I often get asked by parents “Why wont my child sleep,” and “Why do some children have difficulty sleeping?” If your child wont sleep, it may be because of some common causes that can cause insomnia or sleep deprivation in children. When it comes to children having a difficult time sleeping, some physicians separate these types of sleep problems into 3 main categories:
- Behavioral insomnia of childhood
- Psychological (conditioned) insomnia
- Transient sleep disturbances.
Before focusing just on these issues, there can be a number of other sleep related problems that are not based in developed behaviours. For example, if your child snores or has pauses in breathing with sleep, this should be discussed with your doctor, because it may be a sign of a different condition known as sleep disordered breathing. We are planning to talk more about this topic at a later date, but would like to focus on behavioral sleep problems in this article.
Its also might help first to determine what your child’s sleep needs are, and see if there are any changes you can make to your night time routine to help your child fall asleep more easily.
Behavioral insomnia of the child:
Behavioural insomnia can happen in young children age 0 to 5 years and can also continue until the child is older. If your child has a Behavioural type insomnia, you may be asking yourself the “Why wont my child sleep?” Your child might be refusing to go to sleep, take long time for your child to fall asleep, or start waking up during the night. Behavioural Insomnia is thought to be caused by unhealthy habits during the evenings that are coinciding with when sleep should start. Parents may also have difficulties setting limits or effectively disciplining their child when it comes to sleep, which may contribute to Behavioural Insomnia.
I struggled with forming healthy bedtime habits as well as limit setting in the evenings with Madi. From the time Madi was born until 11 months old, I breastfed her to fall sleep. Madi would wake up in the middle of the night and I would breastfeed and cuddle her until she fell asleep again. She often resisted trying to fall asleep again, so I would pick her up to play with her. Altogether, these are examples of how my unhealthy night time habits and difficulty with setting limits may have reinforced Madi waking up throughout the night and not getting a full night’s rest. When this type of behavior becomes engrained and effects your or your child’s quality of life during the day time, it can be called a type of insomnia. This type of insomnia most commonly develops from a caregiver’s having difficulty setting consistent bedtime rules and enforcing a regular bedtime.
During the night, children experience a brief arousals (waking up from sleep) that occurs at the end of each 60- to 90- minute sleep cycle. This is normal. They may also awaken throughout the night for other reasons and not able to get back to sleep (often due to difficulty “self-soothing”) unless they get what they received in the past to help fall asleep. In Madi’s case, this was breast feeding. We hit a wall where she would not fall back asleep in the night unless I got up and breastfed her.
Self-soothing is a behaviour your child learns to help them fall asleep on their own without the need for their parent or caregiver to rock, cuddle, breastfeed, or sing them back to sleep. Children learn through reinforcement that when they cry in the middle of the night, that Mommy or Daddy will come and cuddle them back to sleep. It is not their fault, or your fault, but it happens often in many families! But over time, this can become challenging for parents because it will wake you up in the middle of the night and prevent you from getting a good nights rest.
The good news is your baby can learn to self-soothe at night!
Psychological (conditioned) insomnia:
Psychological insomnia most often happens in older children and teenagers and may be a cause of your child not sleeping. This is seen in older children and teenagers, where there is anxiety about falling asleep or staying asleep. Psychological Insomnia may be related to genetics, medical problems, acute stress, or mental health problems.
My own personal example of this would be when I am on call at the hospital. On busy call nights my pager would go off every 15-30 minutes with medical consults or patient issues on the wards. But even when it was quiet, I couldn’t seem to fall asleep! I was too worried about my pager going off that I could not relax. This was a good example of conditioned insomnia.
Transient sleep disturbances:
This occurs when a child who used to sleep normally, starts waking up through the night. This can be caused by stress, or disruption of their normal sleep schedule (like travelling).
If your child persistently has trouble falling asleep and maintaining sleep they should see their primary care provider to ensure that there are no medical issues causing the child to have difficulty sleeping.
Madi often experiences transient sleep disturbances after travelling from Atlanta to Edmonton where there is a time change. See how to handle time change when travelling with toddler.
Learn more from Dr. Mom
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