The amount of sleep needed gradually decreases throughout childhood, although most children still need about 10 hours of sleep until age 10. New sleep problems can begin as children reach important developmental milestones. For instance, some toddlers and preschoolers may refuse to go to sleep at their usual bedtime as they begin to assert emotional independence.
In addition, a young child’s growing imagination can lead to the development of nighttime fears. In older children, the need to sleep often competes with the increased stimulation of school, afterschool activities, social activities, and electronic devices.
At NYU Langone, our sleep specialists focus initially on teaching parents how to implement good sleep hygiene habits, taking into account the age of your child and his or her sleep requirements. For example, parents of younger children may focus on establishing a bedtime routine, whereas parents of school-age children may need to set limits on how late a child can engage in stimulating activities, such as watching television or using a computer. These rules and routines are coordinated with your child’s bedtime and wake time.
In addition, our therapists may use cognitive behavioral therapy techniques to help your child cope with irrational thoughts that can interfere with sleep, such as fears about monsters under the bed or feeling unsafe in the house at night. Our therapists can also help children combat anxiety about falling asleep or not getting enough sleep.
They teach your child how to change negative thoughts about sleep with the aid of relaxation strategies, such as progressive muscle relaxation, or by talking about fears during the daytime with a physician, which can make them seem less scary. You can participate by setting goals for your child and reinforcing his or her progress in meeting these.
Cognitive behavioral therapy is always used in combination with good sleep hygiene strategies, age-appropriate bedtime routines, and a consistent sleep schedule. Depending on your child’s age and the severity of his or her anxiety, a psychologist may meet with your child weekly for a handful of sessions to teach, practice, and reinforce these techniques. Children who have an anxiety disorder may need to address this condition before focusing on nighttime fears.
Our therapists can also offer tips about how to make sleeping safe for children with disruptive behaviors that occur during sleep, such as sleepwalking or other parasomnias. Putting a child in the lower part of a bunk bed, for instance, or installing door alarms are simple but effective strategies. Maintaining good sleep hygiene and sticking to a regular sleep schedule can also help to reduce the frequency of parasomnias.