The Phoenix Child Magazine - Spring 2008Reducing Nighttime worries and Promoting Better Sleep

The number of children who visit my office with sleep problems is staggering. This is despite the fact that the majority of these children are in fact going to bed at reasonable times, usually permitting well over eight or nine hours of sleep. Still, these children wake unrested, slow-moving, and at times, cranky. Though certainly some of these children’s sleep challenges can be best explained by Night Terrors or Sleep Apnea, the majority of these children do not suffer from these conditions. Many of these children are bedtime worriers; they do their serious thinking shortly before or just after lying in bed in the evening. So while bedtime might be at 8:30 p.m., some of these children are still tossing and turning close to midnight.

There is not any specific thing about nighttime or darkness in general that promotes obsessive thinking, aside from the fact that this is a time void of activities and other distractions. In other words, without more constant external stimulation, the mind is more able to review past, present, and future events. Several parents describe how nighttime can be a good time to bond with their children; as they tuck them into bed they serve as a good soundboard for discussion. While a relationship with this level of communication and trust is encouraged, saving these types of discussions for late in the evenings is not the best option. Rather than winding things down at the end of the night, these children’s minds are revving up. As the adrenaline begins to surge, sleep is improbable, at least until the mind is worked up to full blown exhaustion.

A better idea is to incorporate a time near the beginning of the day for children to discuss their fears and anxieties. This situation permits a strong parental bond without the counterproductive affect of sleep deprivation. I recommend that parents analyze their children's morning schedule, and attempt to fit in brief relaxation or guided imagery exercises. Immediately following hygiene and breakfast routines, parents will ideally encourage their children to lie down on the couch or bed, while listening to soft music or engage them in brief relaxation exercises. While in this calmer state that promotes more logical thinking, the child shall be encouraged to discuss his or her worries or upcoming problems, and the parent may be available to discuss and talk through their stresses in a more productive manner. Additionally, a beneficial exercise while in this relaxed state will be to imagine successfully handling situations; calmly visualizing oneself completing a test, speaking in front of a group, or speaking assertively to a friend or teacher. Not only do these types of visualization exercises promote greater relaxation, many children find that the sheer planning and foresight garnered from these exercises increases their odds of success. Further, research continuously points to the fact that simply exposing oneself to feared situations, even via imagination, works to desensitize that fear. Children are more likely to face fears in person when they have slightly reduced their levels of anxiety by going through the event in their imagination. Much like jumping into a cold swimming pool and acclimatizing to it, the brain is programmed to tolerate fear if one gives it the time to do so.

An important fact about these exercises is that children and adults who set aside these specific times in the morning are more often able to turn off their minds in the evening. When worrisome thoughts do in fact enter their mind, they are more able and likely to utilize cognitive processes to stop these thoughts with greater success (e.g., “Now is not the time to be thinking about this. I will go over this in the morning, while in a more calm state. Now is the time for sleep.”). Other children report that whispering the word “Stop!” can have a stronger impact on shaking up the processes and turning off the mind.

Although admittedly this type of process requires some planning and reorganization of the morning routine, several parents have mentioned that this type of exercise actually reduces the morning chaos in their home, and can result in greater organization and memory/tolerance for changes in routine. The end result is typically a well-rested child who is relaxed enough for optimal performance in school that day.

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