Child insomnia is persistent poor sleep in children that results in inadequate rest and tiredness during the day. When this condition occurs for three weeks or less it’s called transient or short-term. Longer-term insomnia is defined as difficulty getting or staying asleep most nights that lasts for more than three weeks. There are numerous causes of insomnia in the pediatric population.
Any type of child insomnia may involve a few different features. Some children have difficulty falling asleep, and they may lie in bed for hours waiting for sleep to come, or get up frequently to complain that they are not sleeping. Other kids get to sleep at night, but they wake often, or they may wake early and are unable to resume sleep.
The results of insomnia can vary in children. They might include sleepiness during the day, expressed inability to sleep at night, attentional problems, greater moodiness, and depressed emotional state. People with insomnia often have slightly suppressed immune systems and may be more prone to illness. Children may also express worry about sleep habits, though this doesn’t occur in very young children. Other symptoms could be present, depend on the child, and don’t always point to a clear cause.
Instead, doctors must evaluate sleep problems through discussion with children, when appropriate, and with parents. Physical exams are common to rule out underlying medical problems and a sleep study might be appropriate to rule out conditions like apnea. These measures usually aren’t necessary for transient child insomnia, but are important when the condition is longer-term.
Through examination, doctors may find potential causes of long-term child insomnia like stress, chronic illness or response to certain daily medications. It’s also associated with mental health illnesses, problems like attention deficit hyperactivity disorder (ADHD) or the meds used to treat ADHD, high levels of stress at home or at school, poor sleep hygiene, and use of substances like caffeine. Sleep disorders that affect adults, like sleep apnea or restless legs syndrome (RLS) do occur occasionally in children.
Transient child insomnia usually doesn’t require treatment. Longer-term types do need attention because of ongoing negative symptoms. Sleep medications are usually not recommended for kids. Nevertheless, some doctors do prescribe them, and about a third of children with mental health issues and insomnia receive sleep medicines, despite limited study of benefits or proven safety in children. Alternately, doctors could directly treat underlying medical conditions like asthma, skin conditions, allergies, apnea, or RLS that can all create sleep disturbance.
Severe stress and behavioral health problems can additionally be treated through psychotherapy and drug therapy. Physicians frequently suggest improvements to sleep hygiene, too. These include elements like establishing regular bedtimes, making sure TV is not available in a child’s room, and providing a relaxed and comfortable atmosphere suited to sleep. Other ideas could be tried and are individualized to the child. Child insomnia often improves with treatment, though some interventions require time to work effectively.