pediatrics
Sleep Problems in Children
Awakening During the Night
Everyone awakens multiple times each night. Most people, however, usually fall back to sleep with no intervention. Children often experience repeated night awakening after a move, an illness, or another stressful event. Sleeping problems may be worsened when children take long naps late in the afternoon or are overstimulated by playing before bedtime. Allowing the child to sleep with the parents because of the night awakening reinforces the behavior. Also counterproductive are playing with or feeding the child during the night, spanking, and scolding. Returning the child to bed with simple reassurance is usually more effective. A bedtime routine that includes reading a brief story, offering a favorite doll or blanket, and using a small night-light (for children>3 years of age) is often helpful. To prevent arousal, it is important that the conditions under which the child awakens during the night are the same as those under which the child falls asleep. Parents and other caregivers should try to keep to a routine each night so that the child learns what is expected. If children are physically healthy, allowing them to cry for a few minutes often allows them to settle down by themselves, which diminishes the night awakening. Extended crying is counterproductive, however, because parents then may feel the need to revert to a routine of close contact. Gentle reassurance while keeping the child in bed is usually effective. 