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Child With Sleeping Problem. Advice?

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Posted on Sat, 3 Aug 2013
Question: This question is regarding my son who is about to be 7. He has sleeping problem. From his birth itself., he sleeps very less hours...during the early childhood., he used to sleep for about 5 hours only and he used to cry a lot before he goes to sleep. We clearly observed that he is not sleeping adequately for a baby. We then consulted doctors who said that its normal and as long as the child is active, he is fine...so we did not worry further. However., even now., almost 7 years., he has this problem...he goes very late for sleeping. He controls his sleep., and wants to play play play...but the problem is., if he gets sleepy and controls it and wants to play., he would get cranky and won't listen to most of what we say... Eventually, he would cry at least once before he would listen and then go to sleep. This has become such a routine that before he goes to bed., he cries for something or the other which sometimes is quite annoying...

As a parent., I'm deeply worried., if this is of any concern and how to overcome this for him..

Kindly advise.

Thanks & Regards
XXXXX
doctor
Answered by Dr. Vaishalee Punj (32 hours later)
Hi

Thanks for posting your query on XXXXXXX

Mostly the insomnia in children is behavioral. Medicines are not advised to induce sleep in children. It is important to rule out general medical conditions before jumping to the diagnosis of Behavioral Insomnia of Childhood-sleep onset association type. Other causes can be bloating of stomach, abdominal pain, improper sleep hygiene, anxiety, colic during infancy?
What is the sleep hygiene followed during sleep time?
How much does he sleep during the day?
Does he have other symptoms apart from insomnia?
Does he have a hearty meal at dinner?
What have you tried till date?

Regards

Dr Vaishalee

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vaishalee Punj (2 days later)
Thanks Dr for the response.

Here is the answer to your questions:

Does he have the problem since day 1 of his life or developed slowly after birth?
>> He has the problem since his very early days..probably just after hospital days..

Did he have colic during infancy?
>> During infancy., I think we had the medicine for colic pain also and have given occasionally..but not frequently or daily..

What is the sleep hygiene followed during sleep time?
>> He does brush his teeth before he sleeps. Nothing much apart from that..pls. clarify if you are expecting any particular habits..

How much does he sleep during the day?
>> Until recently, for the majority of days., he would not sleep during the day. During the day time also., even though he would get sleepy., to make him fall asleep., it would take more than 30 minutes to an hour or even longer....Firstly., he would resist that he is not sleepy...then after a long resistance., if he goes to bed also., his mind would be into something of the other (basically distracting his sleep)...After all this., he would sleep for 1-2 hrs some times., and sometimes even shorter duration...

To him., sleeping means, he is missing something...he always wants to play or do something or the other and generally wont listen to us if we ask him to go to sleep..

Does he have other symptoms apart from insomnia?
>> What symptoms are you looking at...may be., pls. list down some that you have in your mind., I shall say yes or no towards that...as Im blank at this point of time as to what would make sense and what may not...

Does he have a hearty meal at dinner?
>> During his early days., he used to have good meal for dinner. Of late., he does not eat properly. He has started to say some reason or the other...and he doesnt focus on eating...

What have you tried till date?
We tried everything to make him sleep early. We would press his legs...up to 30 minutes or even longer...by the moment we stop pressing his legs., he would immediately say., leg is paining and we continue., then he would be quiet..but again when we stop he would say the same that leg is paining and would start crying. We get frustrated and then scold him., then he would cry and fall asleep.

If his mom sings songs also., the same would happen...by the moment she stops., he would ask to sing again...how long we can continue like this...

Telling bed time stories is even more problem., because he would get excited about the story and he would become more active and also he would start narrating the story or he would interrupt and ask questions...

Hope I have given additional details that would help you to understand his condition...Pls. let me know if you would like to ask further questions that you would need to know before you could advise any further...

Thanks
XXXXX
doctor
Answered by Dr. Vaishalee Punj (15 hours later)
Hi

From the history you provided, I think it is mostly behavioral. I feel that either he is an active child or there is some cause for his anxiety. Kids who have been fed formulas containing omega 3, 6, 9 or DHA/ARA can also have similar symptoms. Let me know if that is the case. Though I could not rule out any medical condition, since you did not provide me with reports of any previous blood tests.

I will advice you some sleep hygiene tips for the child. Let us see if these tips work.

Start switching off the lights in the house at least half an hour before his sleep time.
Do not respond to the every small sound that the child makes during sleep.
Do not hold or rock the child for sleeping.
Follow a regular sleep time schedule. Put an alarm for sleeping time and tell him that the alarm means that he needs to go to bed. Do not follow him to the bed.
A transitional object like a blanket or a soft toy that is present at bed time and nap time can be of great help.
Eliminate discussions, noise, music and television from his room.
Avoid surrounding him when he is trying to fall asleep. If you want to be in the same room, then quietly lie down next to him with your eyes closed. If you do not want to be in the same room, then just put him to bed, cover him with blanket, tell him to sleep, switch off the lights and move out. You may soothe him if he cries too much but avoid going into his room. He will learn to sleep on his own in a few days.
Scheduled awakenings are also advised.
Both parents should be on the same platform when it comes to bringing up the kids. Kids usually blame themselves for any arguments that may happen between parents and may develop an anxious personality. Thus avoid arguments in front of kids.

Try to implement these tips. Let me know how it goes. I know it is hard for you. Try to keep patience with him. He will learn to sleep on his own. If it is behavioral these tips will work. Also get some tests done after consultation with a physician. If a cause is found, then treating the cause will help. In either case do not give him sleeping medicines.

Dr Vaishalee


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vaishalee Punj (14 days later)
Check
doctor
Answered by Dr. Vaishalee Punj (6 hours later)
Hi again

If you have a follow-up query, please proceed with it.

Regards

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Vaishalee Punj

General & Family Physician

Practicing since :2003

Answered : 3270 Questions

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Child With Sleeping Problem. Advice?

Hi

Thanks for posting your query on XXXXXXX

Mostly the insomnia in children is behavioral. Medicines are not advised to induce sleep in children. It is important to rule out general medical conditions before jumping to the diagnosis of Behavioral Insomnia of Childhood-sleep onset association type. Other causes can be bloating of stomach, abdominal pain, improper sleep hygiene, anxiety, colic during infancy?
What is the sleep hygiene followed during sleep time?
How much does he sleep during the day?
Does he have other symptoms apart from insomnia?
Does he have a hearty meal at dinner?
What have you tried till date?

Regards

Dr Vaishalee