Helping Your Child Get a Better Night’s Sleep

June 28, 2023

University Hospitals Rainbow Babies & Children'sExperts in Children's Health

Many parents breathe a sigh of relief when their child is finally in bed after a long, busy day. But for other parents, bedtime can cause a lot of anxiety, particularly if their child has trouble falling asleep or extended night wakings.

Insomnia is one of the most common sleep issues in children, and can affect kids of all ages. If a child isn’t getting enough sleep, it can lead to a host of other problems during the day, such as grogginess, inability to pay attention in school, and mood and behavioral issues.

While it’s normal for a child to take up to 30 minutes or so to fall asleep or to wake up during the night, if they regularly take an hour or longer to fall asleep or wake up for long periods of time every night, it may be time to talk to a professional.

Understanding Your Child’s Individual Sleep Needs

University Hospitals clinical psychologist and behavioral sleep medicine provider Carolyn Ievers-Landis, PhD, DBSM, says a sleep expert can consider your child’s sleep habits and find individualized ways to maximize sleep quality.

Seeing a behavioral sleep specialist can be helpful because they are trained to see things that a child’s general pediatrician may not, says Dr. Ievers-Landis. Your child’s pediatrician may focus on things such as sleep hygiene, bedtime routines, and following the established sleep recommendations.

However, every child has different sleep needs that may or may not be in line with the recommendations, which are averages. Dr. Ievers-Landis says that many children may actually need less sleep than what is recommended because these guidelines are based on parent-reported data and are not objective measures of children’s sleep duration.

“I like to ask parents, what is the opportunity for sleep compared to the biological need for sleep?” says Dr. Ievers-Landis. “If your child is in bed for 15 hours a day but only needs 11 to 12 hours of sleep, that’s a lot of time that they are in bed but not sleeping.”

Working with a sleep expert to figure out your child’s sleep needs can help you establish a reasonable goal for bedtime and wake time that will lead to better sleep for your child and less tossing and turning.

Building the Need for Sleep

A behavioral sleep specialist can also work with parents to develop strategies for building up the need for sleep during the day so the child is ready to sleep at bedtime. Activities that can help ensure your child is sleepy at the end of the day include regular mealtimes, moderate to vigorous physical activity, and spending time outdoors in natural sunlight.

Things that can negatively affect sleep include caffeine (in things like chocolate or soda) and sedentary behaviors including screen time and media use. Around age 4, children usually no longer need a daytime nap, so naps in older children could impact their ability to sleep at night. Additionally, some children give up naps very early, even as young as 2 years old. While this is challenging for parents, it’s important for some children to stop napping in order to get enough sleep at night.

Dr. Ievers-Landis notes that these factors are all very different depending on the child and may not affect all children equally.

Strategies for Better Sleep

Some ways parents can assist their child with sleep include:

Bedtime associations: For infants and toddlers who have trouble falling and staying asleep without extended wake ups, it’s important to look at their sleep-onset or bedtime associations. If a child is being nursed or rocked while falling asleep, for example, they may begin to associate these activities with going to sleep – making it hard to get back to sleep without them when they wake during the night. Helping a child learn to self-soothe can improve those normal middle-of-the-night wake periods so they can fall back asleep without a parent’s help.

Distraction techniques: With older children, you can use distraction techniques while they are waiting to fall asleep. This can include soothing, non-stimulating activities such as listening to podcasts or relaxing music. Try out different methods until you find one that works for your child, suggests Dr. Ievers-Landis.

Avoid sleeping in too late: Another thing that can help is waking up roughly around the same time every day. While many kids (and grownups) would prefer to sleep in on the weekends, if their wakeup time varies too much, it can cause “social jet lag”. This can lead to sleep problems during the week, daytime sleepiness, and problems with attention and mood. Dr. Ievers-Landis recommends strategies to make it easier to get up earlier, such as setting an alarm or planning an activity to make them excited to get out of bed.

Dr. Ievers-Landis notes that it’s not necessary to get up at exactly the same time each day. But consider limiting your child to one extra sleep period – no more than 90 to 110 minutes after they typically wake up.

More Help for Sleep Disorders

Dr. Ievers-Landis says the vast majority of children will experience improvements in sleep within three to five sessions with a behavioral sleep expert, and some are vastly improved after only one session. In addition to insomnia, behavioral sleep therapy can also be useful for issues such as:

Some sleep disorders stem from medical issues such as restless legs syndrome and sleep-disordered breathing. In cases like these, a sleep study may be recommended for further evaluation, or your child may be referred to other pediatric specialists as needed.

Dr. Ievers-Landis says that working with a behavioral sleep specialist is worth it if you’re at all concerned about how your child’s sleep is affecting their daily life. Often, implementing some fairly simple strategies is all that is needed to optimize sleep, leading to a healthier, happier child and improving quality of life for the whole family.