Yes to a professional evaluation for this child's sleeplessness

Posted by Barbara F. Meltz  April 7, 2011 06:00 AM

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Hi Barbara:

I have a four year old little girl who is always very busy doing something. She loves to read, play pretend games, run around outside, etc. This is great other then at night. She seems to stay awake after we put her down for the night and wakes during the night many times. My hisband and I thought that she was playing in her room but we have both slept in her room at night and realized that, that is not the case. The issue seems to be that her mind is just racing around, thinking about all the things she wants to do the next day. She loves talking about what we are going to be doing the next day and then I think she thinks about that all night. During the night she is lying still in her bed, but she is awake. We know this because we have gone in there on occasion and she will pop right out of her bed and ask what's going on and we have also slept in there and can tell she is awake at many points during the night. I am frightened to think about what time she gets up in the morning. Sometimes we have heard her at 5:30 (she goes to bed around 8:30). She does not come get my husband or I she is just awake in her room. Once 7:00 rolls around she will come out of her room exhausted, as if she has been up for hours. This happens every day and is getting so frustrating! We have talked to her Doctor and he suggested doing a sleep study at Children's.

What do you think?

From: Sleepless 4 yr old in Concord, MA

Dear Sleepless,

Like adults, some kids simply need less sleep than others, sometimes including less even than the adults in the family. But that she's exhausted the next morning is a sign that that may not be the issue. (The typical 4-year-old needs 10 to 11 hours sleep.)

I'm guessing I'm not the first to tell you to be grateful that she isn't coming in to your room all night long. And I'm guessing I'm not the first to suggest that you try relaxing routines before bed, or tweaking her bedtime by 10 minutes, later and later, to see if that enables her to sleep. Other possibilities include that she's going through a grown or developmental spurt and that this will pass, or that there is a medical issue of some kind which interferes with her ability to stay asleep. Sometimes, when a child is too wound up to sleep, a white noise machine can help, but that's a tough call: Starting with sleep aids for a 4-year-old could create a life-long habit.

I've just consulted a number of books, and the authors (Ferber, Brazelton, Borba) all offer a similar range of solutions. They also suggest consulting a doctor if nothing helps. Since you've done that, I would definitely go to the sleep clinic at Children's Hospital.

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8 comments so far...
  1. Well, you were smart to ask your doctor for a solution and he gave you his advice which sounds like a great idea. No offense to Barbara, but I'm not sure you will get any better advice here than you would by professionals at this point.

    Posted by dad April 7, 11 07:50 AM
  1. It sounds like she has too much on her mind. My son is 10 and extremely imaginative and creative; he NEVER stops thinking or planning. For as long as I can remember at bedtime he has said, "I can't shut my brain off". He always has one more thing to read, write, draw or plan. A few months ago I mentioned to the doctor at his physical how he'd stay up all night if I let him, he said to try a tea made by Republic of Tea, called "Get some zzzzz's". He said to drink it and he'd have no problem falling asleep 20 minutes later. This is a doctor who doesn't recommend over the counter medications or give prescriptions unless absolutely necessary. I haven't tried it yet, as he does fall asleep eventually, after I make him get in bed, but maybe something like that is worth a shot.

    Posted by mom2boys April 7, 11 10:16 AM
  1. I feel like I could have written this letter, with one exception - my 3yr old is not as content to remain quietly in her bed, although I suspect she does that more and more often on nights we think she's sleeping through the night. My husband is actually the same way - he's always waking up in the middle of the night with something on his mind, so i'm convinced a lot of it is heridity, but it is upsetting to know that your child is starting her day exhausted (not to mention the unpleasant behavior that results). I did go to Children's about 6 months ago and found Ferber's strategies helpful. I've noticed that with my daughter it's very cyclical - a few good months, then a few not so good months. Best of l

    Posted by AK47mom April 7, 11 11:00 AM
  1. Sounds like she is too tired to relax. Try having her take a nap early in the afternoon. It is the same with adults, you get so tired that it's impossible to relax enough to fall asleep. So many parents have the foolish notion that if the child takes a nap, they won't sleep at night when just the opposite is true.

    Posted by C. Primmerman April 7, 11 11:03 AM
  1. I have an anxious child and fitful sleep has been a problem for almost three years. The issue at the heart of the matter--she is doing too much thinking to let herself calm down. My other child, who is not anxious, does the same thing and claims that bedtime and sleep is the bane of her existence. "It's a waste of time and sooo boring." As a teen I had an issue with insomnia and as an adult have had panic attacks in middle of night. So whether or not anxiety plays a role, not sleeping well can simply be the result of an overactive mind!

    Also, sleep is just super complicated. Almost everyone in my family has a sleep challenge of some kind. It's easy to assume that no one else has this problem, but it's highly prevalent. Seeking help is a good thing, but also not beating yourself up about it is also a good thing. Some people are highly successful on low amounts of sleep and yet others just go through stages.

    Posted by Anonymous April 7, 11 02:05 PM
  1. I am 60 years old, and I honestly don't think I have EVER slept through the night. As a small child, I would get up and wander around the apartment. That would wake up my parents, so I next would go into the kitchen to read. That would also wake them up, so I would go to the living room and sit and look out the window. I watched many a sunrise. Your daughter may never grow out of this, but if she has something to entertain her, she may eventually fall back asleep.

    Posted by patches April 7, 11 05:21 PM
  1. The bedtime tradition of a hot cup of cocoa has nutritional merit that helps the muscles to relax. You have to make it yourself from unsweetened cocoa and milk (soy/other OK) and sugar to taste--which is a much smaller amount of sugar than the packaged mixes. You get a good dose of magnesium which is necessary for muscle function including relaxing them.

    There are also hereditary B vitamin issues that cause twitches at night. The problem is often an inability to absorb nutrients properly from food, so a B vitamin complex supplement after supper makes a huge difference.

    I don't mean to say that these work for everybody--but they are worth a try for a week. If they make a difference, then you have some clue.

    Posted by Irene April 8, 11 08:08 AM
  1. Is it possible that there is something in her diet keeping her up as well? Personally, I feel like that if I eat any chocolate--I'm stressful, jumpy, hyper, and can't sleep. Caffeine, in general, and sugar can be a problem, too. My daughter couldn't sleep if she's had dairy products (she's lactose intolerant).

    But, I second the idea to go hear what a professional has to say about this as well.

    Posted by Beth April 8, 11 09:29 AM
 
8 comments so far...
  1. Well, you were smart to ask your doctor for a solution and he gave you his advice which sounds like a great idea. No offense to Barbara, but I'm not sure you will get any better advice here than you would by professionals at this point.

    Posted by dad April 7, 11 07:50 AM
  1. It sounds like she has too much on her mind. My son is 10 and extremely imaginative and creative; he NEVER stops thinking or planning. For as long as I can remember at bedtime he has said, "I can't shut my brain off". He always has one more thing to read, write, draw or plan. A few months ago I mentioned to the doctor at his physical how he'd stay up all night if I let him, he said to try a tea made by Republic of Tea, called "Get some zzzzz's". He said to drink it and he'd have no problem falling asleep 20 minutes later. This is a doctor who doesn't recommend over the counter medications or give prescriptions unless absolutely necessary. I haven't tried it yet, as he does fall asleep eventually, after I make him get in bed, but maybe something like that is worth a shot.

    Posted by mom2boys April 7, 11 10:16 AM
  1. I feel like I could have written this letter, with one exception - my 3yr old is not as content to remain quietly in her bed, although I suspect she does that more and more often on nights we think she's sleeping through the night. My husband is actually the same way - he's always waking up in the middle of the night with something on his mind, so i'm convinced a lot of it is heridity, but it is upsetting to know that your child is starting her day exhausted (not to mention the unpleasant behavior that results). I did go to Children's about 6 months ago and found Ferber's strategies helpful. I've noticed that with my daughter it's very cyclical - a few good months, then a few not so good months. Best of l

    Posted by AK47mom April 7, 11 11:00 AM
  1. Sounds like she is too tired to relax. Try having her take a nap early in the afternoon. It is the same with adults, you get so tired that it's impossible to relax enough to fall asleep. So many parents have the foolish notion that if the child takes a nap, they won't sleep at night when just the opposite is true.

    Posted by C. Primmerman April 7, 11 11:03 AM
  1. I have an anxious child and fitful sleep has been a problem for almost three years. The issue at the heart of the matter--she is doing too much thinking to let herself calm down. My other child, who is not anxious, does the same thing and claims that bedtime and sleep is the bane of her existence. "It's a waste of time and sooo boring." As a teen I had an issue with insomnia and as an adult have had panic attacks in middle of night. So whether or not anxiety plays a role, not sleeping well can simply be the result of an overactive mind!

    Also, sleep is just super complicated. Almost everyone in my family has a sleep challenge of some kind. It's easy to assume that no one else has this problem, but it's highly prevalent. Seeking help is a good thing, but also not beating yourself up about it is also a good thing. Some people are highly successful on low amounts of sleep and yet others just go through stages.

    Posted by Anonymous April 7, 11 02:05 PM
  1. I am 60 years old, and I honestly don't think I have EVER slept through the night. As a small child, I would get up and wander around the apartment. That would wake up my parents, so I next would go into the kitchen to read. That would also wake them up, so I would go to the living room and sit and look out the window. I watched many a sunrise. Your daughter may never grow out of this, but if she has something to entertain her, she may eventually fall back asleep.

    Posted by patches April 7, 11 05:21 PM
  1. The bedtime tradition of a hot cup of cocoa has nutritional merit that helps the muscles to relax. You have to make it yourself from unsweetened cocoa and milk (soy/other OK) and sugar to taste--which is a much smaller amount of sugar than the packaged mixes. You get a good dose of magnesium which is necessary for muscle function including relaxing them.

    There are also hereditary B vitamin issues that cause twitches at night. The problem is often an inability to absorb nutrients properly from food, so a B vitamin complex supplement after supper makes a huge difference.

    I don't mean to say that these work for everybody--but they are worth a try for a week. If they make a difference, then you have some clue.

    Posted by Irene April 8, 11 08:08 AM
  1. Is it possible that there is something in her diet keeping her up as well? Personally, I feel like that if I eat any chocolate--I'm stressful, jumpy, hyper, and can't sleep. Caffeine, in general, and sugar can be a problem, too. My daughter couldn't sleep if she's had dairy products (she's lactose intolerant).

    But, I second the idea to go hear what a professional has to say about this as well.

    Posted by Beth April 8, 11 09:29 AM
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About the author

Barbara F. Meltz is a freelance writer, parenting consultant, and author of "Put Yourself in Their Shoes: Understanding How Your Children See the World." She won several awards for her weekly "Child Caring" column in the Globe, including the 2008 American Psychological Association Print Excellence award. Barbara is available as a speaker for parent groups.

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