About insomnia in children and teenagers
Insomnia is a sleep problem. If your child has insomnia, it means she has trouble getting to sleep or staying asleep at night, or she might wake up too early.
Short-term insomnia lasts only a few days or weeks. This is also called acute insomnia.
Long-term insomnia is when your child has trouble sleeping at least three times a week, and this problem lasts for a month or longer. This is also called persistent or chronic insomnia.
The amount of sleep your child needs to be at his best for play, learning and concentration during the day depends on his age.
Signs and symptoms of insomnia
A change in your child's sleeping behaviour - like going to bed later than you'd like - isn't necessarily a sleep problem. But your child might have insomnia if she:
- lacks energy or constantly feels tired
- makes excuses to avoid going to bed
- takes a long time to get to sleep
- keeps getting out of bed and asking for things
- keeps waking up throughout the night and can't go back to sleep
- struggles to wake or refuses to get out of bed in the morning
- naps for long periods during the day or falls asleep at school
- struggles to concentrate or remember information
- sleeps at different times from day to day.
During adolescence, your child starts to release melatonin later at night than he did in childhood. This affects his circadian rhythm and makes him want to go to bed later at night - often around 11 pm or later - then get up later in the morning.
Causes of insomnia
Insomnia has many different causes. They include:
- sleep associations - for example, when a child can't go to sleep without a bottle of milk or being with a parent
- bedtime behaviour - for example, too much screen time, particularly in the bedroom, or not enough time in the bedtime routine for calm, quiet activities
- emotional issues - for example, stress, child anxiety or child depression, and teenage anxiety or teenage depression
- environmental factors - for example, a hot or noisy sleeping environment
- medical conditions - for example, asthma, sleep apnoea or restless leg syndrome
- illnesses that make it hard to sleep - for example, colds or ear infections
- medications - for example, some drugs used to treat attention deficit hyperactivity disorder or antidepressants
- caffeine - for example, energy drinks, coffee, chocolate or cola.
Does your child need to see a doctor about insomnia?
It's a good idea to talk with your GP if you're concerned that problems with sleep are affecting your child's wellbeing, schoolwork or relationships.
Also talk with the GP if the problems are making your child anxious, or if they go on for more than 2-4 weeks.
Your GP might refer you to a paediatrician, psychologist or other health professional with experience in identifying and treating persistent sleep problems in children.
Your doctor will usually take your child's medical history, as well as a physical exam to check for any signs of a medical problem. This can sometimes include a blood test.
Your doctor will also take a detailed history of your child's sleeping patterns.
Sometimes, if the causes of your child's insomnia aren't clear, your child might be monitored overnight at a sleep centre.
Before you take your child to see the GP about insomnia, it can help to track your child's sleep in a log or diary. You could do this for a few weeks before seeing the GP.
Treatment for insomnia
Treatment for insomnia depends on what's causing your child's insomnia. Your doctor will work with you and your child to find the best way to help her sleep better. Insomnia treatments can include any of the following.
Sometimes treatment for insomnia might just be a case of changing your child's sleeping habits. This can include:
- avoiding daytime naps
- removing clocks from the bedroom
- having a quiet and relaxing bedtime routine and sleep environment.
Your child's daytime habits can make a difference to how well he sleeps. Make sure your child gets some physical activity and plenty of bright, natural light during the day. Regular mealtimes might also encourage better sleep habits.
If a medical condition or sleep disorder is causing your child's insomnia, she might need some kind of medical treatment.
For example, if your child has obstructive sleep apnoea that's caused by enlarged adenoids, he might need an operation to take out his adenoids. This should improve his breathing during sleep and stop him from waking up so often.
If negative thoughts and worries are making it hard for your child to sleep, she might benefit from cognitive behaviour therapy. This therapy can help your child deal with the negative thoughts and worries so she's relaxed enough to fall asleep.
Sleep medications are rarely used to help children sleep because medications can have side effects. Even herbal or 'natural' medications can have side effects.
In some extreme cases, sleep medication might be used for a short amount of time. For example, a doctor might prescribe melatonin. Children shouldn't take melatonin without medical advice and supervision.
You should give your child sleep medicine only if your doctor advises you to do so, and only if your doctor is supervising your child's treatment. Never give your child more than the recommended dose of any medication.