Preschooler Sleep – February 2016

Q: Help! My 3 year-old won’t let me leave his room when it’s time to sleep. He keeps coming out and won’t settle into bed unless my husband or I are in there with him. Sometimes it only takes 10 minutes for him to fall asleep but sometimes it’s longer and we often fall asleep ourselves. We haven’t been able to figure out what the problem is. I’m concerned about it becoming a habit. How do we get him to stay in his room and fall asleep on his own?
_____________________________________________________________________________________

A: A preschooler’s sleep problem is everybody’s sleep problem. Late night crying or playing can wake family members or keep them from falling asleep in the first place. Nighttime wandering (not to be confused with sleepwalking) can be a safety issue. And then there is the joy of waking up at 3 am with a small face an inch from yours, or jolted awake from cold little feet on your back.

True sleep disorders are rare in children (but they do occur, so talk to your pediatrician to rule that out) but sleep problems are common in preschool years. It’s likely that there are some habits that are interfering with their ability to fall asleep. And that’s a good thing because that’s where you can make some changes.

It’s good to start with knowing how much sleep your child needs. In general, kids ages 1-3 need 12-14 hours of sleep in a 24-hour period. Kids ages 3-5 need 11-13 hours of sleep. Three can be a tricky age because they might be phasing out of napping. If they fall asleep toward the end of what is now Quiet Time, resist the urge to let them nap late in the day because it could make falling asleep at bedtime more difficult. That said, being overly tired can also interfere with their ability to fall asleep. If you’re now thinking that it sounds impossible to find the perfect moment to put your child to bed, take heart. Most likely you just need to change a few things and give them a chance to adjust to a new routine.

Good sleep hygiene is imperative when sleep is amiss. Start by getting rid of factors that can keep your child from getting sleepy: any kind of monitor or screen in the hour before bed (blue wavelength light is deeply stimulating), spicy foods or caffeine (in chocolate cookies or coffee ice cream), sugar, bright light (which can trip up their circadian rhythm), and roughhousing before bed (gets adrenaline pumping). If their bladder is interfering with sleep, restrict liquids for 2 hours before bed. If a pet is interfering with their sleep, remove it from the room.

Other sleep hygiene habits that are important for many kids to fall asleep or stay asleep include doing a relaxing bedtime routine and waking at the same time every day (so their body gets into a rhythm), using the bed only for sleep (so they don’t associate their bed with energizing activity), having a positive association with their bedroom (if they are sent there as punishment it can be hard to associate it with relaxing sleep), enjoying the regular pre-bedtime quiet activity (to get them into a relaxed, positive mood), and dimming the light for 30-60 minutes before bedtime (to release melatonin, which makes people feel sleepy). Keep their bedtime routine consistent, allow them a security object, and keep the bedroom cool, quiet, and dark. Many parents have found it helpful to keep the door cracked open, use nightlights, white noise or soothing music, or quietly play a relaxing children’s audiobook (might help a restless child focus and drift into sleep).

Now for ideas to help your son let you leave their room easily so you can have that small window of time before your own bedtime that can be important to a healthy marriage (or your own sanity). First, explain to him that the expectation is that once you’ve left he stays in his room and doesn’t turn the lights on. Now, ditch the idea of punishing him for his poor sleep – he doesn’t like it any more than you do. Give him an incentive – figure out a reward that you could reasonably give for several weeks the morning after he’s met the expectation (a temporary tattoo, hand stamps, sprinkles on his oatmeal or a squirt of whipped cream on his waffle if there are no food-related concerns). If he forgets about the reward at night, put a picture of it where he can easily see it. Give him praise the next morning for earning it when he does; say little or nothing about it when he doesn’t (if he asks for his reward without having earned it, calmly and briefly explain why he isn’t receiving it and end with a vote of confidence that he will stay in his room tonight and earn it tomorrow).

Another idea is to start the routine you described, but instead of staying there until he’s asleep you stay in his room until he gets sleepy. Then tell him you’ll be in to check on him in one minute (or if he can’t tolerate one minute say “I’ll be right back” and come back in 30 seconds. If he’s not easily letting you go at all and is getting riled up and more awake, tell him you are going to use the bathroom or something else that he can understand and be okay with). Check in on him when promised but don’t stay; say “I’ll be back in 2 minutes” and then maybe next time it’s 5 minutes. Gradually increase the amount of time you stay out of the room so that he gets used to being in there without you. After one or a few nights, start leaving right after putting him to bed. Maybe you can start with “I’ll check on you in 5 minutes.” Maybe you don’t need to give times after a while, and just say “I’ll be back to check on you.” If he comes out of his room, gently lead him back without talking or emotion and put him back in bed saying that you’ll be back to check on him. The point here is to help him develop trust that you’ll come back, that he can be alone in his room without you at bedtime, and eventually that he can fall asleep on his own.

Remember that it can take up to a month to change a habit. Give something a try for 2-4 weeks before deciding that it doesn’t work. Don’t lose hope – something will work or change on its own in time. I guarantee you won’t find yourself falling asleep on your 17 year-old son’s floor.