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Sleep Difficulties in Older Children


Last week I wrote about helping babies sleep. Teaching my infants to sleep was much easier than older children and now teenagers. It is even hard for me to sleep some nights. There are so many distractions and things to think about, so many people I love and worry about that falling asleep is a challenge. And I am a person who generally pursues good sleep hygiene practices.

It is pretty easy to google sleep hygiene. This consists of creating good habits to help habituate your body to knowing it is time to sleep. In young children we do this by eating dinner, taking a bath, brushing teeth, reading a few stories, then getting a bedtime kiss before turning out the light. Sometimes the routine includes doing a check under the bed for monsters or getting a little back rub.

Establishing good sleep hygiene is difficult in tweens and teens because it isn’t very fun. The half-life of caffeine is 5 hours. So if they want to go to a coffee shop with their friends in the evening and get a drink, half of the caffeine from that drink will still be in the system 5 hours later. Screen time, particularly video games and movies, is very stimulating to the brain. The blue light from screens, even screens put into night mode, is confusing to the brain, stimulating daytime and inhibiting the secretion of melatonin. Melatonin is nature’s way of telling our bodies to go to sleep. People who want to establish a good sleep routine should go to bed at the same time each night and get up at the same time each morning. Even on weekends. Some kids are willing to forego caffeinated drinks in the afternoon. The really exhausted ones are willing to go to bed at the same time and not sleep in quite so late. Very few young people want to put their screens away.

I often tell patients that I don’t have medication to take the place of good habits. There is no safe sleeping pill that will overcome stimulating your brain through video games to the point that you can’t fall asleep. But giving up video games is not fun. And children want life to be fun. They also want life to be fair. Since they will be able to identify at least one friend whose parents do not police screen time, allowing a phone in the room and hence youtube and Fortnite to all hours, your child will only think it is fair that she gets this same privilege.

As a parent, I know this is an exhausting battle. We did not have cell phones when we were teenagers, certainly not when we were in elementary school, so navigating this world is difficult. I know that phones these days are so much more than phones. They are white noise machines, audiobooks, classical music, all things that might help somebody go to sleep. They are also alarms, critical to getting up and off to school on time. For all of these reasons, we bought echo dots for our kids to have in their rooms. These can do all of the things listed above and can be purchased on Amazon for $50. I understand that not everybody has $50 to spend but would remind people that smartphones cost more than this. My kid's phones are charged outside of their rooms at night. If we have any doubts about them being used after bedtime, they are locked in our closet overnight.

All of this said, there are people who practice good sleep hygiene and still have trouble falling asleep. The world is a crazy place. We ask more of our children in terms of scheduling and mental stimulation than has ever been asked of people before. The number of children living in homes with trauma is high and the odds that your child goes to school with somebody who has suffered trauma is even higher. So rates of anxiety are through the roof right now. Our children don’t get very much downtime to process their thoughts. They get up and race off to school, play a sport or do theater or participate in band after school, come home to scarf down dinner, spend a few hours on homework, and use every in-between moment to catch up on social media. When their bedraggled heads hit the pillow, they finally have time to process the day. But they know they have to get up for school again in 7 hours so staying awake to process is stressful which makes it even harder to fall asleep. And then the alarm goes off and it starts all over again.

This pattern is exhausting. Writing this post is exhausting because I feel like the solutions all so obvious but I have trouble enacting them in my own home. How frustrating is it to know what we SHOULD do but feel somewhat powerless to enact it? Nevertheless, I encourage people to keep fighting. There will be good days and bad days. Days where your child convinces you to let them play videogames with friends late into the night and then you all pay the consequence when he doesn’t sleep well. But hopefully, there will be good days as well. When you spend more time outside, play a family game together and all get to sleep at a reasonable time. My hope is that these nights carry you through to set limits and to continue setting limits even after you are convinced by those amazing child negotiators to bend the rules time and time again.

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