Understanding and Managing Sleep Problems
Managing and Supporting your Child’s Sleep Problems
Sleep problems can affect children and adolescents of all ages as well as their parents who may bear the brunt of sleepless nights along with their children. The most common of these include insomnia (difficulty getting to sleep), waking in the night due to changed sleep conditions (eg. a parent that was present when initially falling asleep that is no longer there during the night) and delayed sleep phase. Poor sleep can affect children’s capacity to pay attention in class, consolidate their learning, lead to anxiety, poor emotional regulation, behavioural difficulties, mood difficulties and overeating.
Sleep problems can be the result of many things including: lack of regular sleep/wake cycles, device use, caffeine use, over crowded schedules, poor or lack of pre-bedtime routine and general sleep hygiene as well as behavioural difficulties like oppositionality around going to bed or unhelpful sleep or bed associations. There may also be underlying organic causes to sleep difficulties such as obstructive sleep apnoea which require medical treatment. If sleep problems are left untreated, they are more likely to persist over time. There are highly effective interventions for sleep problems for children ranging from the very young to teenagers and beyond. Whilst sleep hygiene is important in ensuring a good night’s sleep, sometimes help is required beyond those basic sleep hygiene habits. Talking to a child psychologist can be a good place to start.
What You Need to Know About Sleep Problems
How much sleep do children and teens need?
Children in the early primary years need roughly 11 hours which reduces in upper primary usually to closer to 10 hours. However when children start school, they often need more sleep to cope as they adjust to the demands of the school day, so may need closer to 12 hours. Adolescents commonly need at least 9 hours per night, though their body clock may naturally lead to them wanting to go to bed later and wake up later. Whilst a shift of up to 2 hours is common, this is typically not compatible with school life, with them still needing to get up early for school and before school activities. Many adolescents are getting around 1.5-2 hours less sleep than they need.
Signs of poor sleep:
- Struggling to get to sleep.
- Not waking naturally or being cranky upon waking.
- Headaches in the morning.
- Sluggishness during the day.
- Falling asleep in class, or on the way home or after school.
- Hyperactivity (in younger children) that occurs just prior to bedtime which is often a symptom of over tiredness.
- School can’t – poor sleep can lead to children feeling too overwhelmed to attend school.
- Anxiety – there is a bidirectional relationship between poor sleep and anxiety (those who are anxious may be more likely to suffer sleep difficulties but also poor sleep does seem to increase anxiety, so it can become a vicious cycle).
- Depression – there is also a bidirectional relationship between adolescent sleep and depression
Autism, ADHD and relevant sleep issues
Neurodivergence also increases the likelihood of sleep issues, with 70% of autisitic and ADHDers will have a problem with sleep at some stage during their lifetime. Poor sleep can have a significant impact on a young person’s general functioning and behaviour. Sleep problems can increase hyperactivity, attention problems, quality of life for the young person as well as parent mental health. Being able to address sleep difficulties is an important part of learning to thrive as a neurodivergent person.
When to Seek Help for Sleep Issues
Sleeping problems, if left untreated, are more likely to persist over time. Whilst the odd bad night’s sleep is completely normal and to be expected for all of us, problems that continue can snowball. When you find that a pattern of poor sleep has emerged over weeks or months, seeking help can prevent it getting worse and provide the answer to getting sleep and wellbeing back on track.
What Treatment May Look Like
Treatment to reduce problems around sleep vary depending on the age of the child or adolescent. Firstly it is important to have a really good understanding of what the young person’s sleep schedule looks like, so keeping a log of their sleep (as much as possible) will be a helpful place to start. Keeping track of what is happening during the day is also important information that your child or teen’s psychologist will find useful in order to understand what is going on for them.
- For younger children, parent involvement is key in ensuring that consistent sleep/wake schedules are maintained and a helpful bedtime routine is employed to assist the body to prepare for sleep at the right time. This sometimes involves creative problem solving to identify the barriers that might be getting in the way and identify the most helpful strategy. It may also be necessary to employ approaches such as camping out or check-ins in order to reduce parental involvement at bedtime and facilitate consistency of conditions for throughout the night.
- When children and adolescents are struggling with insomnia or a delayed sleep phase (either where they may be trying to get to sleep but can’t or their body’s sleep -wake cycle has shifted to be later), bedtime fading is a helpful approach. This is where we gradually pull the young person’s bed time to be earlier than when they are currently naturally falling asleep. With this approach it is important to have a really good understanding of when they are actually falling asleep and sleep logs will be especially important.
- Learning relaxation strategies such as progressive muscle relaxation as well as mindfulness strategies and identifying those individual daily habits that can help your child or teen calm down at the end of the day. Everybody is different and so finding ways to adapt universally helpful sleep hygiene principles is important to ensure it fits the individual.
- Treating negative thinking patterns around sleep – central to insomnia in young people and adults is a an unhelpful thinking pattern that emanates from negative experiences not being able to get to sleep. These unhelpful thought patterns can contribute to reinforcing the difficulty with falling asleep. Cognitive behaviour therapy is a useful and effective approach to challenging these and putting into place more useful strategies when trying to get to sleep that are age appropriate.
- Treating underlying anxiety and/or depression. Whilst sleep problems can affect the way we handle anxiety and stress and lead us to feel depressed, underlying emotional problems may actually be causing the sleep issues and need to be treated, along with the sleep difficulty.
- More info:
Murdoch Children’s Research Institute Sleep series Podcasts https://www.mcri.edu.au/impact/watch-listen/listen/sleep-podcast
Sleep Foundation https://www.sleepfoundation.org/children-and-sleep
Your Sleep Problem Questions Answered
How long does it take to improve sleep with psychological support?
This will depend on how long sleep has been a problem and whether there are other complicating mental health issues that go along with it. Some clients see significant changes from only a few sessions, others require a longer period of intervention.
My child has frequent nightmares. Will treatment help?
Nightmares are developmentally normal and generally reduce with age. Addressing any underlying anxiety as well as ensuring that bedtime is calm and predictable may help the occurrence of nightmares, however sometimes this is simply associated with a developmental stage that will pass.
Do you work with children of all ages?
We generally focus on school aged children with sleep difficulties.
Do you work with both parents and children?
Depending on age and developmental stage, yes we do. The younger the child the greater degree of parent involvement. With very young children, parenting sessions may be appropriate. In the case of working with teens, typically the parent is less involved, although if the teen is comfortable, it can be helpful to keep parents in the loop with strategies the teen might be using as they may be able to help them remember them at more challenging times.
Are your sessions conducted in person?
We conduct sessions in person and via telehealth, depending on the client’s preference. Generally we recommend starting treatment in person if possible.
Will you prescribe medication to help my child with sleep problems?
No. If medication (most commonly melatonin) is thought to be a useful adjunct to therapy, your psychologist will refer you back to your GP or specialist medical professional (e.g. paediatrician or psychiatrist) for advice.
Why Choose The Young Mind Clinic?
Expertise
The Young Mind Clinic psychologists use and are highly trained in the use of internationally recognised gold-standard assessment tools.
Our experience with these tools can provide accurate and reliable evaluations, ensuring that each assessment is both comprehensive and tailored to the unique needs of every individual.
Experience Working With Young People
Our psychologists are skilled in addressing the unique needs of young people, offering assessments that utilise well-thought-out methods to synthesise relevant information gathered during the assessment into concise and personalised reports.
With this, we can provide well-thought-out recommendations for families, young people and their schools where appropriate.
AHPRA Registered Psychologists
Our clinicians are all psychologists registered with the Australian Health Practitioner Regulation Agency (AHPRA).
THE YOUNG MIND CLINIC
Enquire About an ADHD Assessment at The Young Mind Clinic
Early assessment, diagnosis, and intervention may make a significant difference in assisting children to manage their symptoms and discover their potential. At The Young Mind Clinic, our ADHD assessments focus on the positive while aiming to find techniques to assist them in both the home and school environments. To find out more or to book an appointment, contact us today.