Many children will at one time or another struggle with fears of monsters or things-that-go-bump-in-the-night. While it seems rather normal for a child to have trouble sleeping alone or coping with nightmares, the experience of bedtime refusal and sleeplessness can put an entire family on edge. Not only do children desperately need sleep to promote overall mental, physical, and cognitive functioning, their parents rely on the moments of respite that come when their children are fast asleep. After a few nights of interrupted sleep, parents and children, alike, will be emotionally and physically exhausted, leading to a host of other behavioral and relational problems. Disrupted sleep patterns are a leading cause of sleep terror disorders in children, which tends to be quite an emotional and frightening (though usually harmless) form of sleepwalking in children. So what is a parent to do? The following is a brief list of suggestions to get you and your child back onto the path of fearless and independent sleep.

1. Rule out the need for professional or medical help.
If your child has experienced any traumatic or life-threatening event, disruption of sleep is a common side effect of a more serious psychological problem. Some children are more prone than others to be anxious, but if the child recently experienced the death or loss of someone (family, friend, pet, teacher, etc), witnessed a traumatic accident or assault (even the news can trigger some of these reactions), or experienced a serious illness, it is advised that you seek the advice of a psychologist or pediatrician. Sleep can be disrupted by certain illnesses, as well, so if simple behavioral adjustment in the absence of a psychological disorder does not work, consider a visit to the pediatrician to assess the need for a sleep study.

2. Exercise!
Our society is becoming increasingly sedentary. Make sure your child is engaging in aerobic activities (i.e. something that gets the heart pumping and sweat pouring). The chemicals released during aerobic exercise promote restfulness and release of tension and anxiety.

3. Enforce a bedtime routine (even on weekends!)
This should include more than telling your child to go to his or her room. Depending on family size and specific needs, we often suggest that a child begins his or her bedtime regimen at least 30 minutes prior to the time you want him or her to be asleep. Children aged 3-12 need between 10 and 12 hours of sleep each night. It’s a good idea to include some relaxation exercises (guided imagery, deep breathing, progressive muscle relaxation) during the bedtime preparations. Listening to relaxing, familiar music and reading are great ideas, as well. Encourage your child to complete all the tasks he usually asks to do after already in bed (get a drink, have a snack, go to the bathroom, etc.).

4. When afraid of monsters or boogeymen…
It can be helpful for children to draw pictures of the monsters they fear might be in their bedrooms or closets. This can be a family activity in which the parent instructs the child to create a detailed picture of the thing the child fears most. The next step is to make the monster look silly by adding silly hats or glasses or by drawing the monster in a cage or silly situation. This helps the child learn basic skills for controlling his or her imagination.

5. Have a distraction box or list nearby…
Another useful item to help a child manage his or her fears is to create a box or list of items, activities, or story prompts whereby the child can look at or read to distract his thinking away from monsters. The items or ideas listed should be relaxing and things the child can do while being tucked in bed. Some children like to have something like clay or PlayDoh with which they can fidget. Other children do well with a list of story prompts in which they tell themselves a story.

6. Charting and rewards
When done properly, rewards can help a child maintain focus and control his or her thoughts and worries. One reward-based activity known to help children who struggle with bedtime refusal is to give the child 3 tickets to get out of bed or ask for a parent’s assistance. If the child has any tickets left by the time morning rolls around, he or she can earn points. The points can be used to buy some small item or to win a privilege.

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