The elimination of early rise school times and many late-night activities have been beneficial for many kids, says Bobbi Hopkins, M.D., medical director of Johns Hopkins All Children’s Sleep Center. These kids are sleeping longer; closer to the recommended amount of sleep because they have time to do so.
However, some children are no longer on a good sleep schedule. They go to bed and wake up at various times, creating difficulties falling to sleep, waking in the morning and sometimes difficulty sleeping during the night. These kids feel sluggish during the day and may take a nap, making it hard to fall asleep the next night. Children in middle school and teens are particularly susceptible to this problem.
What are the symptoms of a child or teen having sleep problems?
Difficulty going to sleep, frequent night awakenings, nightmares and sleep terrors are some of the symptoms of trouble sleeping at night. When a child does not sleep enough or if their schedule is not predictable, they are more likely to feel tired and sluggish during the day. They are more likely to have difficulty focusing on their school work. Just like adults, they are more likely to be irritable or emotional. Anxiety and depression are more common in children who have chronic sleep problems.
How is anxiety related to sleep?
Anxiety problems and sleep problems feed each other and create a cycle. If a child is anxious, they may not be able to fall asleep. If the child does not sleep well, they are more likely to be anxious. Creating the best sleep environment and a good opportunity for sleep is one way to reduce anxiety.
Should children with anxiety take medications to help them go to sleep?
There are some children who benefit from taking medications to go to sleep. However, medications should be paired with a strict bedtime and wake time schedule, learning meditation and excellent sleep hygiene. Ideally, the child should be evaluated by a physician familiar with both medications as well as cognitive behavior therapy for insomnia before taking medications for anxiety.
What can a family do to reduce anxiety-related sleep problems?
- Ensure a set bedtime and set wake time, allowing the child to have an age-appropriate amount of time to sleep. For the average 10-year-old, this is about 10 hours of sleep. Older kids may need a little less sleep and younger kids need more sleep.
- Monitor exposure to electronics. TV programs, video games and social media can result in anxiety by raising concerns regarding life and death in family members, concerns about their parents’ jobs, or may contain fanciful scary content. In general, we recommend elimination of electronics at least one hour before bed.
- Eliminate caffeine. Caffeine can interfere in a child’s ability to go to sleep. Caffeine is found in teas, coffee and soda.
- Children with anxiety often have difficulty turning off their thoughts. A child should be given an opportunity to express their concerns earlier during the day or before bed by talking to their parent and/or writing their concerns down.
- When it is time to go to bed, children with anxiety need a way to occupy their thoughts in a way that helps them go to sleep. I often steer families away from TV or video games. Deep breathing and progressive muscle relaxation exercises can be helpful. For families who are not familiar with these exercises, the Calm or Headspace apps may be used to help the children learn meditation and relax their brains prior to sleep.
On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital medical experts. Visit HopkinsAllChildrens.org/Stories each Monday for the latest report.