Psychological Services

Non-Medical Treatment for Childhood Sleep Disorders

Behavioral treatment for children has been very successful in addressing the following problems:

  • Bedtime limits
  • Bedtime routine and positive bedtime hour
  • Making the bedroom an inviting place to sleep
  • Insomnia: difficulty getting to or maintaining sleep
  • Working through awakenings in the night such as night terrors
  1. Bedtime Limits

    Set a bedtime limit that is appropriate for your child’s age and consistent with his or her peers. Bedtime naturally becomes later in the summer due to it still being light out. Once set do not change the bedtime hour until your child is developmentally ready which should be every few years as less sleep is required as your child grows and develops, below are general guidelines realizing that every child is different with different sleep needs.

    • 2 to 3 years: 12 to 14 hours
    • 4 to 5 years: 11 to 12 hours
    • 6 to 12 years: 9 to 11 hours
    • 13 years and up: Adult sleep of 7 to 8 hours

    Once having developed the bedtime, it is important to follow through. This means that even if your child gets out of bed 10 times, they still go to bed at the same time.

  2. Bedtime routine and positive bedtime hour

    This is a specific routine that is followed every night, understanding that naturally the routine will change somewhat when out of town or on the weekends or for special events. Bedtime involves hygiene (washing up or bath or shower), snacks, and reading stories as necessary parts of the bedtime hour. This allows your child time to wind down. They may request rituals involving stuffed animals and certain prayers. Suggested snacks are those that are calming (such as ice cream) and that don’t require a lot of digestion; avoiding sugar or caffeine products. Soothing instrumental music in the background can be helpful.

  3. Establishing the Bedroom as a Great Place to Sleep
    • Avoid using the bedroom for time out or discipline reserving it as wonderful place to sleep.
    • It is important to keep the room clean and environmentally conducive to sleep.
    • The atmosphere should not be too cold or too hot. Safe and cozy.
    • Down lighting makes a soft bedroom atmosphere.
  4. Insomnia and common bedtime issues:

    Your Child Is Not Ready to go to Sleep:

    • Your child may have a delayed internal clock and not be tired. Further diagnosis with a sleep specialist is needed.

    Your Child Does Not Want to Go to Bed:

    • Your child is hungry, not tired, something lives under the bed, they want a glass of water, they are thirsty again, they want you with them, the dialogue goes on and on. Supply what is needed and back to bed. Give one response for being thirsty, going to the bathroom, wanting to be tucked in and kissed good night, checking the room and stop. Limits and control. Work with a sleep specialist to develop a program.

    Your Child Continues to Cry, Calls from Bed or Actually Gets Out of Bed:

    • Structure and continuity are critical. Set behavioral consequences: If the parent gets up two times, this costs the child one job. If the parent gets up three times, it is two jobs the next day and so on. These are rules set up during the day in a special ceremony where the rules are presented in written form and explained and then posted somewhere important in the home.

    Your Child Has Nightmares and Develops a Pattern of Coming into Your Room to Sleep at Night:

    • Consult with a sleep specialist to determine if there is a specific time that this occurs and to rule out other sleep disorders.
    • Talk with a sleep specialist regarding an overnight sleep study to rule out a sleep related breathing disorder especially if you hear gasps, snoring or mouth breathing.
    • Talk with your child at length to figure out what is actually waking them up, why they come into your bedroom and so on.

    Your Child Has Night Terrors, Sleep Walking Episodes, Rhythmic Movement Disorders (Body Rocking, Body Rolling, Head Rolling, or Head Banging):

    • Consult with sleep specialist for accurate diagnosis.
    • The first key is safety. Using gates, locks, closed doors, or alarms to keep the child safe from harm.
    • Do not attempt to wake the child, guide them back to bed if sleepwalking and do not discuss the event the next day.
    • Maintain a regular sleep schedule, avoid sleep deprivation.