Insomnia

About insomnia in children and teenagers

Insomnia is a sleep problem. If your child has insomnia, it means they have difficulty getting to sleep or staying asleep at night, or they might be waking up too early.

Short-term insomnia lasts only a few days or weeks. This is also called acute insomnia.

Long-term insomnia is when your child has trouble sleeping at least 3 times a week, and this problem lasts for a month or longer. This is also called persistent or chronic insomnia.

The amount of sleep your child needs to be at their best for play, learning and concentration during the day depends on their age.

Signs and symptoms of insomnia

A change in your child’s sleep behaviour – like going to bed later than you’d like – isn’t necessarily a sleep problem. But if you’re concerned that your child might have insomnia, there are signs you can watch for at bedtime, during the night and during the day.

Bedtime and night-time signs of insomnia
Your child might have insomnia if they:

avoid going to bed
take a long time to get to sleep
often get out of bed and ask for things
feel tired but are suddenly wide awake once they go to bed
often wake up during the night and can’t go back to sleep.

Daytime signs of insomnia
Your child might have insomnia if they:

struggle to wake or refuse to get out of bed in the morning
nap for long periods during the day or fall asleep at school
sleep at different times from day to day
lack energy or constantly feel tired in the day
struggle to concentrate or remember information.

Insomnia is common in adolescence because this is when your child starts to release melatonin later at night than they did in childhood. This affects your child’s circadian rhythm. Your child might not feel sleepy until around 11 pm or later, so they’ll want to go to bed later at night. When children go to bed later, they’ll often get up later in the morning too.

Causes of insomnia

Insomnia has many different causes. These include:

sleep associations – for example, when a child can’t go to sleep without a bottle of milk, a parent nearby or music in the background
bedtime behaviour – for example, too much screen time or not enough time for calm, quiet activities before bed
emotional issues – for example, stress, child anxiety, child depression, teenage anxiety or teenage depression
environmental factors – for example, a hot or noisy sleeping environment
medical conditions – for example, asthma, eczema, sleep apnoea or restless leg syndrome
illnesses that make it hard to sleep well – for example, colds or ear infections
medicines that might make children more alert – for example, antidepressants, cold and flu tablets, or medicines used to treat attention deficit hyperactivity disorder (ADHD)
caffeine – for example, energy drinks, coffee, tea, chocolate or cola.

Medical help: when to get it for children with insomnia

It’s a good idea to talk with your GP if you’re concerned that the insomnia is affecting your child’s wellbeing, schoolwork or relationships.

Also talk with the GP if the insomnia is making your child anxious, or if it goes on for more than about 2 weeks.

Your GP might refer you to a paediatrician, psychologist or a childhood sleep specialist with experience in identifying and treating persistent sleep problems in children.

Diagnosing insomnia

Your child’s doctor will probably ask a lot of questions to understand why your child might be having difficulty sleeping. The doctor might also examine your child to check for any signs of a medical problem. This can sometimes include a blood test.

The doctor might suggest that you and your child complete some questionnaires or surveys about your child’s sleep. This can help you all better understand your child’s sleep difficulties.

Sometimes, if the causes of your child’s insomnia aren’t clear, your child might be monitored overnight at a sleep centre or at home.

Before you take your child to see the GP about insomnia, it can help to track your child’s sleep in a log or diary. You could do this for a few weeks before seeing the GP.

Treatment for insomnia

Treatment for insomnia depends on what’s causing your child’s insomnia. Your doctor will work with you and your child to find the best way to help them sleep better. Insomnia treatments can include the following.

Sleep habits
Sometimes treatment for insomnia might just be a case of changing your child’s sleep habits. This can include:

avoiding daytime naps
removing clocks from the bedroom
changing your child’s bedtime
having a quiet and relaxing bedtime routine and sleep environment
encouraging your child to go to bed at night as soon as they show signs of being sleepy.

Daytime habits
Your child’s daytime habits can make a difference to how well they sleep. Make sure your child gets some physical activity and plenty of bright, natural light during the day. Make sure your child also has a satisfying evening meal at a reasonable time. Feeling hungry or too full before bed can make it harder for your child to get to sleep.

Medical treatment
If a medical condition or sleep disorder is causing your child’s insomnia, they might need some kind of medical treatment.

For example, if your child has sleep apnoea that’s caused by enlarged adenoids and tonsils, they might need an operation to remove them. This should improve your child’s breathing during sleep and stop them from waking up so often.

Cognitive behaviour therapy for insomnia
If negative thoughts and worries are making it hard for your child to sleep, they might benefit from cognitive behaviour therapy for insomnia.

This therapy can help your child deal with negative thoughts about sleep so they can relax and fall asleep. This therapy can also help your child identify behaviour that makes it hard to go to sleep and replace this with behaviour that promotes sleep.

Medicine
Sleep medicines are rarely used to help children and teenagers sleep because medicines can have side effects. Even herbal or ‘natural’ medicines can have side effects.

In some extreme cases, sleep medicine might be used for a short amount of time. For example, a doctor might prescribe melatonin. Your child shouldn’t take melatonin without medical advice and supervision.

You should give your child sleep medicine only if your doctor advises you to do so and only if your doctor is supervising your child’s treatment. Never give your child more than the recommended dose of any medicine.