• Dr. Emily W. King

3 Most Common Reasons For Bedtime Anxiety

Updated: Feb 8, 2021

The past year has been an incredibly challenging time to be a parent. It's also been a challenging time to be a kid. School is different, parents' jobs are different, access to friends is different. Everything is different. When our anxiety goes up, our sleep tends to get disrupted. This is also true for our kids.

The Importance of Sleep

All parents know that sleep is important. No one knows sleep deprivation like a new parent with an infant who wakes every 2-3 hours to eat. I recall 5 hours being my personal threshold for feeling human in those early days of being a parent. Less than 5 hours of sleep and I was nearly non-functional.

Everyone has their own threshold for sleep, our kids included. Many children with autism spectrum disorders are even more sensitive to the emotional and sensory impacts of not getting enough sleep. Children and teens with ADHD can struggle to wind down and fall asleep. And, of course, children who are already anxious may experience their most intense worries when the lights go out.

We've all read about the negative impact of not enough sleep for kids. And, we all know that when children are well-rested, they are better able to remain emotionally regulated when things don't go their way, they are able to access learning by staying focused in class, and they are generally happier.

Stress during the quarantine of COVID-19 has impacted kids in many ways, and sleep is one of them. As a child psychologist working with families online for nearly a year now, I have seen many disruptions to sleep. Here are the top three most common issues that are getting in the way of our kids getting good sleep and my tips for getting back on track.

  1. Anxiety About Separating

From birth, parents serve in a role of co-regulation in helping children fall asleep. We instinctively rock and bounce and hum and sing, whatever it takes, to lull a child to sleep. As children grow, they may transition to a safety object that replaces a parent at bedtime such as a lovey, stuffed animal, or even a toy. These items serve as a "security blanket" but also help a child not feel alone. For some children, they may not have ever attached to an item of comfort other than their parent, or this item just may not be enough for them to feel safe.

When a child feels lonely or scared in their bed at night, they will often engage in any number of "tactics" like one more drink of water, one more story, or one more song to get a parent to stay. Sometimes kids begin to talk about fears that happen when they are alone, like the dark or an unexpected noise (see #2). They are seeking your connection, which it not a bad thing in and of itself, but ultimately everyone needs sleep.

What to do: During the daytime, engage your child in a discussion of a plan to make their bed the most comfy place to get sleep at night. Allow them to rearrange their space, choose items that help them feel safe, and if you don't already have one, tighten up the bedtime routine. When the bedtime routine is simple and consistent, over time kids will learn that negotiating doesn't even work because this is just the plan. They will also begin to feel safe in their routine because it's predictable. Remember that the routine belongs to the child, not to the parent. While each parent might have a special thing that they do to connect with their child, the step-by-step of the bedtime routine needs to remind consistent so that parents can go in and out of the routine when one parent wants to meet up with friends or the other has to work late. Otherwise, as a parent you will feel chained to the routine and that's exhausting.

Once you have the routine down, some children need additional strategies to stay in their bed after that last goodnight kiss. Many kids benefit from knowing that their parent will come back and check on them in one minute, 5 minutes, 10 minutes, and so on. Encourage your child to stay in their bed until you come check on them. That way, their body will continue to settle and over time they will get used to falling asleep in their bed. Some kids might need an external reward on top of this strategy to get things started. I've worked with families who have found success with the Sleep Fairy strategy (like the Tooth Fairy, but for staying in your bed all night). While external rewards are not sustainable because they wear out over time, it could be what your child needs to establish a new behavior pattern of independence at bedtime.

2. Anxiety About Their Environment

If children are scared to be alone in their bed, soon you will hear all the reasons why they feel that way. Perhaps they are afraid of the dark, perhaps they heard a noise they cannot explain, perhaps they just can't get comfortable. When our children voice these complaints, it's really hard to tell sometimes what is a true fear of these things and what is a stalling tactic (see #1).

What to do: Most of the time, making sure kids have ownership over the set up of their sleeping space can help with any worries about not being able to get comfortable. The unseen fears of the night (e.g., the dark and ominous noises) are sometimes more challenging to support.

First, we want to start with explaining to children with their room and home remain safe whether the lights are on or off. For example, we've never seen monsters during the day so we promise they aren't here at nighttime either. Here is where I often introduce the idea of REAL worries versus TRICK worries to a young child. TRICK worries are things that can't really happen like monsters and aliens in our closet. REAL worries are things like a thunderstorm that are a real danger if we were climbing trees during a storm (something kids will say for sure they know is not a good idea because it's dangerous). We can then let our kids know, even if they hear a storm or a siren outside, they are safe inside and can trust that we will keep them safe.

Next, it can be helpful to add play to a dark room to give your child more positive associations with the dark. Play with a flashlight in your child's room making shadow puppets and they will begin associating a fun memory with the dark. Another strategy is to lie down in the dark with your child at bedtime and play a guessing game about all the noises you hear. Most noises can be explained by appliances, HVAC systems, and the neighbors' dog. Helping your child connect noises to people or things they are familiar with during the daytime will help ease their mind at night.

3. Anxiety About Their Thoughts

Once kids know they are safe to sleep alone and know that monsters aren't real, they can still be kept awake by an endless list of thoughts. Children who are anxious during the day are most likely to also have thoughts bother them at bedtime. The most common reason for this is that during the day they are distracted by school, family, friends, and entertaining things that keep anxious worries in the back of their mind. At night, their anxious thoughts take center stage and seem much more significant in the dark and quiet.

I often ask kids to think of their anxious thought like a character in a musical (or a player on a sports team, whatever makes the most sense to them). During the day, our anxious thought is just one actor blending in with the chorus. At night, our anxious thought gets a solo performance while everyone else is waiting backstage where it's dark and quiet. We might feel more anxious because we notice our thought more, but it's not truly scarier, it just seems that way because it's in the spotlight.

What to do: Many kids I've worked with have benefitted from writing down their nighttime worries on a notepad by their bed. This doesn't have to be in the form of journaling paragraphs (as many kids I work with hate to write!). It can just be writing bullet points on a notepad and serves like a "brain dump" before climbing into bed. Have your child say, "good-night" to those silly worries and tell them you will deal with them in the morning. When your child wakes up in the morning, have them look over the list and cross out what is irrational and make a plan together for problems that need to be solved.

Additional note: Some kids have anxiety about not being able to fall asleep and then get anxious that they will be tired the next day. Always remind a child that their body is a machine and will always eventually feel tired. If your child is struggling to settle beyond these strategies, check in with your pediatrician or a mental health provider to talk through strategies specific to your child and family's need for rest.

Stay connected!

~Dr. Emily

**All content provided is protected under applicable copyright, patent, trademark, and other proprietary rights. All content is provided for informational and education purposes only. No content is intended to be a substitute for professional medical or psychological diagnosis, advice or treatment. Information provided does not create an agreement for service between Dr. Emily W. King and the recipient. Consult your physician regarding the applicability of any opinions or recommendations with respect to you or your child's symptoms or medical condition. Children or adults who show signs of dangerous behavior toward themselves and/or others, should be placed immediately under the care of a qualified professional.**

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