What should you know about childhood insomnia?

A child may take a long time to settle, wake repeatedly, wake too early, or need a parent’s help to return to sleep. The pattern can be linked with changes in routine, worry, discomfort, medicines, breathing problems, or an unsettled sleep environment. Daytime sleepiness and difficulty concentrating can follow disrupted sleep.

Sleep needs vary with age, so one late night does not by itself establish insomnia. A clinician looks at the pattern, its duration, the child’s daytime behaviour, and possible physical or emotional contributors. Difficulty sleeping can be a symptom of another problem, rather than a sign that the child is choosing not to sleep.

Keep a simple sleep diary recording bedtime, time taken to fall asleep, awakenings, wake time, naps, screens, caffeine, medicines, and daytime alertness. Use a predictable wind-down routine, a dim and quiet room, and consistent wake times. Keep screens away from the immediate bedtime routine and avoid using the bed for stimulating activities.

Arrange a medical review if the pattern persists, interferes with school or family life, or comes with snoring, pain, low mood, or anxiety. A clinician may recommend behavioural strategies and address the underlying cause. Do not give sleep medicines or supplements without advice.

Seek urgent help if the child has severe breathing difficulty during sleep, is difficult to wake, is confused while awake, or expresses thoughts of self-harm. Contact a clinician promptly for loud regular snoring with pauses, marked daytime sleepiness, or a sudden major change in behaviour.

Could pain, breathing, mood, worry, medicines, or another condition be disturbing sleep? What sleep routine fits my child’s age? Should we use a diary, behavioural support, or a further assessment?