The following suggestions can help when your child does not want to go to bed or is having trouble staying in bed:
Maintain firm bedtime rules
Your child will benefit from the structure and rules you set regarding bedtime limitations. In fact, having firm rules can ease – not cause – anxiety in children. Make sure you explain the new bedtime rules to your child. When you, the parent and/or guardian, are consistent with the bedtime rules, your child will learn what to expect, learn self control, and learn to adapt. In fact, they will learn to like the predictability of the sleep routine, but the initial few days need some determination on your part to succeed. It is also very important not to lose ground during holidays and vacations. All adults involved in bedtime routines should agree to act similarly so the child is not confused and learns not to push limits with one or the other adult.
Establish a set bedtime
Establish a regular bedtime for your child and be consistent about sending your child to bed at this time. If you’d like to a establish an earlier sleep time than your child current has, you can start setting your child’s bed time 15 minutes earlier every few nights until you meet your new goal time. For example, if your child currently falls asleep at 9:30 p.m. and you would like him or her to go to bed at 8:30, you could start making his or her bedtime 9:15 for a few days, then move it back to 9:00 p.m. This technique is called bedtime fading. Be cautious about moving the bedtime back too quickly or making it so early (for your own convenience) as to make it age inappropriate. Doing so may cause your child to not be able to fall asleep, leading to a lot of frustration. Your child’s sleep physician may sometimes recommend a late bedtime to begin with and then advise the fading technique. This strategy may reduce stress as you introduce the other quiet activities and routines around bedtime noted below.
Plan up to 1 hour of quiet time before bed for bedtime routines
Before bedtime every night, set aside up to 1 hour for calm activities, such as listening to quiet music or reading a book. The activity should be something that is fun, and that can be used as a tool to create a sense of approaching bedtime. However, the activity should not be too stimulating – such as TV watching, computer gaming, or heavy homework, which may arouse rather then calm your child. The last several minutes of quiet time activity should take place in the room where your child sleeps.
Activities such as going to the restroom, a relaxing bath, brushing teeth, etc may be incorporated in this time. Also, it is important for children to be brought to bed/put into bed awake so that they learn to fall asleep themselves.
If your child cries, speak calmly, reassure your child "that he or she is fine and that it is time to go to sleep." Make your visit brief, and then leave the room. If your child continues to cry, space out the time between visits to the bedroom, and when you do return, do not do anything but talk calmly, briefly (1-2 minutes), and then leave. No arguments or discussions need to take place. The purpose of your visit is to let your child know that you are present and to reassure him or her that they are okay. Your child will learn to calm down and go to sleep if you stick with this routine.
If your child starts developing a habit of getting out of bed, these tips may help resolve this problem. Take your child back to bed, tell him or her that the door will be closed (but not locked) if he or she gets out of bed again and that he or she has control of keeping the door open by staying in bed. If your child stays in bed, the door stays open. If your child gets out of bed, close the door for 1 or 2 minutes. If your child gets out of bed again, put your child back in bed and close the door again for another couple of minutes. Be consistent. You may increase the length of time the door is closed by 1-2 minutes if you do not get a desired response. When your child stays in bed, open the door and acknowledge their good efforts with praise. If age appropriate, a bedtime pass to allow one exit from the bedroom for a specific reason may work as well to give the child a sense of control.
A word on rewards and penalties
Do praise your child and reward your child when he or she stays in bed or does what you want him or her to do regarding bedtime activities and sleeping. Consider stickers, breakfast treats, small toys, or other special prizes as some possible ways to reward your child. Be careful not to offer junk food as reward. Use positive phrases, such as, "you are doing a great job of staying in bed." On the other hand, don’t dwell on misbehavior from the previous night. Don’t use the bedroom as a place of punishment or time outs – so your child doesn’t associate the bedroom with negative behavior. Also, don’t lock your child in his or her bedroom. This again can be considered more of a punishment by a child or can even scare some children.
Patience and persistence
Changing any habit takes time. Your child will learn new sleep habits if you stick to your prescribed routine. Your child may want to argue or complain about new bedtime rules. You must ignore these arguments and protests. Firmly and calmly let your child know that this is the new bedtime plan. It may be very challenging at first and may take several nights to get your child used to the new plan but with some persistence, you will succeed. Remember, consistency is the key!
Additional Sleep Information and Suggested Readings
Mindell, JA and Owens, JA. A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Philadelphia, PA: Lippincott Williams and Wilkins, 2003.
www.sleepeducation.com and other educational links on the American Academy of Sleep Medicine website www.aasmnet.org.
The National Sleep Foundation at www.sleepfoundation.org/.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved
Can't find the health information you’re looking for?
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/26/2009…#14304