Originally published in Wisconsin State Journal, January 31, 2013.
Dear Dr. Johnson: My 10 year old has a difficult time falling asleep. Are there things I can do to help her get a good night’s sleep?
Dear Reader: Some children will fall asleep quickly after their head hits the pillow but others find it difficult to settle into sleep. Since they often don’t have the luxury of then sleeping in, falling asleep later often means less sleep overall.
We know that poor sleep can lead to behavior problems in school and overall difficulty with learning. It is also known that sleep is important for overall health.
I have written in the past about the importance of a bedtime routine for infants. What many people do not realize is that a bedtime routine also can be beneficial for older children, adolescents and even adults. What the bedtime routine does is help the body transition from the bustle of the day’s activities into restful sleep.
The bedtime routine should be the same each night and the activities should be in progression with movement toward the bed. For example, it shouldn’t be go into the room to read a book, then back out to brush teeth. More ideal would be to brush teeth and then into the room to read a book and then into bed.
A consistent bedtime and wake-up time is important. How much sleep a child needs will vary a bit but a good indication if they are getting enough is when they wake-up when allowed to “sleep in”.
Most school-age children require 10 to 12 hours of sleep. Teenagers should get 8 to 10 hours. If a child or adolescent sleeps another hour or two on the weekend or school holiday than during the week, they may need an earlier bedtime during the week to get adequate sleep. They should also feel rested on a typical morning and not easily fall asleep while riding in the car or watching TV during the day.
Another indication that a child needs an earlier bedtime is if they seem tired before bedtime. We have all experienced the “second wind.” If we force ourselves to stay awake when tired, our body cycles out of sleep onset, and we may then have a difficult time falling asleep.
A recent pediatric study confirmed that use of electronics in the 90 minutes before bed increased the time to sleep onset in children and adolescents. Activities prior to bed should be relaxing. Electronics (using or watching) can stimulate the brain. Physical activity also can be stimulating to the body and make it harder to fall asleep if done too close to bedtime.
Some children have difficulty falling asleep because they are thinking about the day’s activities. They may benefit from talking through things before bed, writing ideas down in a journal or doing some deep breathing to help relax their thoughts.
While it probably seems obvious and most 10 year olds should not be drinking it anyway, caffeine should be avoided in the late afternoon and evening.
If despite working on your child’s sleep hygiene, she continues to have difficulty getting an adequate night’s sleep, you should discuss it with her doctor, as poor sleep can affect on so many other aspects of her life.