Wednesday, June 4, 2008

Childhood Insomnia

When does your child go from having sleep problems to having childhood insomnia? Pediatric sleep specialist Dr. Sarah Zallek says she's not convinced insomnia is a cause for not sleeping. She says it is usually a symptom of another problem: like sleep apnea, breathing obstruction, or anxiety. "Childhood Insomnia isn't necessarily a condition on it's own. It's a behavioral thing most of the time. Childhood insomnia can also be caused by medications like the ones used to treat asthma, ADHD and others," said Dr. Zallek.

Causes of Childhood Insomnia:

1. Limit Setting

Dr. Zallek: There are some kids who are developmental abnormal and have insomnia. That's a different story. For most kids, behavioral insomnia in childhood can be related to limit setting. Keep the child within limits, put them in bed, don't give in when they ask for another drink, etc. It turns into a not sleeping thing because they get attention for getting up. She advises her parents to say, "Go to bed and stay in bed." If the child gets up, don't let them snuggle in bed with you, watch T.V. or anything else. Don't get them into that habit.

Dr. Zallek: I would go back to the sticker chart, a series of squares to put stickers in. Three nights of good behavior gets a little toy. For an older child, it would be a week of good sleeper gets a toy. You reward what you want them to do. Punishment almost never works.

Jen: I can attest to that last statement. We have tried punishment for bad sleeper. Completely pointless in my house!

2. Bedtime Fears

Dr. Zallek: Bedtime fears can cause childhood insomnia. Sometimes they will be totally good sleepers, then they will start saying there's a monster in the closet. There are shadows or something. The best way is to make sure and tell them the monster doesn't exist in the first place. Don't invent monster spray. No checking under the bed for alligators. Rationally explain to the child those things don't exist. Reassure them they are loved and protected.

3. Caffeine

Dr. Zallek: It is also outstanding to me how many kids get caffeine. Even one caffeinated beverage early in the day can effect their sleep. That little bit of caffeine gets in more than people realize. It's not just Coke and Pepsi. It's Sunkist Orange all those energy drinks. I found a Mango smoothy that included caffeine. It had the equivalent of three cups of coffee. Even if it looks like a natural drink, make sure you read labels.

Dr. Zallek: Chocolate gets a bad rap. It really doesn't have that much caffeine in it. A & W cream soda has caffeine in it. And not all products label caffeine in terms of milligrams, so you really have to be careful and read the ingredients part of the packaging. gives these causes of childhood insomnia:

If you set a realistic bedtime and your child is still not getting a good night's sleep, then common causes of insomnia can include:

  • poor sleep habits
  • caffeine
  • stress
  • obstructive sleep apnea (snoring)
  • side effects of medications, including stimulants used to treat ADHD, antidepressants, corticosteroids, and anticonvulsants
  • asthma (coughing)
  • eczema (itching)

  • depression

  • anxiety

  • restless legs syndrome
  • neurodevelopmental disorders, such as autism, mental retardation, and Asperger's syndrome

There are several medications used to treat childhood insomnia and also some non-medical approaches. Doctors seem to agree that treating childhood insomnia is no easy feet. Here's an interesting perspective published in Psychiatric News.

Here are the others blog posts on getting our kids to sleep through the night:

Breastfeeding babies and sleep
Sleep ApneaHow many hours of sleep do kids need?
"The Sleep Fairy" Book for toddlersOlder kids losing sleep when new baby arrives

-NewsAnchorMom Jen


Kari said...

Hi Jen,
Im a long time lurker. I know your mom through CGCH and she is incredible.

My question for this story is what happens when kids start giving up their nap? This definitely changes sleep patterns etc. My awesome sleepers now challenge me regularly!
Kari Kelly said...

Thanks for reading Kari! I think that's a great question. I will ask Dr. Zallek. Your question also made me wonder when are kids supposed to stop taking naps?

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