Bedtime basics

This article was written by Margaret Seiler and originally appeared in the Portland Monthly 2016 Kids’ Health Annual magazine.

While anything from caffeine to a chronic illness to the excitement of household visitors can make it tough for kids to sleep, one of the most common sleep disruptors for children – and adults – is simply stress.

“It’s when we’re stressed and hyperaroused, physiologically, that it’s hard to initiate sleep,” says Kyle P. Johnson, M.D., a child psychiatrist and sleep physician at OHSU Doernbecher Children’s Hospital. “Families can suffer stress that can resonate, given the sensitivity of kids. The resonating stress and worry may get in the way of sleep, either falling asleep at night or returning to sleep after natural awakenings in the middle of the night.”

Just like for adults, the lack of sleep can set off a vicious cycle for kids, Dr. Johnson says: “Then they begin to worry about not being able to sleep and this worry causes more stress, which perpetuates the problem.” Trying to catch up on lost sleep, as teenagers sometimes try to do by sleeping in on the weekends, “can impact your circadian system, which can exacerbate the problem.”

Between school and work schedules it’s easy for families to feel harried, and it’s impossible to eliminate stressors altogether. But there are steps parents can take to help their children be ready for sleep, and help themselves relax before bed, too. “All of us need wind-down time. When we’re stressed about certain things, we may be tempted to try to deal with that thing all the way up until the time we turn out our lights, and that can cause problems with sleep onset.”

When under stress, it is important to maintain wind-down time, including disconnecting from electronic items, decreasing light exposure and, says Dr. Johnson, “continuing with established bedtime rituals and routines.”

Dr. Johnson says it’s also smart to talk with children (at an age-appropriate level) about the anxiety they’re feeling or stressors that the family is under. “They’ll catastrophize,” Dr. Johnson notes: A child might overhear a parent talking about financial woes and start worrying they’ll lose their home. “If you have a discussion, you can often allay some of those worries and concerns.”

Have these talks well before bedtime, so kids have time to process. If a child brings up a worry at night, a parent can offer brief reassurance but suggest talking more at another time.

If your child has a persistent sleep problem that’s causing distress at home or difficulties at school, talk to your pediatrician. To schedule an appointment with OHSU Sleep Medicine, call (503) 346-0640.