Can toddlers have insomnia?
Yes. They most definitely can.
What does insomnia in a toddler look like?
Insomnia in a toddler can look like a child who has one or more of the following
difficulty going to sleep
difficulty staying asleep
waking up earlier than desired
shows resistance in going to bed
has difficulty sleeping without a parent or caregiver intervention
Parents or caregivers may observe any of the following:
daytime fatigue or malaise
issues with attention, memory or concentration
impariment in social, family, or academic disturbance
mood issues or irritability
daytime sleepiness
behavioral problems (impulsive, hyperactive, aggressive)
decreased motivation and energy or iniriative
prone to errors or accidents
Most commonly, children can have transient or temporary disruption in their sleep and display some or all of the above. But if their sleep disturbance persists for at least three times per week and has been present for at least three months and most importantly it cannot be better explained by another sleep disorder then this it fits the definition of being a chronic insomnia disorder.
What to do if your child has insomnia
In young children, insomnia is most commonly related to behavioral issues and for this reason has been referred to as behavioral insomnia. Strategies that have been shows and proven to work based on research are
Having an appropriate and consistent bedtime routine EVERY day of the week
Limit setting by parents including:
Establishing clear bedtime rules
Ignoring protests or complaints about bedtime
Putting a child to bed drowsy but awake
Checking in on the child (especially if they are upset or crying)
Returning the child to their bed or room
Sticking to firm bedtime limits
Strategic napping
Younger children typically need at least four hours between sleep periods in order to build up enough sleep drive to allow them to sleep again
Positive reinforcement (sticker charts for example)
Rewards should be immediate and concrete
Bedtime fading
If a child has a natural 'evening' preference as in takes some time to fall asleep (more than 30 minutes), set the bedtime to the current 'later' bedtime and gradually set the bedtime earlier over several weeks
What to not do if your child has insomnia
Do not treat with medications like melatonin without addressing the behavioral issues.
Why should insomnia be addressed and treated?
Persistent insomnia has been related to worse health-related outcomes, incrased risk of mood and behaviour problems, impact on learning and academic achievement and of course adverse impact on the quality of life of caregivers.
If behavioral interventions do not work, or a child's behaviour is very disruptive, the child should be assessed further for other conditions such as other sleep disorders, mental health issues or medical conditions.
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