Why do some children have difficulty falling asleep?

By Dr Raj Khillan

Sleeping difficulties in children and what to do about them

Sleeping difficulties in children are common. A child’s poor sleep quantity and quality is often caused by a number of factors, including developmental, social, behavioural, cognitive, academic, and health difficulties.

In some cases, sleep problems can also negatively impact a family. Some common symptoms to watch out for are mood swings, performance issues, accidents, injuries, slower reaction time, and daytime sleepiness. Should you find your child experiencing these symptoms, you need to know what you can do about it.

Sleeping difficulties in children are common. Some are outgrown while others need treatment. Paediatric insomnia and anxiety can be managed with medication, including natural alternatives. Treatment is especially important following a post-traumatic stress disorder. However, it is always important to see a specialist to manage severe conditions. By following these tips, you can help your child to enjoy quality sleep and general well-being.

✚ Insomnia

Insomnia is common in children and is associated with difficulty falling asleep, staying asleep, and waking up very early. It can last for a few days or weeks. Insomnia is particularly common in children with anxiety. It can trigger pain, mental health issues, and chronic stress.

What to do 

Identify possible stressors. This could be problems with friends, trauma, additional tasks, moving to a new neighbourhood, or generalised anxiety. These triggers could be addressed by limiting daytime tasks or comforting the children if there’s a relevant hardship. Additionally, establish a regular bedtime routine and consider using natural supplements to calm anxiety. If insomnia persists, talk to a doctor about it.

✚ Snoring

When a child chronically snores, it means the airways are partially blocked and because of this, the air inhaled does not reach the lungs. Snoring is caused by different factors, including enlarged adenoids, tonsillitis, and chronic nasal congestion. Symptoms include snoring at night, daytime sleepiness, and fatigue.

Snoring is harmless, but it leads to poor sleep in quality and quantity which can lead to mood swings and energy alterations. In severe cases, snoring causes obstructive sleep apnea in which the child stops breathing.

What to do

Identify what is causing your child to snore. If the snoring is caused by tonsillitis or enlarged adenoids, a doctor may recommend surgery. Weight loss can also be recommended, as snoring is sometimes related to weight. In some cases, it could be related to sleep apnea.

 Obstructive Sleep Apnea

Obstructive sleep apnea is common in children with snoring issues. It affects many children today. Its symptoms include snoring at night with occasional pauses, sleep disruption, choking, and gasping. Other children may suffer from bedwetting, learning problems, hyperactivity, or abnormal growth. Sleep apnea is caused by enlarged adenoids, tonsils, obesity, and allergies.

What to do

Obstructive Sleep Apnea (OSA) can be addressed through a number of ways. Some suggestions are to manage allergic rhinitis, use nasal steroids, lose weight, or try antibiotics. As a last resort, an adenoidectomy or tonsillectomy may be considered. Continuous positive airway pressure is also used to treat sleep apnea. This involves a special machine with a nasal mask, used to deliver compressed air pressure to keep the child’s airway open during sleep. According to the American Sleep Apnea Association, finding a specialist in sleep disorders is important in the effective treatment of OSA.


Sleepwalking and bedwetting also affect many boys and girls. Sleepwalking is highly associated with an immature central nervous system. It can occur due to being extremely tired and often persists into adulthood.

Sleepwalking can occur about one, two, or three hours after falling asleep. It’s important to be attentive to this issue as sleepwalkers can get harmed. Talking to the child after incidents of sleepwalking helps to prevent anxiety related to the difficulty.

What to do

Do not try to wake a sleepwalking child. Talk gently and guide them to bed. Waking a sleepwalker could aggravate the situation, causing potential harm. Reassure the kid that all is well. Close and lock all doors and windows. Install alarms, remove anything that could be a tripping hazard, keep keys out of reach, and install safety gates in your home.


Bedwetting can continue into elementary years. It can be caused by emotional issues, allergies, infections, and anxiety. Many kids outgrow bedwetting, but if it persists, there might be an issue.

What to do

Be mindful of when your child is consuming fluid and hot drinks. Eliminate any bladder irritant, as it causes allergies that lead to bedwetting. Instead of punishing, encourage the child with the knowledge that bedwetting happens, and it will be ok. Ensure that the child is consuming liquid throughout the day, and not in the late evening. Schedule bathroom breaks, if that is age appropriate.

Night Terrors

Night terrors, or sleep terrors, are characterised by sudden screaming, agitation, increased heart rate, crying, and dilated pupils. Often, they are caused by an immature central nervous system. It can begin at 18 months and is often outgrown by the age of 6.

What to do 

Talk and reassure the child that they are ok. Reassure family members that sleep terror episodes are harmless. Keep the child’s room safe. Maintain a sleep regime to manage any stressors and anxiety before bedtime.

The writer is Director, Western Specialist Centre


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