Kid Sleeping Problem

For some children, it seems, sleep isn't high on their list of priorities. Sleep problems are the most common cause for concern among parents of young children - it's a major issue for one in five families.

What is it?

Almost every child has disrupted sleep now and then, with problems ranging from difficulty settling to sleep, nightmares, night terrors or sleepwalking, and excessive sleepiness during the day.
What causes it?

Getting a child into a regular sleeping habit is one of the hardest tricks of parenting.

The cause of sleeping problems is often not clear. In young children, however, failure to establish a regular routine is frequently to blame. Newborn babies alternate between brief periods of sleep and wakefulness. As they get older they sleep for longer periods at night, but habit and routine play a large part in encouraging this. Physical factors such as bedwetting, general illness and developmental delay can cause sleep problems.

Psychological factors that can cause sleep problems include anxiety about separation from parents, fears (for example, of the dark), depression, drug abuse (in older children) and sexual abuse. Problems in the child's bedroom such as cold, damp or noise may be a factor.

Nightmares, terrors and sleepwalking may be caused by traumatic experiences or other stress, but also tend to increase when a child is overtired and not getting enough rest. Depression can cause a child to wake early in the morning, while daytime drowsiness usually results from inadequate sleep at night, although it may be caused by rare physical conditions or sleep apnoea (where the airway is obstructed during sleep.)

Who's affected?

Sleeping problems are common throughout childhood.
What are the symptoms

Sleeping problems can cause daytime sleepiness, behavioural problems, growth delay (especially in sleep apnoea - growth hormone is only released during deep sleep) or poor performance at school. In a nightmare, a child wakes in an anxious state and may remember the bad dream, while in a night terror the child is terrified and appears awake but isn't and cannot coherently respond to the parent.
How is it diagnosed and treated?

It can be very difficult to establish a cause for sleeping problems, but an enjoyable routine (bath, story, reassurance etc) at a regular time can be very effective. Sleeping position, along with a history of tonsil/adenoid problems, may be a clue to sleep apnoea (children typically sleep on their elbows and knees with their bottom in the air and neck hyperextended). Drug treatments are seldom appropriate.
Further help

If sleeping problems don't settle with simple methods, or there are specific problems such as bedwetting or sleep apnoea, talk to your health visitor or doctor.

This article was last medically reviewed by Dr Rob Hicks in December 2005.