Boy (8-10) sitting in bed, looking upJoey was six years old when the sleep issues began. According to his mom, he was one of those babies who slept through the night by six months, napped clear through preschool, and always fell asleep easily. He was a pro sleeper.

Two months into his kindergarten year, however, something changed.

The little boy who always enjoyed his nightly routine now had meltdowns at bath time every night. It became nearly impossible to read stories when the new routine included tears, frustration, and clinginess.

As Joey’s mom and I explored the bigger picture, we discovered that those evening meltdowns were a cry for help. Joey’s transition to full-day kindergarten and after-school care was an enormous change. Mornings were rushed, and he missed afternoons spent at home. Joey was overtired and under stress, and bedtime was when he let his stress out.

Parents are conditioned to believe that the first year of life is the most difficult when it comes to sleep patterns, but big kids have their own sleep issues. One study showed that 3.7% of youth have a diagnosable sleep disorder. That doesn’t account for kids like Joey, however, who get into negative sleep patterns due to stress, anxiety, or over-scheduling.  

Insufficient sleep can wreak havoc on the lives of kids (and their families). Sleep deprivation in kids is linked to asthma, obesity, poor immune systems, anxiety, behavior issues, poor school performance, and low tolerance for frustration. Kids who are lacking sleep have difficulty concentrating, struggle with memory, and are more likely to display aggressive behavior.

For Joey, the key to getting him back on track was reducing after-school activities, creating a much earlier bedtime, and keeping weekends free for downtime. He and his mom worked together to come up with a relaxing bedtime routine, and Joey’s sleep pattern returned to normal.

Stress and over-scheduling can certainly play a role in bedtime troubles, but kids can experience a number of sleep-related issues, like these:

1. Sleep Apnea: Kids with sleep apnea briefly stop breathing several times a night. These mini-wakeups leave them fatigued the next day because they don’t log enough deep sleep. Kids with sleep apnea tend to be loud breathers or snore. Sleep apnea is linked to oversized tonsils or adenoids. It can also be related to obesity.

Sleep Strategy: If you suspect sleep apnea, make an appointment to see the pediatrician for a proper diagnosis and treatment plan.

2. Stress or Anxiety: The bottom line is that kids have worries, too. It might seem like preschool and kindergarten are all fun all the time, but kids experience stress related to friendships, pleasing parents, teachers, and other adults, transitions, new siblings, divorce, illness, and many other reasons.

If your little one repeatedly asks for one more hug, demands water and other things the moment the lights go out, appears clingy at bedtime, or puts off bedtime entirely, stress and/or anxiety might be the culprit. Like adults, kids experience a spike in anxiety when the lights go out because the busy part of the day is done. This is when the worries creep in. Kids struggling with stress and/or anxiety need a longer bedtime routine that includes time to get their worries out and extra comfort from parents.

Sleep Strategy: Start the bedtime routine earlier. Your child may need at least 30 to name their worries, talk about solutions, and get some extra snuggles and reassurances.

  • Try telling your child a relaxing story while they close their eyes and focus on deep breathing.
  • A worry box can be a great way to help your child name and put away their worries before bed at night.
  • Check the lighting of the room. Too much darkness can feel overwhelming for little kids, but too much light can make it difficult to fall asleep.
  • Empathize with your child. Nighttime worries feel very scary.

3. Night wakings: It’s hard enough when illness jolts kids awake in the middle of the night, but many kids experience sleepwalking, night terrors, or nightmares somewhat regularly.

Sleepwalking occurs during an incomplete sleep-stage transition where the brain is still asleep but the body can move around.

Night terrors are characterized by screaming, heavy breathing, sitting up, staring with wide eyes, and sweating. Kids are not awake when they experience night terrors, and most don’t remember them the following morning. Night terrors can be triggered by fatigue, stress, anxiety, disrupted sleep schedules, and fevers.

Nightmares can be very scary for children and trigger a fear of falling asleep. Young children encounter new information at a steady pace, and some of that learning can be overwhelming. Nightmares are a normal part of growing up, but they can become disruptive when they occur frequently. Sometimes nightmares are the result of something scary a child witnessed or saw on TV, but other times they come out of the blue.

Sleep strategy: In general, kids will outgrow sleepwalking and night terrors, but nightmares can continue into adolescence.

  • Clear the path for sleepwalkers. Make sure the halls are free from toys and other hazards and install high locks on doors that lead to the outside. Consider consulting your pediatrician if your child sleepwalks regularly.
  • Treatment for night terrors generally isn’t necessary. If you suspect that stress is the underlying cause, consider revisiting your child’s schedule to make it more manageable and work on ways to cope with triggers of stress.
  • Not all nightmares can be avoided, but you can decrease exposure to media (specifically the news) and scary content, use nightlights, discuss nighttime fears during the day, offer a security object to help self-soothe, provide comfort when nightmares occur, and focus on relaxing activities before bed (puzzles, drawing, reading, Play-Doh, etc.)

Remember, healthy sleep habits begin hours before bedtime!

A great way to improve sleep habits is to establish a healthy routine, and this requires advanced planning. Make sure kids are getting outdoor exercise time each day and avoiding caffeine (including chocolate in the evenings). As much as possible, stick to the same schedule — even on weekends and during vacations. As the Daniel Tiger song goes, “Bath time, brush teeth, PJs, story and song, and off to bed.” When kids know that every day ends the same way, the routine itself will cue the body that it’s time to sleep. And that’s good news for the whole family.


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