The most common bedtime problems among toddlers and school-aged children are
How many kids are affected? According to surveys of American parents, 20-30% of young children have significant problems going to bed and/or awakening during the night (Mindell et al 2006).
Rates may be even higher among school-aged children because many parents are unaware that their older children are having sleep problems (Gregory et al 2006).
Pediatric sleep specialists often advise parents to tackle sleep problems by putting their children through sleep training. Several training programs have been scientifically tested, and, in general, parents who stick with these programs report improvements in bedtime behaviors.
However, before you try sleep training, it's important to understand why your child won't sleep. Kids may resist bedtime for a variety of reasons. Once you identify your child’s personal sleep issues, you'll find it easier to choose a sleep training program that’s well-suited to your child’s needs.
Just as important, you might discover that you don't need to try sleep training at all. Some bedtime problems have relatively simple remedies. This article reviews common triggers of bedtime troubles, and suggests practical solutions for coping with them.
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.
Night after night, you have trouble falling asleep at bedtime. Sooner or later, you may dread bedtime for this very reason. And that anxiety or dread -- the fear of insomnia -- keeps you awake. Instead of calming down at bedtime, you become more restless.
It's a vicious circle commonly observed in adults with insomnia. Kids can experience it as well. And children are prone to other learned associations.
For example, some children 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 conflict -- not calm.
Other children may learn to expect indulgence. They employ their nightly stalling tactics, and parents give in: Kids successfully delay bedtime each night (Moore et al 2006).
With repetition, children learn to expect the whole rigmarole before falling asleep. In effect, they have created their own bedtime routine -- one that is long, drawn-out, and frustrating for parents to cope with.
What to do?
Clearly, we need to stop bedtime from becoming an occasion for conflict, negative emotions, and endless stalling tactics. But how can parents be expected to keep things calm and upbeat, while also making sure that kids really do go to bed?
First, it's important to ask yourself: What else might be going wrong?
Perhaps these bedtime problems were triggered by another factor -- like nighttime fears, late afternoon naps, or some other issue mentioned below.
If you address the underlying trigger, you'll have an easier time getting rid of your child's negative sleep associations.
Then you may also want to try a technique called "bedtime fading." For more about this, see the next section ("The wrong bedtime").
Research suggests that many parents are sending their kids 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 children either (1) refuse to stay in bed, or (2) lie awake, alert and bored. With nothing else to occupy their restless minds, they may begin to dwell on their anxieties and fears (Ferber 2006).
In effect, parents are contributing to the development of learned, maladaptive bedtime associations (see above).
What to do? It depends on the individual child. What are his or her true sleep needs?
In some cases, parents are simply mistaken about their children's sleep requirements. Their kids need less sleep than they think.
It's not the most common problem, but research suggests that a sizable percentage of parents overestimate their children's sleep needs (McDowall et al 2017). If this is you, you may be able to solve the problem 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 only real problem is that the child's internal clock is out of sync with the parent's preferred bedtime policy.
If that's the trouble, 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.
First, watch out for naps that may be delaying nighttime sleepiness. See "Napping too close to bedtime," below.
Second, expose your child to the right environmental cues. See "Circadian rhythm problems," below.
And try this evidence-based technique: "Bedtime Fading."
Bedtime fading works by immediately eliminating replacing your current (unsuccessful) bedtime with a much later one -- a time when your child is physiologically ready to fall asleep.
This puts an abrupt end to any bedtime battles. What's left is to gradually re-adjust your child's inner clock, so that your child will eventually be able to fall asleep at an earlier, more desirable time.
Researchers advise parents to follow these steps.
1. Before you begin, do some detective work: Figure out what time your child usually falls asleep at night.
This may require you to keep a sleep log over the course of several days.
2. Set a new bedtime -- one that begins even later than your child's usual time of sleep onset.
How much later? Researchers have suggested that you add as much as 30 minutes. For example, if your child tends to fall asleep at 10 p.m., you might set the new bedtime for 10:30 pm.
3. Keep your child awake (with calm, pre-sleep activities) until the newly-appointed bedtime.
Why? Up until now, your child has been associating bedtime with conflict, alertness, or a failure to fall asleep. You want to help your child to learn a new association -- one that connects bedtime with an easy transition to sleep. If your child falls asleep before bedtime, you'll have missed that learning opportunity.
4. Once bedtime begins, note how long it takes for your child to fall asleep.
If your child falls asleep within 15 minutes, consider this a success. Enforce the same bedtime on the next night.
If your child takes more than 15 minutes, try again the next night with an even later bedtime.
5. After two nights of success, set a somewhat earlier bedtime.
If -- for two nights in a row -- your child falls asleep within 15 minutes of "lights out," make an adjustment: Set a new bedtime that is 15 minutes earlier.
Continue making these adjustments (aiming for a progressively earlier bedtime) until you've achieved the desired schedule (Piazza and Fisher 1991; Cooney et al 2018).
Circadian rhythm sleep disorders affect the timing of sleep: The internal clock gets out of sync with the demands of your daily schedule. Individuals with circadian rhythm problems may fail to become drowsy at the preferred bedtime, or have trouble staying awake during the day.
To remedy the problem, you can gradually re-adjust the biological clock with crucial zeitgebers, or environmental cues.
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). In addition, toddlers who stick with regular bedtime routines may sleep longer at night (Staples et al 2015).
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.
If your child has trouble falling asleep, 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 she having trouble at school or in daycare? Is she feeling displaced by a new sibling? Or might she 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).
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.
Throughout the world, children's sleep problems have been linked with television and other electronic screen use.
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 probably a question of light exposure. As noted above, 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.
(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).
Personally, I don’t like interfering if a child takes the occasional long nap. If a child sleeps spontaneously, it may be because he really needs to catch up on his sleep. In such cases, a nap doesn’t disrupt the child’s long-term sleep schedule. It puts him back on track.
Moreover, research suggests that naps have a powerful and beneficial effect on learning (Kurdziel et al 2012).
It's also important to note that naps can help us recover from sleep deprivation. In an experiment on adults, a couple of 30 minute naps was enough to restore stress and immune system chemistry after a night of highly-restricted sleep (Faraut et al 2015).
But if your child is routinely taking long naps—particularly naps
that end in the later afternoon or evening—this may be contributing to
her bedtime problems. Among kids older than 2 years, long naps have been linked with later bedtimes (Komada et al 2012).
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.
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.
Ainsworth MDS, Blehar MC, Waters E, and Wall S. 1978. Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum.
American Academy of Sleep Medicine. 2005. International classification of sleep disorders: diagnostic and coding manual. 2nd ed. Westchester, IL: American Academy of Sleep Medicine. J Pediatr Health Care. 2012 Jul-Aug;26(4):276-82.
Arora T, Broglia E, Thomas GN, Taheri S. 2014. Associations between specific technologies and adolescent sleep quantity, sleep quality, and parasomnias. Sleep Med. 15(2):240-7.
Baddam SKR, Olvera RL, Canapari CA, Crowley MJ, Williamson DE. 2019. Childhood Trauma and Stressful Life Events Are Independently Associated with Sleep Disturbances in Adolescents. Behav Sci (Basel). 9(10).
Bagley EJ, Kelly RJ, Buckhalt JA, El-Sheikh M. 2014. What keeps low-SES children from sleeping well: the role of presleep worries and sleep environment. Sleep Med. pii: S1389-9457.
Brockmann PE, Diaz B, Damiani F, Villarroel L, Núñez F, Bruni O. 2016. Impact of television on the quality of sleep in preschool children. Sleep Med. 20:140-4.
Chen B, van Dam RM, Tan CS, Chua HL, Wong PG, Bernard JY, Müller-Riemenschneider F. 2019. Screen viewing behavior and sleep duration among children aged 2 and below. BMC Public Health. 19(1):59.
Calamaro CJ, Yang K, Ratcliffe S, Chasens ER. 2102. Wired at a young age: the effect of caffeine and technology on sleep duration and body mass index in school-aged children.
Chen B, van Dam RM, Tan CS, Chua HL, Wong PG, Bernard JY, Müller-Riemenschneider F. 2019. Screen viewing behavior and sleep duration among children aged 2 and below. BMC Public Health. 19(1):59.
Cooney MR, Short MA, Gradisar M. 2018. An open trial of bedtime fading for sleep disturbances in preschool children: a parent group education approach. Sleep Med. 46:98-106.
de la Iglesia HO, Fernández-Duque E, Golombek DA, Lanza N, Duffy JF, Czeisler CA, Valeggia CR. 2015. Access to Electric Light Is Associated with Shorter Sleep Duration in a Traditionally Hunter-Gatherer Community. J Biol Rhythms. 30(4):342-50.
El-Sheikh M, Buckhalt JA, Mize J, and Acebo C. 2006. Marital conflict and disruption of children's sleep. Child Dev. 77(1):31-43.
Faraut B, Nakib S, Drogou C, Elbaz M, Sauvet F, De Bandt JP, Léger D. 2015. Napping reverses the salivary interleukin-6 and urinary norepinephrine changes induced by sleep restriction. J Clin Endocrinol Metab. 100(3):E416-26.
Falbe J, Davison KK, Franckle RL, Ganter C, Gortmaker SL, Smith L, Land T, Taveras EM. 2015. Sleep duration, restfulness, and screens in the sleep environment. Pediatrics. 135(2):e367-75.
Ferber R. 2006. Solving your child’s sleep problems: New, revised, and expanded edition. New York: Fireside.
Garrison MM, Liekweg K, Christakis DA. 2011. Media use and child sleep: the impact of content, timing, and environment. Pediatrics. 128(1):29-35.
Garrison MM and Christakis DA. 2012. The impact of a healthy media use intervention on sleep in preschool children. Pediatrics. 130(3):492-9.
Glaze DG. 2004. Childhood insomnia: why Chris can’t sleep. Pediatrics Clinics of North America 51: 33-50.
Gregory, AM, Frühling, VR, and Eley, TC. 2006. A Twin-Study of Sleep Difficulties in School-Aged Children Child Development. Vol. 77 (6): 1668–1679.
Guerrero MD, Barnes JD, Chaput JP, and Tremblay MS. 2019. Screen time and problem behaviors in children: exploring the mediating role of sleep duration. Int J Behav Nutr Phys Act. 2019 Nov 14;16(1):105.
Helm AF and Spencer RMC. 2019. Television use and its effects on sleep in early childhood. Sleep Health. pii: S2352-7218(19)30058-0.
Jenni OG, Fuhrer HZ, Iglowstein I, Molinari L, Largo RH. 2005. A longitudinal study of bed sharing and sleep problems among Swiss children in the first 10 years of life. Pediatrics 115(1 Suppl):233-40.
Kelly Y, Kelly J, Sacker A. 2013. Changes in bedtime schedules and behavioral difficulties in 7 year old children. Pediatrics. 132(5):e1184-93.
Komada Y, Abe T, Okajima I, Asaoka S, Matsuura N, Usui A, Shirakawa S, Inoue Y. 2011. Short sleep duration and irregular bedtime are associated with increased behavioral problems among Japanese preschool-age children. Tohoku J Exp Med. 224(2):127-36.
Komada Y, Asaoka S, Abe T, Matsuura N, Kagimura T, Shirakawa S, and Inoue Y. 2012. Relationship between napping pattern and nocturnal sleep among Japanese nursery school children. Sleep Med. 13(1):107-10
Kuhn BR, Mayfield JW and Kuhn RH. 1999. Clinical assessment of child and adolescent sleep disturbance. Journal of Counseling and Dev 77: 359-368.
Kurdziel L, Duclos K, and Spencer R. 2013. Sleep spindles in midday naps enhance learning in preschool children. PNAS 110 (43): 17267–17272.
LeBourgeois MK, Carskadon MA, Akacem LD, Simpkin CT, Wright KP Jr, Achermann P, Jenni OG. 2013. Circadian phase and its relationship to nighttime sleep in toddlers. J Biol Rhythms. 2013 Oct;28(5):322-31
Li S, Jin X, Wu S, Jiang F, Yan C, and Shen X. 2007. The impact of media use on sleep patterns and sleep disorders among school-aged children in China. Sleep 30(3):361-7.
McDonald L, Wardle J, Llewellyn CH, van Jaarsveld CH, Fisher A. 2014. Predictors of shorter sleep in early childhood. Sleep Med. 15(5):536-40.
McDowall PS, Galland BC, Campbell AJ, Elder DE. 2017. Parent knowledge of children's sleep: A systematic review. Sleep Med Rev. 31:39-47.
Mindell JA, Kuhn B, Lewin DS, Meltzer LJ, Sadeh A and the American Academy of Sleep Medicine. 2006. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep 29: 1263-1281.
Moore M, Allison A, and Rosen CL. 2006. A review of pediatric nonrespiratory sleep disorders. Chest 130(4): 1252-1262.
Moore M, Meltzer LJ, and Mindell JA. 2007. Bedtime problems and night wakings in children. Sleep Med Clin 2: 377-385.
Owens JA, Spirito A, McGuinn M, and Nobile C. 2000. Sleep habits and sleep disturbance in elementary school-aged children. J Dev Behav Pediatr 21: 27-36.
Paavonen EJ, Pennonen M, Roine M, Valkonen S and Lahikainen AR. 2006. TV exposure associated with sleep disturbances in 5-to 6-year-old children. J Sleep Research 15: 154-161.
Petit D, Touchette E, Tremblay RE, Bolvin M, and Montplaiser J. 2006. Dyssomnias and parasomnias in early childhood. Pediatrics 119: e1016-e1025.
Piazza CC and Fisher W. 1991. A faded bedtime with response cost protocol for treatment of multiple sleep problems in children. J Appl Behav Anal. 1991 Spring;24(1)
Plancoulaine S, Reynaud E, Forhan A, Lioret S, Heude B, Charles MA; EDEN mother−child cohort study group. 2018. Night sleep duration trajectories and associated factors among preschool children from the EDEN cohort. Sleep Med. 48:194-201.
Sadeh A. L. Pergamin, Y. Bar-Haim2006. Sleep in children with attention-deficit hyperactivity disorder: A meta-analysis of polysomnographic studies. Sleep Medicine Reviews, Volume 10, Issue 6, Pages 381-398.
Seifert SM, Schaechter JL, Hershorin ER, Lipshultz SE. 2011.
Health effects of energy drinks on children, adolescents, and young adults. Pediatrics. 127(3):511-28.
Shur-Fen Gau S. 2006. Prevalence of sleep problems and their association with inattention / hyperactivity among children aged 6-15 in Taiwan. Journal of Sleep Research 5(4): 403-414.
Staples AD, Bates JE, and Petersen IT. 2015. Ix. Bedtime routines in early childhood: prevalence, consistency, and associations with nighttime sleep. Monogr Soc Res Child Dev. 80(1):141-59.
Wahnschaffe A, Haedel S, Rodenbeck A, Stoll C, Rudolph H, Kozakov R, Schoepp H, and Kunz D. 2013. Out of the lab and into the bathroom: evening short-term exposure to conventional light suppresses melatonin and increases alertness perception. Int J Mol Sci. 14(2):2573-89.
C.M. Worthman and M. Melby. 2002. Toward a comparative developmental ecology of human sleep. In: Adolescent Sleep Patterns: Biological, Social, and Psychological Influences, M.A. Carskadon, ed. New York: Cambridge University Press, pp. 69-117.
Zarowski M, Modzikowska-Albrecht J, Steinborn B. 2007. The sleep habits and sleep disorders in children with headache. Adv Med Sci. 2007;52 Suppl 1:194-6.
Content of "Bedtime problems" last modified 1/2020
Image credits for Bedtime problems
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image of child watching TV
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