtimes may be helpful for many bedtime-resistant children, those who take a longer time falling asleep and have a history of troubled sleep may experience even more distress if parents try to strictly enforce bedtimes.

The information above was received from the American Psychological Association (APA), in Washington, DC.

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This research presents parents with a dilemma. Yes, strict bedtimes may be needed, but if a child is too resistant, parents may want to experiment with more calming and soothing activities around bedtime, and the avoidance of harsh or strict routines, raised voices or threats of punishment.

Parents can also set the mood for a calm and predictable evening by avoiding the discussion of disturbing world or family events at dinner time or within ear-shot of the child during the evening. Parents are often unaware of the frightening fantasies children can conjure up, based on what they thought they heard, and more often than not, what the often did hear. In today's world, it is easy for parents to get carried away in the moment and discuss troubling events with another adult, but within full hearing range of a child. Such discussions are best kept between adults, behind closed doors around bedtime.

If a child cannot sleep, sitting and talking long enough to uncover the source of their anxiety at bedtime might be appropriate.Uncovering and addressing the problem at night time might be enough in the moment to allow the parent to think of a soothing response and allow the child to drift off to sleep. With persistent anxieties, a fuller discussion the next day might be warranted.

To initiate such an activity, the child might be asked about it right after dinner, or before the bedtime routine starts. If the child is young enough to enjoy drawing or scultping, it could be worthwhile to ask the child to recreate the source of the anxiety with questions such as "If it had a color what would it be? If it had a shape, what would it be?" etc.

Depending on the child, the parent can help with the drawing, scuplting, story or whatever the creative exercise might involve. More specifically, if the activity is drawing, the parent might ask can ask the child which crayon or pen to use to draw which image, where, etc. and thereby allow the child to direct the drawing session.

Then the most important part of the exercise follows. Before putting the drawing instuments away, the parent can ask the child to draw a happy and peaceful ending to the frightening drawing. From that point on, if that anxiety re-surfaces at bedtime, the focus can be placed on the second drawing when trying to calm the child, drawing attention away from the distressing scene.

Over time, the actual drawing exercise can be eliminated, and the parent sitting on the edge of the child's bed can ask the child to draw a calming, soothing replacement for new and ever-changing frightening stories or images together, that is, using the parent and child's shared imagination.

Parents of bedtime resistant children might consider turning off violence or murder-themed television programming after 6 p.m.; avoid listening to night-time news programs, game shows, dance or signing competitions or any other television programs that are stimulating to the nervous system. They themselves can avoid playing noisy electronic games or engaging in other activities that can be heard by a child.

Sound from parents' watching such television programming might be muffled with calm or soothing music chosen by the child him or herself. If a child uses an iPod or other MP3 player to go to listen to sleep-inducing guided imagery or meditative music, parents would do well to avoid alternative choices by the child once the parent leaves.

An inexpensive MP3 player might be obtained for night time, that is, one that holds only bedtime music selections. Double checking to make sure a child is not playing with toys, cell phones, laptops or other media under the covers, and removing all stimulating cell phones, laptops and other media from a child's bedroom to prevent late-night bursts of activity after bedtime can be necessary.

Other things parents might try include restricting incoming telephone calls to the home after a child's bedtime, use of low-watt night-nights, and keeping an open-door policy if the child needs frequent calming or re-assuring. Predictable routines and rituals at bedtime might also include a hot bath, followed by traditional rocking and book reading, or back, foot, or head rubs that allow a child to relax and drift off to sleep.

If none of these work, arange a private meeting to discuss your child with your physician or local child psychologist. Your active involvement in finding solutions for your child's sleep problems might help put an end to what otherwise might be an anxiety-ridden, sleep-deprived childhood and set the stage for an adulthood of restful sleep.