Sleep presents different difficulties at each stage of life, but there are many common challenges within age groups, because of both biological and environmental influences.
0-3 Years Old
Newborns and infants have the highest sleep need, but due to the amount of time spent in sleep, they will frequently experience nighttime wakings due to hunger and undeveloped circadian rhythms. Children from the infant to toddler range may also have difficulty learning to self-soothe, often relying on parental reassurance if they are used to receiving it, and experience separation anxiety, making bedtime challenging. In later toddlerhood, changes in naptime schedules may result in overtiredness which can increase nighttime wakings due to high levels of cortisol.
While some of these challenges cannot be fundamentally reduced, like a newborn’s hunger during the nighttime, others can be eased with the implementation of healthy sleep habits. To help your child develop a consistent circadian rhythm (internal clock), do your best to maintain consistent sleep and wake times. This will help the baby’s body get used to the cycle between nighttime and daytime, triggering the biological processes that help with sleep approaching bedtime. Keeping nap times consistent and counting the hours spent napping as contributing towards total sleep time can help prevent overtiredness. Creating a consistent bedtime routine is the foundation for healthy sleep across the lifetime, and it can start in early childhood. Keep the bedtime routine calm and simple. Many parents like to spend low-energy quality time before putting their toddler to bed by reading a book or telling stories. This is a great way to wind down, followed by lights out.
Help your child get used to independent sleep by ensuring that they are falling asleep without your constant presence at nighttime. While this may be challenging, introducing a transitional object, like a stuffed animal, can make it easier for them to find comfort when you are not in the bedroom. In infancy and toddlerhood, separation anxiety or other worries may lead them to cry out and seek your reassurance. However, providing consistent reassurance when this happens will reinforce the attention seeking behavior. It is encouraged that you find a way to check in on your child without providing them with direct attention that will maintain this cycle, like using a baby monitor, or providing a low stimulation check in that could look like whispering to them in their dark bedroom without picking them up. Seeing a child in distress is painful for parents, but encouraging independent sleep will help the whole family unit in the long run.
3-5 Years Old
Pre-school aged children display increased drive for independence, which can often result in bedtime resistance, like delaying bedtime routines. Transitions in nap times, and nap lengths, in this period may also introduce some growing pains. In addition, they more frequently experience nightmares, fear of the dark, and other related anxiety.
Many of the same tips apply; do your best to maintain predictable and calm bedtime routines, including low stimulation activities like reading a book. To reduce bedtime resistance, you can begin to incorporate limited choices throughout routines. This may look like allowing a choice between two sets of pajamas, toothpaste flavors, or books. Giving your preschooler a sense of involvement and agency can satisfy some of their urge for independence. Importantly, be sure to limit screen time before bed, since the light from screens may disrupt the brain’s ability to send a message to the body that sleep is approaching. To encourage sleep, keep bedrooms dark, cool, and quiet.
6-12 Years Old
Children in this age range are experiencing a great deal of social and environmental change. Busier schedules, increased homework demands, increased use of screens, anxiety about social relationships and school, and inconsistent sleep schedules during the weekend can make getting good quality sleep challenging.
Managing these changes will be easier for your child if they are getting good sleep, and talking to them about the importance of sleep can help them learn the value in it and buy into cooperating with good sleep hygiene strategies. Maintain some of the earlier strategies described, including prioritizing consistent bedtimes, and co-creating relaxing bedtime routines. It can also be helpful to remove electronic devices from bedrooms, to reduce the temptation of using screens when in bed. Other sleep hygiene strategies include encouraging physical activity during the day and limiting caffeine at this age. If your child seems to worry a lot, check in with them about their worries earlier in the day, rather than at bedtime. Anxiety often heightens before sleep, because there is less to distract from worries. If you make space with your child to talk about any worries before bedtime, this effect may be reduced.
13-18 Years Old
Once teenagers reach puberty, they experience a shift in their circadian rhythm, where melatonin, the sleep hormone, is released later in the evening than it was before. Naturally, this results in teenagers staying up late in the evening. However, this is a problem for many teens as school often requires early wake times, resulting in sleep deprivation. Teens will also face even higher demands from school, sports and extracurriculars, jobs and social life, increasing busy schedules and stress that can impact sleep. Finally, excessive use of social media and screens at nighttime can exacerbate sleep issues.
Going to bed late is not always a choice that a teenager makes; it can be helpful to understand that there is a natural shift in bedtime sleepiness post puberty that cannot be fully changed. However, you can encourage your teen to prioritize getting 8-10 hours of sleep every night, and maintain a consistent waking time, even on the weekends. Keeping the same wake time can help train their circadian rhythm to align better with the needs of their schedule. Technology and screentime management are very important for supporting teens, since late night use of devices can mess up the body’s biological signals for sleep, and the pull of the online social world can lead to sleep procrastination. Discuss openly with your child about the pros and cons of device use before sleep and come to a collaborative plan. Best practice is to avoid screens for about 30-40 minutes before bed and keep devices outside of the bedroom whenever possible. Finally, teens may use caffeine more frequently to manage busy schedules and tiredness. Help your teen avoid using caffeine later in the day, to reduce the impact that caffeine may have on sleep quality.
Strategies and guidelines for cultivating healthy sleep hygiene with children can feel overwhelming, and it’s hard to know what to tackle first. With a therapist’s help, you can prioritize evidence-based strategies to reduce conflict at bedtime, encourage healthy routines, and reduce nighttime challenges common in childhood and adolescence. The clinicians at The Baker Center can work with you as a team to figure out the best plan for supporting your child and their sleep.
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