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Sleep Problems in Children

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Children may wake up or not sleep well during the night for different reasons. Here is information from the American Academy of Pediatrics about common sleep problems and how parents can help their children develop good sleep habits. Common sleep problems include nightmares, night terrors, sleepwalking and sleep talking, and bedwetting.

Keep in mind that children differ in how much sleep they need, how long it takes them to fall asleep, and how easily they wake up. If you have any questions about your child's sleep habits, ask your child's doctor.

Nightmares

Nightmares are scary dreams that often happen during the second half of the night, when dreaming is most intense. Children may wake up crying or feeling afraid and may have trouble going back to sleep.

What You Can Do

  • Go to your children as quickly as possible.

  • Assure children that you are there and will not let anything harm them.

  • Encourage children to tell you what happened in the dream. Remind them that dreams are not real.

  • Allow children to keep a light on if it makes them feel better.

  • Once children are ready, encourage them to go back to sleep.

  • See whether there is something scaring your children, like shadows. If so, make sure it is gone.

Night Terrors

Night terrors occur most often in toddlers and preschoolers and take place during the deepest stages of sleep. Deepest sleep usually happens early in the night, often before parents' bedtime. During a night terror, children might

  • Cry uncontrollably

  • Sweat, shake, or breathe fast

  • Have a terrified, confused, or glassy-eyed look

  • Thrash around, scream, kick, or stare

  • Not recognize you or not realize you are there

  • Try to push you away, especially if you try to hold them

Although night terrors can last as long as 45 minutes, most are much shorter. Most children fall right back to sleep after a night terror because they have not actually been awake. Unlike with a nightmare, children will not remember a night terror.

What You Can Do

  • Stay calm. Children are unaware of ever having a night terror because they are asleep, so there is no effect on children, only parents.

  • Make sure children cannot hurt themselves. If they try to get out of bed, gently restrain them.

  • Remember, after a short time children will probably relax and sleep quietly again. If children have night terrors, be sure to tell the babysitters what night terrors are and what to do. If night terrors persist, talk with your child's doctor.

Sleepwalking and Sleep Talking

Like night terrors, sleepwalking and sleep talking happen when children are in a deep sleep. While sleepwalking, children may have a blank stare. They may not respond to others, and it may be very difficult to wake them up. Most sleepwalkers return to bed on their own and do not remember getting out of bed. Sleepwalking tends to run in families. It can even occur several times in one night among older children and teens.

What You Can Do

  • Make sure children don't hurt themselves while sleepwalking. Clear the bedroom of things children could trip or fall on.

  • Lock outside doors so children cannot leave the house.

  • Block stairways so children cannot go up or down.

  • Do not try to wake children when they are sleepwalking or sleep talking. Gently lead them back to bed, and they will probably settle down on their own.

Bedwetting

Bedwetting at night (also called nocturnal enuresis) affects 5 million children in the United States. Although most children are toilet trained between 2 and 4 years of age, some children may not be able to stay dry at night until they are older. Children develop at their own rate. For example, studies have showed that 15% of 5- and 7-year-olds wet the bed. But by age 15, fewer than 1% wet the bed.

What You Can Do

  • Do not blame your children. Remember that it is not their fault.

  • Offer support, not punishment, for wet nights. Let your children know bedwetting is not their fault and that most children outgrow bedwetting.

  • Set a no-teasing rule in your family.

  • Let your children help. Encourage them to help change the wet sheets and covers. This teaches responsibility. It can also keep them from feeling embarrassed if the rest of the family knows. However, if they see this as punishment, it is not recommended.

  • Parents may try waking children to use the toilet 1 to 2 hours after they go to sleep or encouraging children to drink less in the evening. However, keep in mind that bedwetting could still occur because even if your children urinate before going to bed and drink very little in the evening, their kidneys continue to produce urine.

  • If you are concerned about your child's bedwetting, talk with your child's doctor. There are treatments available.

For More Information

American Academy of Pediatrics www.aap.org and www.HealthyChildren.org

Disclaimer

Adapted from the American Academy of Pediatrics (AAP) brochure Sleep Problems in Children.

The AAP is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.

In all aspects of its publishing program (writing, review, and production), the AAP is committed to promoting principles of equity, diversity, and inclusion.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.