Mental health and growing up factsheets

Sleep problems in children and young people: information for parents, carers, young people and anyone who works with them

About this leaflet

This is one in a series of leaflets for parents, teachers and young people entitled Mental Health and Growing Up. These aim to provide practical, up-to-date information about mental health problems (emotional, behavioural and psychiatric disorders) that can affect children and young people. This factsheet looks at the reasons behind why some children and young people have sleep problems, and offers some practical advice on how to deal with them.

Introduction

Sleep problems are very common problems in toddlers and young children. The child may have difficulty settling to sleep, waking in the night, or sleeping on their own.

Why do sleep problems matter?

Most children's sleep problems happen only occasionally. They are not serious and get better on their own, with time. If they don't, you need to take them seriously. As well as being upsetting, they may interfere with your child's learning and behaviour. There may be an underlying health problem, physical or mental.

How much sleep does my child need?

The amount of sleep children need gradually decreases as they get older. Every child is different, but as a general rule of thumb:
  • toddlers need about 12-14 hours sleep (including daytime naps)
  • pre-school children (aged 3-5) need 11-12 hours sleep
  • school-aged children need 10-11 hours sleep
  • teenagers need 9-10 hours sleep.

Why can't my child sleep?

Very young children often fear being left alone at night. This can be very normal for this age group.

  • Bedtime fears: young children are afraid of the dark, monsters, ghosts etc ...
  • Bad habits: no exercise, watching too much TV, or playing computer games.
  • "I'm not sleepy" - you might find that when your child gets very tired, they get irritable, aggressive or even overactive - hence the phrase 'overtired'.
  • Physical illness can also cause difficulties with sleeping, such as ear-aches, a temperature or a cold.
  • Where they are sleeping - the room can be too hot, too cold, too noisy etc ...

Sleep problems in adolescents

Teenagers can also have problems with sleeplessness, particularly if they are worried, drinking too much caffeine,  spending too much time on the computer or watching television. It may be a symptom of a mental illness, such as depression, anxiety or using drugs and alcohol. Some will just get into the habit of going to sleep very late. After a while, they find that they can't get to sleep at an earlier time.

Are there any other reasons for sleep problems in children and young people?

  • Restless legs syndrome: this is a condition where the child complains of crawling feelings or 'growing pains' in their legs that make them want to keep moving them which stops them getting to sleep.

 

  • Daytime sleepiness: this can simply be caused by your child not getting enough sleep at night. They could be because they are going to bed too late, or have problems sleeping for the reasons above.

 

  • Narcolepsy is an unusual condition that causes unpredictable attacks of sleep during the day. People with narcolepsy may also have sudden attacks of weakness - this is called cataplexy.

 

  • Nightmares: most children have nightmares occasionally. These are vivid and frightening dreams. Children will usually remember the dream, and will need to be comforted so that they can get back to sleep. Nightmares can also be caused by worry or other emotional problems and stresses such as bullying or abuse. In this situation, it is important to seek help.

 

  • Night terrors: these most commonly affect children between the ages of 4 and 12 years and are completely different from nightmares or anxiety-related dreams. Unlike nightmares, they happen to young children an hour or two after falling asleep. The first sign is that your child is screaming uncontrollably and seems to be awake. In spite of appearances, your child is still asleep. They will not be able to recognise you, will be confused and unable to communicate, and it is usually hard to reassure them. It is best not to try and wake them, but sit with them until the night terror passes, usually after about 5 minutes. Try not to feel upset yourself. It can be very distressing to see your child so disturbed, but they will not remember it in the morning. Children usually grow out of this. If the night terrors persist however, seek help from your general practitioner or health visitor.

 

  • Sleepwalking: is similar to night terrors, but instead of being terrified, the child gets up out of bed and moves around. The main thing you can do to help is to make sure that they don't hurt themselves and that the child is safe . You may need to take practical precautions such as using a stair-gate, securing windows and doors . Children usually grow out of this.

What else can you do to help your child sleep better?

It is important that your child has a regular sleep routine. There are some simple things you can do to help your child sleep better:

 
  • Develop a consistent, relaxing bedtime routine with your child. This should start with quiet time to help your child to wind down - for example, a bath followed by a short bedtime story before you say goodnight. This helps children to settle, and should end with your child falling asleep without the need for you to be with them.
  • It is important to be loving, but firm, about when it is time for your child to settle down for the night. When your child cries out, it is important to be sure that they are not wet, ill or in pain. It is best to do this quickly, while still comforting and reassuring them. Don't spend too much time with them or take them into your bed, because this will reward them for being awake.
  • A dummy can help to comfort young infants who wake needing to suck. Once you have weaned your child on to solid foods, it is best not to give them a bottle or dummy at night - if they wake and can't find it, they will probably start crying. A cuddly toy or favourite blanket can often help young children to cope with their separation anxiety.

 

Here are some things that your child can try:

 

DO  

  • Go to bed same time everyday
  • Try to relax by reading book or listening to relaxing music
  • Check if your bed is comfortable
  • Have a glass of warm milk an hour before bed

DON’T 

  • Watch TV, use/play computer at least an hour before going to bed
  • Sleep during daytime
  • Drink sugary, energy drinks or alcohol before sleep/with medication.

How to help your teenager sleep better

  • Agree with them reasonable and consistent bedtimes - for week-days and week-ends.
  • Most teenagers like to have a 'lie-in' at week-ends - limiting the getting up time to only an hour of two later than week-days will ensure they can get into a stable sleep routine.
  • Help them get into a routine of having a 'quiet time' before bed - no TV, texting, homework or using the computer.
  • They should avoid daytime napping.
  • Getting some fresh air, exercise and day light watch day will help them to sleep at night.
  • They should avoid caffeine and heavy exercise for four hours before bed as these can cause problems getting to sleep.
  • Encourage them to do their worrying before getting into bed - perhaps by writing a 'to do' list for the following day earlier in the evening.

Where can I get help?

Your general practitioner or health visitor can offer advice and help. If things don't get better, your general practitioner or another healthcare professional can refer your child for a specialist opinion from a paediatrician. This will help to find out exactly what the problem is and how it can be best resolved. Specialist sleep clinics might be available in your local area.

References

  • Dahl R and Harvey AG (2008) Sleep disorders. In: Rutter M et al (eds) (2008) Rutter's Child and Adolescent Psychiatry (5th edn). Oxford: Blackwell. pp894-905.
  • Kotagal S and Pianosi P (2006)) Sleep disorders in children and adolescents, BMJ; 332: 828-832.
  • Galland BC and Mitchell EA (2010) Helping children sleep. Archives of Disease in Childhood 2010: 95: 850-853.

Sources of further information

  • Peterson J and Peterson M (2003) The Sleep Fairy: Behave'n Kids Press. This is an American children's book that, through the story, teaches your child to go to sleep in their own bed in order to get a reward from the 'Sleep Fairy'. It has explanatory notes from parents.

 

  • The Mental Health and Growing Up series contains 36 leaflets on a range of common mental health problems. To order the pack, contact Book Sales at the Royal College of Psychiatrists, 17 Belgrave Square, London SW1X 8PG; tel: 020 7235 2351, ext. 146; fax: 020 7245 1231; e-mail: booksales@rcpsych.ac.uk, or you can download them from this website.

 


 

© September 2011. Royal College of Psychiatrists.

Reviewed by the Royal College of Psychiatrists' Child and Family Public Education Board. This factsheet may be downloaded, printed out, photocopied and distributed free of charge as long as the Royal College of Psychiatrists is properly credited and no profit is gained from its use. Permission to reproduce it in any other way must be obtained from the Head of Publications. The College does not allow reposting of its leaflets on other sites, but allows them to be linked to directly.

 

 


Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.

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© 2011 Royal College of Psychiatrists