Pediatric InsomniaInsomnia is defined as difficulty falling and/or staying asleep with a feeling of not being rested during the day. This definition evolved during the study of adults with insomnia, and doesn't adequately define the problem in children because insomnia in young patients can look quite different. Often, overly tired children become more active, even hyperactive, and rarely will a child complain of being tired. Instead, their daytime behavior suffers. Tired children are often difficult to raise because they can be irritable and obstinate while having more than enough energy to outlast their parents attempts to control them. Parents are usually unaware the child is too tired to behave better because the child's hyperactivity fools them into believing the child is well-rested. This is the reason why "bedtime battles" develop. Parents try to use discipline to get a child who is unable to fall asleep to go to bed when they should. Insomnia is never fun, and children will do anything to not go to bed where it is most difficult to stay when unable to fall asleep quickly. They learn to involve their parents in the problem by getting into battles about sleeping. Once asleep, many children with insomnia will sleep until morning, but some have difficulty staying asleep as well. Night waking past the age when feeding requires it is usually caused by insomnia. Some children fall asleep without problem initially, but wake during the night and can't return to sleep. After they are awake long enough, they will call out to the parent. Anxiety worsens insomnia. At 9 months of age, when children develop separation anxiety (anxiety caused by being apart from the parents) many children with insomnia will start sleeping worse, and the only thing that seems to help is staying with the child or bringing them into the parents bed. The most important thing to learn here is that parents don't cause insomnia and they can't teach children to sleep poorly. They also can't force a child to sleep better using "crying it out." |
