Bedtime problems in children: Solutions for the science-minded

© 2020 Gwen Dewar, Ph.D., all rights reserved



Bedtime problems are pretty common, especially among young children. But are these problems inevitable? No. Cross-cultural research -- and clinical studies -- indicate that we can quash most troubles by making a few, key changes.


What should we do when our children fail to fall asleep at bedtime, or protest that they aren't sleepy? Or engage in stalling tactics? Or throw a tantrum?

For many families, these struggles are a regular feature of daily life. But they don't have to be. Anthropological research suggests that bedtime problems are heavily influenced by culture.

For example, hunter-gatherers have very few sleep complaints, especially when it comes to initiating sleep at night (Yetish et al 2015). Yet in more modernized societies, insomnia is quite common, and a sizeable percentage of parents (10-30%) report that their babies and toddlers experience difficulties at bedtime (Mindell et al 2010).

Why? It isn't because our children are genetically programmed to stay up late. It's because something about their lifestyle is preventing them from experiencing powerful feelings of drowsiness at bedtime.

Do a bit of detective work -- figure out what that something is -- and we can solve our children's bedtime problems. Here I review common triggers of sleep onset troubles and bedtime resistance, and I suggest practical, evidence-based remedies.

Understanding your child’s bedtime problems: A troubleshooting guide

1. Does your child suffer from nighttime anxieties or fears?

Otherwise well-adjusted young children frequently experience anxiety when they are separated from their parents (Jenni et al 2005; Ainsworth et al 1978), and most children -- at some point -- experience nighttime fears. 

How should we respond?

Some people mistakenly believe that sleep training is the answer. But sleep training programs aren't designed to address a child's nighttime anxieties and fears, and there's no evidence that they are helpful on this score.

Indeed, research suggests that ignoring your child’s fears may lead to nightmares and emotional problems.

Children lack the brain maturation and cognitive skills to cope well with distressing emotions, so they need our guidance. If you suspect that nighttime fears or separation anxiety are contributing to your child's bedtime problems, see these Parenting Science tips for teaching kids how to cope.

2. Has your child learned to expect sleep troubles, delays, or bedtime battles? Learned sleep associations can sabotage your child's ability to become drowsy.

You've probably experienced this yourself. You try -- and fail -- to fall asleep. Then you get frustrated or anxious about the consequences. Tomorrow is going to be a disaster if I don't get enough sleep tonight.

Do these thoughts and feelings help you fall asleep? Of course not. They make you feel more alert. And if this keeps happening -- night after night -- you end up training your brain to respond to bedtime by becoming more uptight, and less drowsy. In effect, you teach yourself to become an insomniac.

Similar processes affect our children. They can learn to associate bedtime with bad feelings, and these feelings sabotage their ability to become physiologically drowsy.

For some kids, the feelings are the same frustration or anxiety we've just mentioned. I've got that big test tomorrow. Why can't I fall asleep? I'm going to be so tired in morning!

But children -- even toddlers -- experience other feelings, too. For example, some kids might not dread bedtime so much as resent it. They actively resist going to bed when they are told, and they come to expect that bedtime is the signal for family conflict -- not calm.

Other children may learn to expect indulgence and negotiation. They employ their nightly stalling tactics, and their parents give in (Moore et al 2006).

So what can you do if your child has learned to associate bedtime with sleep troubles, delays, or bedtime battles?

The first step is to stop pushing a bedtime that isn't currently working.

Pressuring a child to sleep is ineffective. Kids fall asleep because they are physiologically drowsy, not because we insist that they snooze. And if we keep insisting, we're just contributing to the problem -- reinforcing those negative sleep associations.

The next step is to address any underlying problems that are making it hard for your child to feel drowsy at bedtime. Then you can use a technique called "bedtime fading" (below) to get your child back on track.

It's a good bet that learned sleep associations aren't the only thing standing in the way of a good night's sleep. In fact, the whole process of learning negative sleep association is often triggered by another factor.

Maybe your child's internal clock is out-of-sync with bedtime you want to impose. Maybe your child suffers from nighttime fears. Or too much stimulation before bedtime. Or one of the other issues mentioned in this article.

So continue to troubleshoot. If you address the underlying triggers, you'll have an easier time getting rid of your child's negative sleep associations.

And then, when your ready, you can use the technique known as "bedtime fading" to retrain your child to accept the bedtime you prefer. For help, see my Parenting Science article, "Bedtime fading: An evidence-based, step-by-step guide (with examples)".

3. Is your official bedtime currently mismatched with your child's internal clock? (Don't worry! You can fix this.)

Research suggests that many parents are sending children to bed too early, long before they are physiologically ready to fall asleep. Their bodies haven't yet produced enough melatonin, a key hormonal regulator of sleep (LeBourgeois et al 2013).

As a result, these kids either (1) refuse to stay in bed, or (2) lie awake, alert and restless. And they learn to associate bedtime with all the wrong things -- frustration, anxiety, conflict, stalling tactics.

What should a parent do? It depends on the individual child. How much sleep does this child actually need?

In some cases, parents are simply mistaken about their children's sleep requirements. They've overestimated how much sleep their kids need.

It's not very common, but research suggests that a sizable percentage of parents make this miscalculation (McDowall et al 2017). If this is you, you may be able to solve your child's bedtime problems by setting a later, more appropriate bedtime. My article about child sleep requirements can help you decide if you're expectations are realistic.

In other cases, parents have realistic expectations about their children's overall sleep requirements. The trouble is that the child's internal clock is out-of-sync with the parents' preferred bedtime policy.

If that's your situation, one solution is to be accommodating: Reschedule your child's bedtime so that it aligns with his or her natural circadian rhythms.

But of course this isn't always possible or desirable. Work and school schedules may get in the way. Is the situation hopeless, then? No.

Even if a child has "night owl" tendencies, there are ways to reprogram his or her inner clock. 

How?

First, watch out for poorly-timed naps. As I noted below, late afternoon naps can delay the onset of drowsiness at night.

Second, use evidence-based tactics to shift your child's circadian rhythms.

These tactics include exposing your child to bright light in the morning, and preventing your child from encountering bright (artificial) lights after sundown. Read more about them in my article, "How to reset your child's internal clock for an earlier bedtime."

In addition, consider using bedtime fading in combination with your other efforts. As I explain in my guide to bedtime fading, the technique is specifically designed to help realign your child's internal clock with the bedtime you prefer.

4. Is your child napping too close to bedtime?

Naps can help us recover from sleep deprivation (Faraut et al 2015). They appear to have a powerful and beneficial effect on learning (Kurdziel et al 2012). And they may play an important role in early development: Babies and toddlers tend to increase their naps in the days leading up to a growth spurt (Lampl and Johnson 2011).

So personally, I don't like interfering if a child takes the occasional long nap. The child might really need or benefit from the extra sleep!

But if your child is routinely taking long naps -- particularly naps that end in the late afternoon or evening -- this could be contributing to bedtime problems. Among kids older than 2 years, long naps have been linked with later bedtimes (Komada et al 2012).

5. Are electronic media triggering bedtime problems?

Throughout the world, children's sleep problems have been linked with television and other electronic screen use. 

  • The more time babies and toddlers spend using tablets, the less they tend to sleep (e.g., Chen et al 2019; McDonald et al 2014). 
  • Preschoolers who watch lots of TV tend to experience more sleep disruptions, and may get less total sleep (e.g., Helm and Spencer 2019).
  • School-aged kids who spend more time watching TV are more likely to say they have sleep-related problems (Falbe et al 2015; Arora et al 2014).

Problems include bedtime difficulties, like nighttime anxiety, sleep-onset delays, and bedtime resistance (Li et al 2007; Owens et al 1999).

They also include trouble that occurs after bedtime -- like more frequent nightmares and night wakings, and increased daytime sleepiness (e.g., Guerrero et al 2019; Plancoulaine et al 2018; Garrison et al 2011).

And kids don't have to be active users of technology to suffer.

In Finland, researchers have uncovered evidence that even passive viewing -- being present while parents watch adult programs -- can contribute to bedtime problems. Young children (aged 5-6 years) who were exposed to adult programs, like the evening news, slept less overall and experienced more sleep disturbances (Paavonen 2006).

So what, exactly, is the cause of these links between sleep and electronic media use?

In part, it's a question of light. Artificial light exposure -- in the hour before bedtime, and afterwards, during the night -- can disrupt the body's internal clock. And electronic screens emit light, including blue light wavelengths that may be especially disruptive (e.g., Wahnschaffe et al 2013). 

For more details -- including evidence-based tips for reducing the impact of electronic media -- see this Parenting Science review.

But it's also clear that content matters. Exciting or disturbing content can overstimulate, making it harder for children to fall asleep and stay asleep.

For example, in an experimental study of preschoolers, researchers asked parents to stop exposing their young children to violent and age-inappropriate content. When parents replaced this content with non-violent, educational programming, kids experienced better sleep (Garrison and Christakis 2012).

Does this mean you must kill your electronic devices? No. But a careful look at the evidence suggests that electronic media -- including television, mobile phones, and video game systems -- can undermine sleep in children.

Read more about it in my article, "How television affects sleep - and what we can do to sleep better." And try two simple rules:

1. Avoid electronic screen use before bedtime. How soon in the evening should you begin this "blackout"? There isn't any hard data pointing to a specific amount of time. But in many correlational studies, researchers have found that kids tend to sleep better when they stop using electronics for one hour before bedtime.

2. Keep televisions and other electronic screens out of your child's bedroom. As I note in my article about television and sleep, studies report strong links between poor sleep and the presence of electronic screens in the bedroom (e.g., Helm and Spencer 2019; Falbe et al 2015).

6. Is your child's schedule too irregular?

The practice of setting a regular bedtime is by no means universal. In many traditional cultures, the timing of sleep is flexible and opportunistic, with people making up for the occasional "late night" by taking naps in the day (Worthman and Melby 2002).

This approach might work for you, too, if you don't have problems meshing your work schedule with your circadian rhythms. But if your lifestyle disallows naps, or you just aren't the type to take naps, then irregular bedtimes can spell trouble.

Studies of people living in industrialized countries suggest that young children who lack regular bedtimes have more behavior problems (e.g., Komada 2011; Kelly et al 2013).

7. Does bedtime feel chaotic? Try introducing a soothing, pre-bedtime routine.

It doesn't have to be anything elaborate. In fact, the idea is to keep things simple and calm: Putting on pajamas, brushing teeth, having a cuddle, reading a bedtime story.

Such routines make bedtime feel more predictable and less stressful, and they are linked with fewer bedtime problems.

For example, in an international study of young children, researchers found evidence of a dosage-dependent relationship. The more frequently a family adhered to a bedtime routine, the quicker kids fell asleep at night (Mindell et al 2015).

In addition, toddlers who stick with regular bedtime routines may sleep longer at night (Staples et al 2015).

8. Is your child "overtired"?

Children are tricky when it comes to showing signs of tiredness. Some kids seem to get ever-more active as the night wears on, even though they are in desperate need of sleep. When kids become overtired, they may be too stimulated or nervous to fall asleep (Kuhn et al 1999).

If this is your child's problem, review your family's evening schedule. Is bedtime too late? Do you help your child wind down before bed by leading him through a pleasant, soothing bedtime routine? Do household activities quiet down in the last 2 hours before bedtime?

Although you might be tempted to wear your child down with exercise, research suggests that exercise keeps people alert for at least two hours after it's over.

9. Is your child experiencing too much stress during the day?

If your child has trouble falling asleep, he or she may be experiencing daytime stress.

Research shows that kids who suffer from "pre-sleep worries" are more likely to suffer from sleep problems (Bagley et al 2014). So are kids struggling with stressful life events, including peer problems, a family move, and changing schools (Baddam et al 2019).

And no wonder: Stress can raise stress hormone levels at night, making kids feel too alert to sleep.

So for a better night's sleep, it's important to address your child's daytime stress levels. Is he having trouble at school or in daycare? Feeling displaced by a new sibling? Or might your child be mirroring the stress she perceives in others?

Research confirms that stress is contagious, and even very young children are affected. As I explain elsewhere, babies can tell when their mothers feel tense, and they are sensitive to strife and anger in the home.

In one experiment, babies who were living with angry, squabbling parents showed heightened activity in parts of the brain that process stress, even during sleep. In another study, young children exposed to marital conflict were more likely to suffer from bedtime problems (El Sheik et al 2006).

10. Is your child consuming caffeine? Watch out for unexpected dietary sources.

Everybody knows that caffeine is a stimulant that should be avoided in the hours before bedtime. People are often less aware of the relative amounts of caffeine found in everyday consumables.

For instance, a 12-ounce "classic" Coke contains about half the caffeine found in a 12-ounce Mountain Dew or 3.5 ounces of dark chocolate.

Moreover, some products, like energy drinks, may contain more caffeine than is indicated on the label, because ingredients listed separately--like guarana, kola nut, yerba mate, or cocoa--are hidden sources of additional caffeine (Seifert et al 2011).

For more information about the caffeine content associated with various commercial foods and drugs, see this list put out by the Center for Science in the Public Interest.

11. Does your child have allergies?

A study of American school-aged children reports that kids with allergies are more likely to suffer from insomnia (Stein et al 2001). They are also more likely to suffer from noisy sleep. If your child has allergies and bedtime problems, consult your physician.

12. Is your child snoring at night? Or showing other signs of disordered breathing?

Sleep disordered breathing (SDB) includes snoring, loud breathing, troubled breathing and interrupted breathing (apnea) during sleep. SDB can restrict the oxygen supply to a child’s brain and cause serious health problems. It is also associated with poor sleep quality, frequent night wakings, and daytime sleepiness.

It's possible that SDB plays a role in bedtime problems, too.

A number of studies have shown a link between SDB and hyperactivity (e.g., Hiscock et al 2006; Shur-Fen Gau 2006). Kids diagnosed with ADHD are more likely to have SDB than are other kids. And when hyperactive kids are treated for SDB, their ADHD symptoms improve. This has led some researchers to speculate that at least some cases of ADHD are caused by SDB. Or, put another way—it’s possible that many kids who have been diagnosed with ADHD are really just suffering from sleep problems.

These findings suggest that sleep-disordered breathing could contribute indirectly to bedtime problems by making SDB sufferers more hyperactive and defiant.

This is a controversial idea that some researchers reject (Sadeh et al 2006). However, given the potential health dangers of sleep-disordered breathing, it's important to take symptoms seriously. If you suspect your child suffers from sleep-disordered breathing, consult your physician.

More reading about sleep

For more evidence-based information about sleep, see these Parenting Science articles:





Copyright © 2006-2020 by Gwen Dewar, Ph.D.; all rights reserved.
For educational purposes only. If you suspect you have a medical problem, please see a physician.


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Content of "Bedtime problems" last modified 7/2020

Image credits for Bedtime problems

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image of child watching TV

image of girl asleep on her scooter by Emran Kassim / flickr