Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
10-Year-Old Cannot Fall Asleep | | | QUESTION | | | Dear Dr. Needlman,
My 10-year-old daughter cannot fall asleep at night. She is active in sports, gets plenty of exercise, and is healthy in every other way. Our family doctor suggested writing down my daughter's concerns but this hasn't helped us identify why she cannot sleep. She says that she is not worried about things (other than not being able to sleep).
We have tried putting a fan in her room, a nightlight, closing the door, opening the door, going to bed later, going to bed earlier, removing the clock from her room, reading, routine--we've tried everything I can think of. Could this be a habit she has gotten herself into? If this is a habit, how can we help her break it? Do you have any suggestions? She needs more sleep; this has been going on for about one year.— NKL-l | | | ANSWER |
December 21, 2001 | | | Dear NKL-l,
Trouble falling asleep is a very common problem, both among children and adults. Sleep specialists all recommend one simple step: don't lie in bed too long waiting to fall asleep. Lying around hoping to sleep is very unpleasant. As a result, people who have trouble falling asleep tend to get even more anxious, anticipating that they will have a bad time of it (just as your daughter does), and that only makes it harder to fall asleep. You are caught in a vicious cycle.
So, instead, tell your daughter that if she hasn't fallen asleep within 15 to 20 minutes, at most, she should get up, go to another room, and read a book or do something else quiet (but watching TV is out--TV at night quickly becomes a habit that makes sleeping very, very difficult). When she feels good and tired, she can lie back down again in bed, but only for about 15 minutes. She can repeat this as many times as she needs, until she falls asleep.
Another strategy, along the same lines, is for your daughter to only go to bed around the time that she actually falls asleep. In other words, if she is usually up until one in the morning, she should actually lay herself down to sleep at about 12:45. This avoids the unpleasant business of lying in bed hour after hour. Once she is getting to sleep more easily, she can make her bedtime earlier by a few minutes each night, until it is back to a sensible hour. She should continue to wake up at the normal time for school, and should not allow herself to nap during the day. She's bound to feel very tired, and that will of course help her to fall asleep at night.
It is not a good idea to use sedative drugs to help children sleep. But there is good evidence that melatonin, a natural hormone that you can buy in health food stores, can be helpful. You should talk with your daughter's doctor before starting her on this or any other medication. Every large children's hospital has a pediatric sleep specialist associated with it. If your daughter's sleeping isn't getting better, you could ask her doctor for a referral to the specialists.— by Robert Needlman, M.D., F.A.A.P. |
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