My Kid Won’t Sleep…Please Help!

Insomnia in children is common. About 25% of school-aged children will experience insomnia symptoms. This can be frustrating to parents, as the behaviors associated with insomnia can disrupt a household. Parents may be unable to sleep, leading to more stress and frustration.

Insomnia is characterized by struggles around going to bed, difficulty falling asleep at bedtime, or problems staying asleep at night. Children with insomnia may also wake up very early. Research shows that sleep problems have adverse effects on daytime functioning. Poor sleep is associated with increased rates of disruptive behaviors, depression, and anxiety in children. The good news is that insomnia is treatable with behavioral and pharmacological interventions.

Let's begin with behavioral interventions. Here are a couple of practices to help your child:

• Be consistent. Have your child go to bed at the same time each night and get up at the same time each morning, including on the weekends

• Make sure the bedroom is quiet, dark, relaxing, and at a comfortable temperature. This also should include the home. It may be a good idea for the whole house to have the same bedtime until the child's sleep pattern improves.

• Remove the bedroom's electronic devices, such as TVs, computers, and smartphones. Children should be taught early that the bedroom is for sleep, not play.

• Avoid large meals, caffeine, and alcohol before bedtime.

• Exercise the kids! Being physically active during the day can help you fall asleep more easily at night. I suggest a 30-minute family walks in the evenings. It is a great time to catch up on the day and let the kids burn off some energy.

Pharmacological interventions vary for insomnia and are based on clinical presentation. Usually, short-term treatment is indicated though some children may require long-term help from medications. Often providers will suggest temporary or as-needed trials of melatonin as a first-line treatment. Melatonin is a hormone that a child's brain produces in response to darkness. It can be effective for insomnia though the evidence is limited to mixed regarding the impact of long-term use. Other options include clonidine (a blood pressure medication that is helpful for insomnia in kids with ADHD), Benadryl, Trazodone (an antidepressant that is often used in adults for insomnia), and Vistaril (a drug in the same class as Benadryl that can also be helpful for anxiety). Before starting medications, your prescriber should educate you on the risks, benefits, and alternatives. All medicines carry side effects, and you must monitor your child closely on sleep medication when starting.

I hope this post was helpful. Take care of yourself, and know that recovery is always possible.

Eddie