You said that your child has problems falling asleep at bedtime. You may also notice that your child wakes up at
night and has a hard time going back to sleep. You also said that your child is starting to have trouble at home
or preschool/school or other places because of these sleep problems. Sometimes stressful things make it hard for
children to fall asleep. Some examples are:
Watching a scary TV show or movie
Parents' divorce
Death in the family
Moving to a new home
Switching child care centers
Bad dreams
Worries or fears
Teaching child to use the toilet
Starting preschool
Your child may have problems falling asleep because you have a hard time setting limits. Your child may
"stall" and try to avoid going to bed. S/he may do things like ask for more hugs/kisses, a drink of water, or an
extra book/song. Sometimes children do this because they are feeling stressed or worried. Your child may fall asleep
okay, but then sleep restlessly. You may also notice that your child tosses or turns a lot while sleeping or
sleepwalks. You may notice that your child wants to take more naps during the day since s/he is having so much
trouble sleeping at night.
Warning signs that things are getting worse
Your child is so tired during the day that this begins to cause big problems for him/her.
Your child becomes very irritable during the day.
Your child's problems with falling asleep at night are so bad that you are not getting enough
sleep at night. This makes it hard for you to get through your day.
If you think these problems are getting worse talk to your child's doctor, even if you have discussed these
things before.
Adapted in part from the American Academy of Pediatrics (AAP) Diagnostic and Statistical
Manual for Primary Care (DSM-PC) (1996).
